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Resumo: Trata-se de uma pesquisa vinculada a linha de pesquisa de Políticas e Práticas de Educação, Saúde, Enfermagem e ao projeto guarda-chuva intitulado "Simulação Clínica Multiprofissional: Criação e Validação de Modelos, Cenários e Instrumentos de Avaliação". A pesquisa foi desenvolvida por meio da avaliação do debriefing no cenário clínico simulado com múltiplas vítimas no âmbito hospitalar com graduandos de Enfermagem, cujo objetivo foi analisar a contribuição do debriefing no aprendizado do cenário simulado de atendimento a múltiplas vítimas com graduandos de enfermagem. O método utilizado foi quantitativo com delineamento descritivo e transversal como resultados destaca-se na caracterização do perfil dos participantes que a maioria se congratula no sexo feminino e com idade 20-30 anos. Na avaliação das escalas do debriefing: Escala de Experiência do Debriefing: aponta-se destaque na concordância que o debriefing ajudou a analisar seus pensamentos; ajudou a fazer conexões na aprendizagem; professor permitiu tempo suficiente para verbalizar os sentimentos antes dos comentários; que tiveram tempo suficiente para esclarecer os questionamentos e que o professor realizou uma avaliação construtiva da simulação durante o debriefing. Em relação a Escala de avaliação do debriefing associado a simulação: evidenciou-se que a maior parte dos graduandos concordaram que o debriefing identificou dificuldades na atuação; que foca nos aspectos importantes da atuação; refleti as minhas competências; identifica aspectos que se deve melhorar em atuações futuras e discordam em não querer participar em mais nenhuma simulação; em se sentir desrespeitado e em sentir que foi uma perda de tempo. Conclui-se que a contribuição a partir dos resultados das escalas de avaliação é importante para atuação dos futuros Enfermeiros através das boas práticas de Enfermagem conforme as normas de segurança do paciente. A relevância da contribuição do debriefing constatado a partir dos resultados das escalas de avaliação é importante para o desenvolvimento de habilidades técnicas e comunicativas, competências assistenciais de maneira interdisciplinar. O caráter inovativo da pesquisa: uso de metodologias ativas por meio da simulação clínica. A replicabilidade e impacto social do tema de atendimento de múltiplas vítimas no âmbito hospitalar pode ser aplicado em novas capacitações por meio da simulação clínica com graduandos e profissionais da área da saúde, para que consigam obter conhecimento sobre os cuidados em atendimento em massa com incêndio e como proceder nestas eventualidades.
Abstract: This research is linked to the research line of Education, Health, and Nursing Policies and Practices and to the umbrella project entitled "Multiprofessional Clinical Simulation: Creation and Validation of Models, Scenarios, and Assessment Instruments". The research was developed through the evaluation of debriefing in the simulated clinical scenario with multiple victims in the hospital environment with undergraduate nursing students, whose objective was to analyze the contribution of debriefing in learning the simulated scenario of care to multiple victims with undergraduate nursing students. The method used was quantitative with a descriptive and transversal design. The results highlight in the characterization of the participants' profile that most of them are female and aged 20-30 years. In the evaluation of the debriefing scales: Debriefing Experience Scale: it is highlighted in the agreement that the debriefing helped to analyze their thoughts; helped to make connections in learning; teacher will allow enough time to verbalize feelings before comments; that they had enough time to clarify the questions and that the teacher made a constructive evaluation of the simulation during the debriefing. In relation to the Rating scale of the debriefing associated to the simulation: it was evident that most undergraduate students agreed that the debriefing identified difficulties in the performance; that it focused on important aspects of the performance; that it reflected my skills; that it identified aspects that should be improved in future performances, and disagreed on not wanting to participate in any further simulation; on feeling disrespected, and on feeling that it was a waste of time. We conclude that the contribution from the results of the evaluation scales is important for the performance of future Nurses through good Nursing practices according to patient safety standards. The relevance of the contribution of the debriefing verified from the results of the evaluation scales is important for the development of technical and communicative skills, and care competencies in an interdisciplinary way. The innovative character of the research: use of active methodologies through clinical simulation. The replicability and social impact of the topic of multiple victim assistance in the hospital setting can be applied in new training courses through clinical simulation with undergraduate students and health professionals, so that they can obtain knowledge about care in mass care with fire and how to proceed in these eventualities.
