Paige John T, Garbee Deborah D, Yu Qingzhao, Zahmjahn John, Baroni de Carvalho Raquel, Zhu Lin, Rusnak Vadym, Kiselov Vladimir J
School of Medicine, Department of Surgery, LSU Health New Orleans Health Sciences Center, New Orleans, Louisiana, USA.
School of Nursing, LSU Health New Orleans Health Sciences Center, New Orleans, Louisiana, USA.
BMJ Simul Technol Enhanc Learn. 2021 Jan 27;7(5):360-365. doi: 10.1136/bmjstel-2020-000685. eCollection 2021.
The evidence for the conventional wisdom that debriefing quality determines the effectiveness of learning in simulation-based training is lacking. We investigated whether the quality of debriefing in using simulation-based training in team training correlated with the degree of learning of participants.
Forty-two teams of medical and undergraduate nursing students participated in simulation-based training sessions using a two-scenario format with after-action debriefing. Observers rated team performance with an 11-item Teamwork Assessment Scales (TAS) instrument (three subscales, team-based behaviours (5-items), shared mental model (3-items), adaptive communication and response (3-items)). Two independent, blinded raters evaluated video-recorded facilitator team prebriefs and debriefs using the Objective Structured Assessment of Debriefing (OSAD) 8-item tool. Descriptive statistics were calculated, t-test comparisons made and multiple linear regression and univariate analysis used to compare OSAD item scores and changes in TAS scores.
Statistically significant improvements in all three TAS subscales occurred from scenario 1 to 2. Seven faculty teams taught learners with all scores ≥3.0 (except two) for prebriefs and all scores 3.5 (except one) for debriefs (OSAD rating 1=done poorly to 5=done well). Linear regression analysis revealed a single statistically significant correlation between debrief engagement and adaptive communication and response score without significance on univariate analysis.
Quality of debriefing does not seem to increase the degree of learning in interprofessional education using simulation-based training of prelicensure student teams. Such a finding may be due to the relatively high quality of the prebrief and debrief of the faculty teams involved in the training.
缺乏证据支持传统观点,即总结汇报的质量决定基于模拟训练的学习效果。我们调查了在团队训练中使用基于模拟的训练时总结汇报的质量是否与参与者的学习程度相关。
42个医学和本科护理专业学生团队参加了基于模拟的训练课程,采用双场景模式并进行事后总结汇报。观察员使用11项团队合作评估量表(TAS)工具(三个子量表,基于团队的行为(5项)、共享心智模型(3项)、适应性沟通与反应(3项))对团队表现进行评分。两名独立的、不知情的评分者使用客观结构化总结汇报评估(OSAD)8项工具对录制的指导教师团队的预汇报和总结汇报视频进行评估。计算描述性统计量,进行t检验比较,并使用多元线性回归和单变量分析来比较OSAD项目得分和TAS得分的变化。
从场景1到场景2,所有三个TAS子量表都有统计学上的显著改善。七个教师团队对学习者的教学中,预汇报的所有分数≥3.0(除两个外),总结汇报的所有分数≥3.5(除一个外)(OSAD评分1=做得差到5=做得好)。线性回归分析显示总结汇报参与度与适应性沟通与反应得分之间存在单一的统计学显著相关性,但单变量分析无显著性。
在对预执业学生团队进行基于模拟的训练的跨专业教育中,总结汇报的质量似乎并未提高学习程度。这一发现可能是由于参与训练的教师团队的预汇报和总结汇报质量相对较高。