Debriefing – the structured discussion following simulated scenarios – is crucial for learning in simulation. Quite different to the clinical setting, in which we take too little time for reflecting on factors leading to success and mistake, often jumping to hasty conclusions, simulation-based training provides time and space for «shared reflection». Debriefings last two to three times longer than the scenario itself. Supported by the facilitators, learners mainly discuss which personal assumptions and team dynamics lead to their actions, and only marginally review the scenario itself. These discussions are substantiated with current insights from medical and team research as well as CRM principles.
Image source: https://debrief2learn.org
We are aware of the fact that our learners are not
used to observation of, and reflection on, their actions by colleagues and facilitators,
and that mutual reflecting is rare. We are adamant about providing the setting
in which the learners feel safe enough to stray out of their «comfort zones»,
and to participate in discussions about their clinical practice, in order to
learn from the experience. Two principles guide our work: the «basic
assumption» (developed in The Center for Medical Simulation) and
the «Las Vegas principle».
The quality of our debriefings is of central concern to us. For this reason we apply structured debriefing approaches and conduct studies on debriefing effectiveness. Likewise, the development of our simulation faculty is important to us.
«We believe that everyone participating at activities at the Simulation Center is intelligent, capable, cares about doing their best, and wants to improve»
The Basic Assumption has been upheld and taught by the Center for Medical Simulation (CMS) in Boston, and forms the basis of our trainings. In our simulations, we work with highly professional participants who have good reason for their actions. We are not interested in blaming and finding culprits, but rather in the frames driving participant`s actions and leading to situations. These impressions help us understand why some situations are expertly resolved, and where help can be provided to improve team-work.
«What happens in Vegas stays in Vegas»
This principle describes our guarantee that everything which happens in trainings stays in trainings. Videos are not shared, contents of trainings are not communicated, no information is publically available.
When scenes from our trainings could be used for teaching purposes, or ideas from debriefings could be expanded upon, the involved people are explicitly asked for allowance.
Similarly, we ask our participants to uphold the same principle and to withhold from passing information from trainings on.