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Humans , Male , Female , Adult , Students, Nursing , Victim Concentration Zone , Disasters , Simulation Training , Learning , Nursing CareABSTRACT
Objective:To evaluate the efficacy of neonatal resuscitation simulation exercise for perinatal medical personnel.Methods:From August 2020 to July 2021, perinatal medical personnel receiving simulated training of neonatal resuscitation in our hospital were prospectively enrolled. The professional backgrounds of the trainees were collected and their performances on both knowledge skills and behavioral skills were scored. The knowledge skills included pre-resuscitation preparation, initial resuscitation, positive pressure ventilation, tracheal intubation, chest compression and umbilical vein catheterization. The behavioral skills included situational awareness, problem solving, resource utilization, communication and leadership. SPSS 26.0 was used for data analysis.Results:Among the 200 participants, 127(63.5%) were neonatal/pediatric doctors and nurses, 65(32.5%) were obstetricians and midwives, 8(4.0%) were anesthesiologists and the ratio of doctors to nurses was 1.74∶1. The score of knowledge skills was (19.52±2.92) at the beginning of the simulation exercise and (27.02±2.72) at the end. The scores on preparation before resuscitation, initial resuscitation and positive pressure ventilation were significantly improved ( P<0.05). The score of behavioral skills was (16.60±2.34) at the beginning and (20.58±1.77) at the end. The scores of resource utilization, communication and leadership were significantly improved ( P<0.05). Conclusions:The simulation exercise provides multidisciplinary teamwork training for perinatal medical personnel, may significantly improve neonatal resuscitation skills and is worth promoting.
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@#Introduction: This study entailed the process of developing an online questionnaire to determine awareness, knowledge, attitude and self-efficacy (AKAS) on healthy eating for nutrition education. Currently, there is no local validated questionnaire that can be used to assess AKAS on healthy eating among Filipino adults. Methods: The study developed the questionnaire based on theoretical frameworks and literature review. The draft questionnaire underwent three stages of development: (1) online modified Delphi technique composing of seven subject matter experts (SME) for content validity; (2) online cognitive debriefing with 32 participants (14 nutrition experts and 18 general public) for construct validity; and (3) online pre-testing with 35 participants (non-nutritionists) using test-retest method. Results: For first stage, the questionnaire contained 16 questions for awareness, 17 questions for knowledge, 17 questions for attitude, and 15 questions for self-efficacy. For second stage, significantly different scores (p-value<0.00) between nutritionist experts and general public were observed, showing good construct validity. For third stage, Spearman’s correlation of test-retest method was 0.640. The questionnaire yielded Cronbach’s alpha of 0.467 to 0.923 (round 1) and 0.435 to 0.923 (round 2). A second analysis was done to improve the internal consistency of the questionnaire. By combining two question categories (awareness and knowledge), the Cronbach’s alpha increased to 0.659 (round 2), and by deleting three questions in attitude category, the Cronbach’s alpha improved to 0.626 (round 2). Conclusion: The process used ensured the questionnaire’s validity and reliability. Hence, this online questionnaire may be adopted by parties interested in developing and assessing nutrition education.
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Objective:To explore the effect of the course ideology and politics teaching model based on the Context-Content-Course (3C) model in the nursing experimental class of endocrine diseases for nursing undergraduates.Methods:From March 2021 to June 2021,168 undergraduates from Class 1 of Chongqing Medical University in Grade 2018 were selected as the experimental group and 163 undergraduates from Class 3 of Nursing as the control group .Taking the humanistic care ability as the entry point of the course ideology and politics education, the experimental group carried out teaching and implement humanistic care education using course ideology and politics teaching mode based on the 3C model; the control group used traditional methods to carry out humanistic care education. After the course, the humanistic care ability, professional self-efficacy, and emotional intelligence of the two groups were compared.Results:After the implementation of the new teaching model, the total scores of humanistic care ability, occupational self-efficacy, and emotional intelligence of the students in the experimental group were 147.55 ± 15.95, 110.13 ± 9.26, and 76.24 ± 8.78, respectively, while those in the control group were 121.16 ± 18.44, 90.45 ± 9.49, and 61.67 ± 12.33, respectively; and the differences of the scores between two groups were statistically significant ( t=13.73, 18.80, 12.24, all P<0.01). Conclusions:The application of the course ideology and politics teaching model based on the 3C model in the nursing experimental class of endocrine diseases is helpful to improve the humanistic care ability, professional self-efficacy, and emotional intelligence of nursing students′ and is conducive to cultivating the comprehensive humanistic qualities of nursing students. It is ansignificant manifestation of accurate course ideology and politics education.
