Assessment of debriefing in high-fidelity mannequin simulation: study among students in cardiology

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Published Nov 6, 2023
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Vol. 101 No. 8-9 (2023): Tunis med aug-sept 2023

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Saoussen Antit
Cardiology Department, Hospital of the Internal Security Forces, La Marsa, Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Khadija Mzoughi
Department of Cardiology , Habib Thameur Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.
Ridha Fekih
Cardiology Department, Hospital of the Internal Security Forces, La Marsa, Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Ihsen Zairi
Department of Cardiology , Habib Thameur Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunisia.
Lilia Zakhama
Cardiology Department, Hospital of the Internal Security Forces, La Marsa, Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia

Abstract

Introduction: Debriefing is the fundamental step in the learning process when teaching by simulation. The Debriefing Assessment for Simulation in Healthcare (DASH) guide is a tool designed to assess and develop the debriefing skills of trainers using healthcare simulation.


Aim: To evaluate the debriefing in high-fidelity mannequin simulation in the management of cardiological emergency by the DASH tool, student version.


Methods: This was a bicentric, prospective, cross-sectional and evaluative study including five groups of students in the first year of the second cycle of medical studies completing their internship in the cardiology departments of the Habib Thameur hospital and the Internal Security Forces Hospital of Marsa during the first semester of the 2021-2022 academic year. The simulation scenario included the diagnosis and emergency management of degenerative syncopal atrioventricular block.


Results: Forty-four students completed the DASH assessment form (28 female, 16 male). According to the students, the trainers had maintained a climate conducive to learning (6.51±0.74). They had conducted the debriefing in a structured way (6.35±0.75). They had aroused engagement in the exchange leading the learner to analyze his performance (6.01±1.03). They had effectively identified the learner's strengths and areas for improvement as well as their reasons (6.39±1.04). The trainers had helped the learners to consider how to improve or maintain a good level of performance (6.57±0.77). The mean DASH score evaluating the trainers was 6.36±0.88.


Conclusion: The DASH tool allows trainers to highlight the strengths and areas for improvement in the debriefing, which ...... ( abstract truncated at 250 words)

Keywords:

