The impact of a high fidelity simulation-based debriefing course on the Debriefing Assessment for Simulation in Healthcare (DASH)© score of novice instructors

Introduction: Experiential learning, followed by debriefing, isat the heart of Simulation-Based Medical Education (SBME) andhas been proven effective to help master several medical skills.We investigated the impact of an educational intervention, basedon high-fidelity SBME, on the debriefing competence of novicesimulation instructors.Methods: This is a prospective, randomized, quasi-experimental,pre- and post-test study. Sixty physicians without prior formaldebriefing expertise attended a 5-day SBME seminar targeted ondebriefing. Prior to the start of the seminar, 15 randomly chosenparticipants had to debrief a spaghetti and tape team exercise.Thereafter, the members of each team assessed their debriefer’sperformance using the Debriefing Assessment for Simulation inHealthcare (DASH)© score. The debriefing seminar that followed(intervention) consisted of 5 days of teaching that included theoreticaland simulation training. Each scenario was followed by a Debriefingof the Debriefing (DOD) session conducted by the expert instructor.At the end of the course, 15 randomly chosen debriefers had todebrief a second tower building exercise and were re-evaluated withthe DASH score by their respective team members. The Wilcoxonsigned-rank test was used to compare pre- and post-test scores.Statistical tests were performed using GraphPad Prism 6.0c for Mac.Results: A significant improvement in all items of the DASH scorewas noted following the seminar. The debriefers significantly improvedtheir performance with regard to “maintaining an engaging learningenvironment” (Median [IQR]) (4[3-5] after the pre-test vs. 5.5[5-6]after the post-test, P<0.001); “structuring the debriefing in an organizedway” (5[4-5] after the pre-test vs. 5[5-6] after the post-test, p=0.002);“provoking engaging discussion” (4[3-5.75] after the pre-test vs. 6[5-6]after the post-test, P<0.001); “identifying and exploring performancegaps” (5[4-6] after the pre-test vs. 6[5-6] after the post-test, P=0.014);and “helping trainees to achieve and sustain good future performance”(4[3-5] after the pre-test vs. 6[5-6] after the post-test, P<0.001).Conclusion: A simulation-based debriefing course, based mainlyon DOD sessions, allowed novice simulation instructors to improvetheir overall debriefing skills including, more specifically, the abilityto foster engagement in discussions and maintain an engaginglearning environment.