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Whole Person Care education at McGill University aims to develop competent and compassionate physicians who can relate as a whole person to facilitate healing and provide better medical care to their patients. A step-by-step approach is adopted for the education throughout the four-year curriculum. It includes classes, experiential learning in small groups (20 students), simulation education, and panel discussions. It promotes interactive and unique experiential learning through a variety of exercises and works, and aims at transformational learning. It is essential to develop an attitude of being as a whole person, learning to be mindful and aware of the present moment (self, other and context).
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Based on the latest results of international researches, combining with the experiences of our team in the simulation of acute dyspnea, Xiangya Hospital Central South University has summarized 7 characteristics, procedures and methods of debriefing, including that immediate feedback happens after simulation; feedback is provided by a trained instructor with clinical experience; feedback time is at least longer than the simulation time; various international methods of feedback can be used; the content of feedback is the learning objective; oral feedback is preferred; video can be used to review the details. The study aims to provide a theoretical basis for debriefing in domestic scenario stimulation teaching, and finally improve the effectiveness of the scenario stimulation teaching.
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Resumo: O ato de ensinar por meio da Simulação Clínica utiliza técnicas educativas e/ou equipamentos tecnológicos e é uma estratégia pedagógica voltada à aprendizagem experiencial. O debriefing é uma das etapas mais importantes desse método de ensino, pois proporciona a revisão, a reflexão e o raciocínio, contribuindo, assim, para a redução dos fatores estressores. Na impossibilidade de contatos presenciais em decorrência da pandemia de Covid-19, a simulação e o debriefing virtual são alternativas de aprendizagem, pois para a sua realização utilizam-se plataformas de videoconferência baseadas na web. O presente estudo, que possui métodos mistos, objetivou avaliar o debriefing virtual realizado com 60 estudantes de enfermagem, em sua maioria jovens e do sexo feminino, matriculados do quinto ao nono período, de três universidades do sul do Brasil entre 2020 e 2021. De início, desenvolveu-se um website para proporcionar a divulgação da pesquisa e viabilizar a coleta de dados. Posteriormente, os estudantes acessaram o website, assistiram a um cenário gravado de simulação clínica sobre rebaixamento do nível de consciência por hipoglicemia e, com o auxílio de plataformas da web, realizou-se o debriefing virtual. Finalmente, os estudantes responderam a dois instrumentos disponíveis no website, quais sejam: a "Escala de Avaliação do Debriefing associado à Simulação" (EADaS) e a "Escala de Experiência com o Debriefing" (EED). Os dados coletados foram inseridos em planilhas do Microsoft Excel® e, em seguida, submetidos à análise estatística descritiva. Por sua vez, para a análise qualitativa utilizou-se o software Iramuteq®. Na EADaS, a concordância apresentada nos resultados de todos os fatores da escala foi de 97,67% nos itens avaliados como concordo ou concordo completamente. Na EED, os melhores escores de concordância foram verificados nos valores psicossocial e cognitivo, com maior discordância no valor afetivo. Tais resultados possibilitam entender que os estudantes compreendem a experiência como positiva. Por esse motivo, a simulação e o debriefing virtual mostram-se como alternativas eficientes para a manutenção da qualidade do ensino remoto, ao qual a comunidade acadêmica foi inserida no contexto pandêmico.