Simulation , Assessment , DASH , Survey

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Valler-Jones T, Meechan R, Jones H. Simulated practice--a panacea for health education? Br J Nurs. 2011;20(10):629-31.
  2. Arafeh JM, Hansen SS, Nichols A. Debriefing in simulated-based learning: facilitating a reflective discussion. J Perinat Neonatal Nurs. 2010; 24(4):302–9.
  3. Miller KK, Riley W, Davis S, Hansen HE. In situ simulation: a method of experiential learning to promote safety and team behavior. J Perinat Neonat Nurs. 2008; 22(2):105–13.
  4. Morgan PJ, Tarshis J, LeBlanc V, Cleave-Hogg D, DeSousa S, Haley MF, Herold-McIlroy J, Law JA. Efficacy of high-fidelity simulation debriefing on the performance of practicing anesthetists in simulated scenarios. Br J Anaesth. 2009; 103(4):531–7.
  5. Warrick D, Hunsaken PL, Cook CW, Altman S. Debriefing experiential learning exercises. J Exp Learn Simul. 1979; 1:91–100.
  6. Zigmont JJ, Kappus LJ, Sudikoff SN. The 3D model of debriefing: defusing, discovering, and deepening. Semin Perinatol. 2011; 35:52–8.
  7. Dreifuerst K. The essentials of debriefing in simulation learning: a concept analysis. Nurs Educ Prospect. 2009; 30(2):109–14.
  8. INASCL Board of Directors. Standard VI: the debriefing process. Clin Simul Nurs. 2011; 7(4 suppl):S16–S17. Available from
  9. https://www.nursingsimulation.org/article/S1876-1399(11)00066-1/fulltext
  10. Fanning RM, Gaba DM. The role of debriefing in simulation-based learning. Simul Health. 2007; 2(2):115–25.
  11. Simon, R., Rudolph, JW., Raemer, DB. Debriefing assessment for simulation in healthcare. Cambridge, MA: 2009. Available from:
  12. https://harvardmedsim.org/debriefing-assessment-for-simulation-in-healthcare-dash/
  13. Jeffries P. A framework for designing implementing and evaluating simulations used as teaching strategies in nursing. Nurs Educ Perspect. 2005;26(2):96-103.
  14. Jeffries P. Technology trends in nursing education: next steps. J Nurs Educ. 2005;44(1):3-4.
  15. Parker B, Myrick F. A critical examination of high-fidelity human patient simulation within the context of nursing pedagogy. Nurse Educ Today. 2008;29(3):322-9.
  16. Zairi I, Mzoughi K, Ben Mrad I, Allouch E, Kamoun S, Ben Moussa F, et al. Intérêt de la simulation dans l’apprentissage du raisonnement clinique. Tunis Med. 2020 Jun;98 (6):466-74.
  17. Parker B, Myrick F. Transformative learning as a context for the human patient simulation. J Nurs Educ. 2010; 49(6):326–32.
  18. Dismukes RK, Gaba DM, Howard SK. So many roads: facilitated debriefing in healthcare. Simul Healthc. 2006; 1(1):23–5.
  19. Kolbe M, Grande B, Spahn DR. Briefing and debriefing during simulation-based training and beyond: Content, structure, attitude and setting. Best Pract Res Clin Anaesthesiol. 2015 Mar;29(1):87-96.
  20. Van Malleghem C. Evaluation de la qualité du débriefing en simulation de santé. 2019. Available from :
  21. http://www.medesim.fr/wp-content/doc/memoire/diu2019-cvanmalleghem-meemoire.pdf
  22. Brett-Fleegler M, Rudolph J, Eppich W, et al. Debriefing assessment for simulation in healthcare. Development and psychometric properties. Simul Healthc 2012;7:288–94.
  23. Ben Amor I, Hentati Y, Gargouri J. Grilles d’évaluation des formateurs en simulation en santé 2018. JIM Sfax Fév 2018;(28):1-9. Available from
  24. http://www.medecinesfax.org/useruploads/files/jim-28.pdf
  25. Fey MK, Scrandis D, Daniels A, Haut C. Learning through debriefing: students’ perspectives. 2014 Clinical Simulation in nursing 10, e249-e256. Available from:
  26. https://www.sciencedirect.com/science/article/abs/pii/S1876139914000103
  27. Durand C, Secheresse T, Leconte M. The use of the Debriefing Assessment for Simulation in Healthcare (DASH) in a simulation-based team learning program for newborn resuscitation in the delivery room. Arch Pediatr. 2017 ;24(12):1197-204.
  28. Ahmed RA, Atkinson SS, Gable B, Yee J, Gardner AK. Coaching From the Sidelines: Examining the Impact of Teledebriefing in Simulation-Based Training. Simul Healthc. 2016;11(5): 334-9.
  29. Loo ME, Krishnasamy C, Lim WS. Considering Face, Rights, and Goals: A Critical Review of Rapport Management in Facilitator-Guided Simulation Debriefing Approaches. Simul Healthc. 2018;13(1):52-60.
  30. Alhaj A., Musallam E. Debriefing quality evaluation in nursing simulation-based education : an integrative review 2018;16, 15-24. Available from
  31. http://www.medesim.fr/wp-content/doc/memoire/diu2019-cvanmalleghem-meemoire.pdf
  32. Kalpokdjian A, Martin A, Measso S, and al. Evaluation de la qualité du débriefing pour la simulation en santé par l’utilisation de l’échelle DASH. Paris 2015. Available from
  33. https://www.sfmu.org/upload/70_formation/02_eformation/02_congres/Urgences/urgences2015/donnees/communications/resume/posters/P062.pdf
  34. Kolbe M, Weiss M, Grote G, Knauth A, Dambach M, Spahn DR, et al. TeamGAINS: a tool for structured debriefings for simulation-based team trainings. BMJ Qual Saf. 2013;22(7):541-53.
  35. Rudolph JW, Palaganas J, Fey M, Morse C, Onello R, Dreifuerst K, et al. A DASH to the top: educator debriefing standards as a path to practice readiness for nursing students. Clin Sim in Nurs 2016;12(9):412-7. Available from
  36. https://core.ac.uk/download/pdf/326327570.pdf
  37. Brown DK, Wong AH, Ahmed RA. Evaluation of simulation debriefing methods with interprofessional learning. J Interprof Care. 2018 Jul;19:1-3.
  38. Fraser KL, Meguerdichian MJ, Haws JT, Grant VJ, Bajaj K, Cheng A. Cognitive Load Theory for debriefing simulations: implications for faculty development. Adv Simul (Lond). 2018 Dec; 3:28.
  39. Roh YS, Kelly M, Ha EH. Comparison of instructor-led versus peer-led debriefing in nursing students. Nurs Health Sci. 2016 Jun;18(2):238-45.
  40. Scherer YK, Foltz-Ramos K, Fabry D, Chao YY. Evaluating Simulation Methodologies to Determine Best Strategies to Maximize Student Learning. J Prof Nurs. 2016;32(5):349-57.
  41. Morse K. Structured model of debriefing on perspective transformation for NP students. Clin Sim in Nurs. 2015;11(3):172-9. Available from
  42. https://www.infona.pl/resource/bwmeta1.element.elsevier-eebac7de-a194-3d08-b9b8-adbb41926a5b
  43. Waznonis AR. Methods and evaluations for simulation debriefing in nursing education. J Nurs Educ. 2014;53(8):459-65.
  44. Oriot D, Alinier G. La simulation en santé - Le débriefing clés en mains. Paris : Elsevier; 2019. Available from
  45. https://www.elsevier.com/fr-fr/connect/etudes-de-medecine/la-simulation-en-sante-le-debriefing-cles-en-mains
  46. Dreifuerst KT. Using debriefing for meaningful learning to foster development of clinical reasoning in simulation. J Nurs Educ. 2012;51(6):326-33.
  47. Johnston S, Coyer FM, Nash R. Kirkpatrick's Evaluation of Simulation and Debriefing in Health Care Education: A Systematic Review. J Nurs Educ. 2018;57(7):393-8.
  48. Fountain RA, Alfred D. Student satisfaction with high-fidelity simulation: does it correlate with learning styles? Nurs Educ Perspect. 2009;30(2):96-8.
  49. Wilson R, Klein JD. Design, implementation and evaluation of a nursing simulation: a design and development research study. The Journal of Applied Instructional Design. 2012;2(1):57-68.
  50. Laschinger S, Medves J, Pulling C, McGraw DR, Waytuck B, Harrison MB, Gambeta K. Effectiveness of simulation on health profession students' knowledge, skills, confidence and satisfaction. Int J Evid Based Healthc. 2008;6(3):278-302.
  51. Jeffries P. Designing simulation for nursing education. Annual Review of Nursing Education. 2006;4:161-77.
  52. Smith S, Roehrs C. High-fidelity simulation: Factors correlated with nursing student satisfaction and selfconfidence. Nurs Educ Perspect. 2009;30(2):74-8.