A Developmental Framework for Developing Debriefing Skills

Transcription

1 A Developmental Framework for Developing Debriefing Skills Jenny Rudolph, PhD Kate Morse, PhD, RN, CRNP Center for Medical Simulation, Massachusetts General Hospital, Harvard Medical School Drexel University, Philadelphia, PA Mary Fey, PhD, RN, CHSE National League for Nursing University of Maryland, School of Nursing

2 Disclosure of Interests JWR, KM: Employees of MGH; faculty at the Center for Medical Simulation (CMS), a nonprofit, educational, charitable organization. CMS offers instructor training through Institute for Medical Simulation. MF: Employee of National League for Nursing and University of Maryland.

3 Element 1 Establishes an engaging learning environment. Clarifies course objectives, environment, roles, and expectations. Establishes a fiction contract with participants. Attends to logistical details. Conveys a commitment to respecting learners and understanding their perspective.

4 1. Practice applying DASH Element 1 to this Instro 2. Session overview and introduction 3. Overview of the DASh 4. Suggested developmental steps for faculty development 5. Creating a local group for instructors to improve Additional DASH information:

5 A space for us to learn together? We have done our best to create a informative session with opportunity for dialogue We ask that you Hold the Basic Assumption Maintain curiosity, respect, courtesy Maintain confidentiality Share their questions

6 The Basic Assumption We believe that everyone participating in activities here is intelligent, capable, cares about doing their best, and wants to improve.

7 DASH Foundation Behaviorally anchored rating scale (BARS) Criterion-referenced testing approach (CRT) Independent of any single debriefing approach Based on literature review and primary research

8 DASH Research Reliability and validity study Brett-Fleegler M, Rudolph J, Eppich W, Monuteaux, M., Fleegler, E., Cheng, A., Simon, R. Debriefing Assessment for Simulation in Healthcare: Development and Psychometric Properties. Simul Healthc. Oct 2012;7(5): Theoretical Basis for Element 1: Rudolph J, Raemer D, Simon R. Establishing a safe container for learning in simulation: The role of the pre-simulation briefing. Simulation in Healthcare. 2014;339-49(6): Study with DASH Student Version to Assess Debriefing for Meaningful Learning Dreifuerst KT. Using debriefing for meaningful learning to foster development of clinical reasoning in simulation. J Nurs Educ. 2012;51(6):

9 The DASH Family DASH Rater Version + Handbook DASH Score Sheet Instructor Version DASH Score Sheet Student Version Long Form Rate Elements and Short Form Rate Elements Long Form Rate Elements and Short Form Rate Elements

10 For faculty and staff development Using the DASH Rater Handbook is an introduction to debriefing Score sheets for self- and other feedback NO SCORES For assessment and standards Rater training required Score sheets rater assessment Half day web training offered 3 times a year

11 Element 1 Establishes an engaging learning environment. Clarifies course objectives, environment, roles, and expectations. Establishes a fiction contract with participants. Attends to logistical details. Conveys a commitment to respecting learners and understanding their perspective.

12 Element Understanding Elements & A high level concept related to effective debriefing Components and aspects of the Element Behavioral Markers Example observable debriefing behaviors

13 Element 2 - Maintains an engaging learning environment. Clarifies debriefing objectives, roles, and expectations. Helps participants engage in a limited-realism context. Conveys respect for learners and concern for their psychological safety.

14 Element 3 - Structures debriefing in an organized way. Encourages trainees to express their reactions and, if needed, orients them to what happened in the simulation, near the beginning. Guides analysis of the trainees performance during the middle of the session Collaborates with participants to summarize learning from the session near the end

15 Element 4 Provokes engaging discussions. Uses concrete examples and outcomes as the basis for inquiry and discussion. Reveals own reasoning and judgments. Facilitates discussion through verbal and non-verbal techniques. Uses video, replay, and review devices (if available). Recognizes and manages the upset participant.

16 Element 5 - Identifies and explores performance gaps. Provides feedback on performance. Explores the source of the performance gap.

17 Element 6 Helps trainees achieve or sustain good future performance. Helps close the performance gap through discussion and teaching. Demonstrates firm grasp of the subject. Meets the important objectives of the session.

18 Novice to Expert using the DASH Elements of the DASH are chunked by level of expertise Novice (Novices can be scaffolded on Elements 1 and 3 this with scripting or cognitive aid) 1. Establishes an engaging learning environment 3. Structures debriefing in an organized way 6. Helps trainees achieve or sustain good future performance Advanced Beginner/Intermediate 4. Provokes engaging discussions 5. Identifies and explores performance gaps Competent/ Expert 2. Maintains and engaging environment for learning Important Note: This Novice to Expert suggested progression is a work-inprogress. It is not based on empirical studies; only the opinion of Jenny Rudolph. Questions? jwrudolph@mgh.harvard.edu Note: Not Based on Empirical Research

19 Reflections?

20 The DASH Family DASH Score Sheet Instructor Version DASH Rater Version + Handbook DASH Score Sheet Student Version