Abstract: The act of teaching through Clinical Simulation uses educational techniques and/or technological equipment and is a pedagogical strategy aimed at experiential learning. Debriefing is one of the most important stages of this teaching method, as it provides review, reflection, and reasoning, thus contributing to the reduction of stressors. Given the impossibility of face-to-face contacts due to the Covid-19 pandemic, simulation and virtual debriefing are learning alternatives, as web-based videoconferencing platforms are used to carry them out. The present study, which uses mixed methods, aimed to evaluate the virtual debriefing carried out with 60 nursing students, mostly young and female, between 2020 and 2021, enrolled from the fifth to the ninth period in three universities from Southern Brazil. Initially, a website was developed to publicize the research and facilitate data collection. Afterwards, the students accessed the website, watched a recorded clinical simulation scenario on the lowering of the level of consciousness due to hypoglycemia and, by means of web platforms, the virtual debriefing was carried out. Finally, the students answered two instruments available on the website, namely: the "Debriefing Assessment Scale associated with Simulation" (EADaS) and the "Experience with Debriefing Scale" (EED). The collected data were entered into Microsoft Excel® spreadsheets and then submitted to descriptive statistical analysis. In turn, for the qualitative analysis, the Iramuteq software was used. In the EADaS, the agreement presented in the results of all the factors of the scale was 97.67% in the items evaluated as agree or completely agree. In the EED, the best scores of agreements were verified in the psychosocial and cognitive values, with greater disagreement in the affective value. Therefore, such results make it possible to apprehend those students understand the experience under analysis as positive, which, consequently, contributes to their learning process. For this reason, virtual debriefing is an efficient alternative for maintaining the quality of distance education, to which the academic community was inserted in the pandemic context.
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Humans , Male , Female , Adolescent , Adult , Students, Nursing , Education, Distance , Education, Nursing , LearningABSTRACT
Introducción: Las prácticas pedagógicas del docente en el debriefing son importantes para asegurar mejores resultados de aprendizaje en la educación basada en simulación clínica. Objetivo: Evaluar la estructura factorial de una versión adaptada de la escala de evaluación del debriefing para simulación en salud en estudiantes de Enfermería. Métodos: Estudio cuantitativo metodológico. Fueron elegidos 159 estudiantes de la carrera de Enfermería de una universidad privada de Concepción (Chile) mediante muestreo no probabilístico por accesibilidad. Estos respondieron la versión adaptada de la escala de evaluación del debriefing para simulación en salud más un cuestionario sociodemográfico, previo consentimiento informado. Se realizó un análisis factorial exploratorio de esta versión adaptada, se evaluó la confiabilidad del factor encontrado a través de alfa de Cronbach y luego se condujo un análisis descriptivo de estos. Resultados: Solo un factor fue identificado, el cual permite evaluar la calidad del debriefing en simulación clínica. El análisis de la confiabilidad del factor identificado mostró un alfa de Cronbach de 0,97, por lo que se clasificó como excelente, según los tramos sugeridos por George y Mallery. Conclusiones: Los resultados presentan evidencia psicométrica que apoya la validez y confiabilidad de la versión adaptada de la escala de evaluación del debriefing para simulación en salud, para emplearla en la evaluación de la calidad del debriefing en simulación clínica en la carrera de Enfermería. No obstante, se asume que su uso debe ser complementario y no excluyente, con un abordaje cualitativo de este fenómeno(AU)
Introduction: Professors' pedagogical practices in debriefing are important to ensure better learning outcomes in clinical simulation-based education. Objective: To assess the factorial structure of an adapted version of the Debriefing Evaluation Scale for health simulation in Nursing students. Methods: A methodological quantitative study was carried out with 159 Nursing students from a private university in Concepción, Chile, chosen through nonprobabilistic sampling for accessibility. They answered the adapted version of the Debriefing Evaluation Scale for health simulation and a sociodemographic questionnaire, with prior informed consent. An exploratory factor analysis of this adapted version was carried out, the reliability of the factor found was assessed using Cronbach's alpha, and then a descriptive analysis of these elements was carried out. Results: Only one factor was identified, which allows assessing the quality of debriefing in clinical simulation. The analysis of the reliability of the identified factor showed a Cronbach's alpha of 0.97, a reason why it was classified as excellent, according to the ranges suggested by George and Mallery. Conclusions: The results present psychometric evidence that supports the validity and reliability of the adapted version of the Debriefing Evaluation Scale for health simulation, to be used for assessing the quality of debriefing in clinical simulation in the Nursing major. However, it is assumed that its use must be complementary and not exclusive, with a qualitative approach to this phenomenon(AU)
Subject(s)
Humans , Students, Nursing , Reproducibility of Results , Factor Analysis, Statistical , LearningABSTRACT
Resumen: Se realizó una simulación in situ del proceso de atención de paciente con diagnóstico de COVID-19 programado para una cirugía de urgencia. Se observó desde la llegada al Departamento de Urgencias y hasta su salida del quirófano. Se llevaron a cabo los protocolos previamente establecidos y se observó por áreas de oportunidad.
Abstract: An in situ simulation was performed of a patient with COVID-19 diagnosis that is schedule for emergency surgery. From the arrival to the Emergency Department to the exit from the operating theatre. Previously stablished protocols were performed, and areas of improvement were looked for.
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Background & objectives: Comprehension and process of consent are important for persons with mental illness as they may not be impaired in considering research participation. The American Psychiatric Association developed a detailed Cultural Formulation Interview (CFI). The present study was a part of field testing of CFI, aimed to standardize cultural information affecting the patients' management in India. This paper describes the process and conclusions from the consent-seeking process of this study. Methods: The purpose and procedures about field trial of the CFI were introduced and the patient and caregiver were requested for participation. Consent process was carried out step by step, by reading out the consent form to the first new patient of the day in the psychiatry outpatients department of a tertiary care hospital in north India, inviting questions followed by the 'comprehension' questions. The entire process was audiotaped without any personal identifiers. The process was repeated if not comprehended. Results: A total of 67 patients consented, 11 refused and majority were educated more than secondary school. Some concerns shown by the patients and caregivers included risk of participation, loss or benefits of participation, privacy, etc. All types of mentally ill patients participated in the study. Interpretation & conclusions: Translations of consent forms used simple words, consonant with understanding of the potential participants. Patients' belief that participating in this long process would improve their care, and serve humanity, influenced their decision to participate. Except for intoxication and severe psychosis, patients could understand and comprehend issues around consent. Main issues were confidentiality and culture. Our experience in the psychiatry OPD refutes the commonly held belief that mentally ill persons lack comprehension and ability to consent.
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ABSTRACT Objective: To identify in the literature methods and techniques of debriefing used in teaching and learning in nursing simulation. Methods: Integrative review of PubMed/MEDLINE®, LILACS, Scopus and CINAHL® databases, with the descriptors "nursing", "nursing education", respective terms in English and Spanish, and the keyword "debriefing". Twelve primary studies, in Portuguese, English and Spanish, from January 2008 to December 2018 were included. Qualitative analysis was used to categorize the domains. Results: The identified meaningful learning methods were based on principles of transfer of learning; model of clinical reasoning, interprofessional, with good judgment and structured and self-debriefing techniques, oral, eye-tracking, video-assisted and written debriefing. Conclusions: The structured method and the oral technique with video were outstanding. One method was not superior to the other but effective for a particular proposal. No national studies have been found. Research should be conducted on the effectiveness of nursing debriefing methods and techniques.
RESUMEN Objetivo: Identificar en la literatura los métodos y técnicas de análisis utilizados en el proceso de enseñanza y aprendizaje en la simulación de enfermería. Métodos: Revisión integradora en las bases de datos PubMed/MEDLINE®, LILACS, Scopus y CINAHL®, con los descriptores "enfermería", "educación de enfermería", términos respectivos en inglés y español y la palabra clave "interrogatorio". Doce estudios primarios en portugués, inglés y español, desde enero de 2008 hasta diciembre de 2018. Se utilizó el análisis cualitativo para clasificar los dominios. Resultados: Se identificaron los métodos de análisis significativo de información; Basado en principios de transferencia de aprendizaje; modelo de razonamiento clínico, interprofesional, bien juzgado y estructurado, y técnicas de autoinforme; oral Seguimiento de los ojos; Video asistido y redacción de informes. Conclusiones: Se destaca el método estructurado y la técnica oral con video. Un método no era superior a otro, pero era efectivo para una propuesta dada. No se encontraron estudios nacionales. Se sugiere, investigación sobre la efectividad de los métodos y técnicas de interrogatorio en enfermería.
RESUMO Objetivo: Identificar na literatura métodos e técnicas de debriefing utilizados no processo de ensino e aprendizagem na simulação em enfermagem. Métodos: Revisão integrativa, nas bases de dados PubMed/MEDLINE®, LILACS, Scopus e CINAHL®, com os descritores "enfermagem", "educação em enfermagem", respectivos termos em inglês e espanhol e a palavra chave "debriefing" Incluíram-se 12 estudos primários, nos idiomas português, inglês e espanhol, de janeiro de 2008 a dezembro de 2018. Utilizou-se análise qualitativa para categorização dos domínios. Resultados: Identificaram-se os métodos de debriefing Meaningful Learning; based on principles of transfer of learning; model of clinical reasoning, interprofissional, com bom julgamento e estruturado, e técnicas self-debriefing; oral; Eye-Tracking; videoassistido e written debriefing. Conclusões: Sobressaíram-se o método estruturado e a técnica oral com vídeo. Um método não foi superior ao outro, mas eficaz para determinada proposta. Não foram encontrados estudos nacionais. Sugere-se, pesquisas sobre a eficácia dos métodos e técnicas debriefing na enfermagem.
Subject(s)
Humans , Transfer, Psychology , Patient Simulation , Clinical Competence , Feedback, Psychological , Education, Nursing/methods , Eye-Tracking TechnologyABSTRACT
ABSTRACT Objective: To identify in the literature methods and techniques of debriefing used in teaching and learning in nursing simulation. Methods: Integrative review of PubMed/MEDLINE®, LILACS, Scopus and CINAHL® databases, with the descriptors "nursing", "nursing education", respective terms in English and Spanish, and the keyword "debriefing". Twelve primary studies, in Portuguese, English and Spanish, from January 2008 to December 2018 were included. Qualitative analysis was used to categorize the domains. Results: The identified meaningful learning methods were based on principles of transfer of learning; model of clinical reasoning, interprofessional, with good judgment and structured and self-debriefing techniques, oral, eye-tracking, video-assisted and written debriefing. Conclusions: The structured method and the oral technique with video were outstanding. One method was not superior to the other but effective for a particular proposal. No national studies have been found. Research should be conducted on the effectiveness of nursing debriefing methods and techniques.
RESUMEN Objetivo: Identificar en la literatura los métodos y técnicas de análisis utilizados en el proceso de enseñanza y aprendizaje en la simulación de enfermería. Métodos: Revisión integradora en las bases de datos PubMed/MEDLINE®, LILACS, Scopus y CINAHL®, con los descriptores "enfermería", "educación de enfermería", términos respectivos en inglés y español y la palabra clave "interrogatorio". Doce estudios primarios en portugués, inglés y español, desde enero de 2008 hasta diciembre de 2018. Se utilizó el análisis cualitativo para clasificar los dominios. Resultados: Se identificaron los métodos de análisis significativo de información; Basado en principios de transferencia de aprendizaje; modelo de razonamiento clínico, interprofesional, bien juzgado y estructurado, y técnicas de autoinforme; oral Seguimiento de los ojos; Video asistido y redacción de informes. Conclusiones: Se destaca el método estructurado y la técnica oral con video. Un método no era superior a otro, pero era efectivo para una propuesta dada. No se encontraron estudios nacionales. Se sugiere, investigación sobre la efectividad de los métodos y técnicas de interrogatorio en enfermería.
RESUMO Objetivo: Identificar na literatura métodos e técnicas de debriefing utilizados no processo de ensino e aprendizagem na simulação em enfermagem. Métodos: Revisão integrativa, nas bases de dados PubMed/MEDLINE®, LILACS, Scopus e CINAHL®, com os descritores "enfermagem", "educação em enfermagem", respectivos termos em inglês e espanhol e a palavra chave "debriefing" Incluíram-se 12 estudos primários, nos idiomas português, inglês e espanhol, de janeiro de 2008 a dezembro de 2018. Utilizou-se análise qualitativa para categorização dos domínios. Resultados: Identificaram-se os métodos de debriefing Meaningful Learning; based on principles of transfer of learning; model of clinical reasoning, interprofissional, com bom julgamento e estruturado, e técnicas self-debriefing; oral; Eye-Tracking; videoassistido e written debriefing. Conclusões: Sobressaíram-se o método estruturado e a técnica oral com vídeo. Um método não foi superior ao outro, mas eficaz para determinada proposta. Não foram encontrados estudos nacionais. Sugere-se, pesquisas sobre a eficácia dos métodos e técnicas debriefing na enfermagem.
Subject(s)
Humans , Transfer, Psychology , Patient Simulation , Clinical Competence , Feedback, Psychological , Education, Nursing/methods , Eye-Tracking TechnologyABSTRACT
Objective: to compare the clinical performance of nursing students in learning scenarios with and without debriefing in a simulation center. Method: a longitudinal, prospective, interventional, crossover randomized study, with a quantitative approach and before-and-after type, with a population composed of 120 nursing students distributed randomly between experimental and control group. The study phases included theoretical and demonstrative practice on child immunization; first Clinical Performance Test, which served as baseline measurement; randomization; scenarios with debriefing for the experimental group and without debriefing for the control group, according to clinical performance/intervention examination; exchange of groups or crossover; third Clinical Performance Test. Results: debriefing was proven to be effective in improving the performance of the students in the clinical exams, because improvement in the performance of the experimental group both in relation to the baseline measurement examination and in comparison with the control group in the post-intervention performance examination and in the third examination, after crossover (p<0.001). Conclusion: the use of scenarios with debriefing constitutes a strategy facilitating the teaching-learning process in the undergraduate nursing course.
Objetivo: comparar o desempenho clínico de discentes de Enfermagem em cenários de aprendizagem com e sem debriefing em um centro de simulação. Método: estudo longitudinal, prospectivo, de intervenção, randomizado em crossover, de abordagem quantitativa, do tipo antes e depois, com população composta por 120 discentes de Enfermagem dispostos aleatoriamente em grupo experimental e de controle. As fases da pesquisa incluíram ministração de aula teórica e prática demonstrativa sobre imunização infantil; primeiro exame de desempenho clínico, que serviu de medida basal; randomização; realização de cenários com debriefing pelo grupo experimental e sem debriefing pelo grupo-controle; segundo exame de desempenho clínico, de intervenção; troca de grupos ou crossover; terceiro exame de desempenho clínico. Resultados: constatou-se que o debriefing foi eficaz para melhorar a atuação dos alunos nos exames de desempenho clínico, pois houve melhora no desempenho do grupo experimental tanto em relação ao exame de medida basal quanto em comparação com o grupo controle no exame de desempenho pós-intervenção e no terceiro exame, após o crossover (p <0,001). Conclusão: o uso de cenários com debriefing constitui estratégia facilitadora do processo ensino-aprendizagem na graduação em Enfermagem.
Objetivo: comparar el desempeño clínico de discentes de enfermería en escenarios de aprendizaje con y sin debriefing en un centro de simulación. Método: estudio longitudinal, prospectivo, de intervención, aleatorio en crossover, de enfoque cuantitativo, del tipo antes y después, con población compuesta por 120 discentes de enfermería dispuestos aleatoriamente en un grupo experimental y en un grupo control. Las etapas de la investigación incluyeron la impartición de clase teórica y práctica demostrativa acerca de la inmunización infantil; primer examen de desempeño clínico, que sirvió de medida basal; aleatorización; realización de escenarios con debriefing por el grupo experimental y sin debriefing por el grupo control; segundo examen de desempeño clínico, de intervención; grupos cruzados o crossover y, por último, tercer examen de desempeño clínico. Resultados: se constató que el debriefing fue eficaz para mejorar la actuación de los alumnos en los exámenes de desempeño clínico, ya que hubo mejora en el desempeño del grupo experimental tanto respecto al examen de medida basal como en comparación con el grupo control en el examen de desempeño posintervención y en el tercer examen, tras el crossover (p <0,001). Conclusión: el uso de escenarios con debriefing constituye una estrategia facilitadora del proceso enseñanza-aprendizaje durante el grado de enfermería.
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Humans , Male , Female , Adult , Students, Nursing , Problem-Based Learning , Education, Nursing, Graduate , TeachingABSTRACT
@#The importance of non-technical skills among healthcare professionals is gaining a widespread recognition as critical elements complementing the technical skills used for improving patients’ safety. These skills are typically acquired through simulation training, which emerged as an effective way to complement clinical training. Non-technical skills frequently use high-fidelity simulation followed by a facilitated discussion known as debriefing. Debriefing by a skilled facilitator is thought to be essential for effective learning through reflective processes. Unfortunately, evidence to support the elements which contributes towards the effectiveness of debriefing remains sparse. We review the studies where elements of debriefing that have been manipulated and its effectiveness on the acquisition of non-technical skills among healthcare professionals through eight publications across four different databases. Non-technical skills performance improved after manipulated debriefing such as multimedia debrief, self-led debrief or no debrief. Besides, there was no added performance when video recording was added to facilitator-led debriefing. The application of learning theory on specific elements together with the application of selected debriefing models is highly encouraging for effective debriefing.
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Abstract@#Introduction: To develop quality cabin crews, trainings involve simulation-based education (SBE) with structured debriefings – a significant component which plays a critical role in optimising learning outcomes. Previous studies have empirically tested the efficacy of the DIAMOND-structured debriefing model and found significant improvement and retention of the cabin crews’ knowledge and skills. This study was aimed to explore the elements of the DIAMOND-structured debriefing model that have been known to promote the acquisition and retention of knowledge and skills in basic life support (BLS). Methods: A qualitative study was conducted with a random sample of 16 individual cabin crew members who participated in an in-depth interview with 13 open-ended questions for 45 – 60 minutes. The interviews were transcribed and independently analysed using inductive thematic analysis. Results: The codes which have emerged during data analysis were clustered into three themes: (1) Cognitive, with three subthemes: engagement, learning environment, and ability to reflect; (2) Methodology, with three sub-themes: concept of debriefing, techniques of questioning, and additional elements; as well as (3) Psychosocial, with five sub-themes: attitude, self-awareness, relationships, self-confidence, and work culture. Several suggestions have emerged, such as the implementation of the model. Conclusion: The DIAMOND-structured debriefing model was a method to reduce cognitive load, which in turn allowed individuals to organise their knowledge, reflect individually and collectively, as well as structure their ideas. It has showed that the elements has a positive impact on the cabin crews’ acquisition and retention of knowledge and skills which will improve the performance and patient safety
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@#The importance of nontechnical skills among healthcare professionals is gaining widespread recognition as criticalelements complementing technical skills that are used to improve patients’ safety. These skills are typically acquiredthrough simulation training which has emerged as an effective way to complement clinical training. Effective simulationrequires structure and effective debriefing methods to enhance its learning outcome. In previous literature, evidence of theeffectiveness of healthcare simulation was available but studies evaluating debriefing method(s) remain sparse. In thispaper, the effectiveness of debriefing methods in eight studies on the acquisition of nontechnical skills among healthcareprofessionals is reviewed. Articles published from 1st January 2016 across three different databases were referred to. Theresults of the review show a statistically significant improvement in the performance of nontechnical and technical skillsacross different professionals through various methods of debriefing. Nontechnical skills such as teamwork, effectivecommunication, decision-making, and situational awareness have improved significantly. In addition, integration ofrealism in simulation learning has begun to emerge as an effective technique of providing a real world experience.However, there was lack of detailed information on the length and type of debriefing conducted in the studies. Thesemethods clearly require further research since the key to successful simulation learning is through debriefing which isthe heart of simulation.
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La adecuada conducción de situaciones críticas en medicina requiere desarrollar un intrincado proceso cognitivo para generar acciones precisas con estrechos márgenes de error; sin embargo, alcanzar estos objetivos suele ser complejo y representa un desafío insalvable a la educación médica tradicional; en este contexto, la implementación del entrenamiento en simulación para el manejo de recursos en crisis (MRC) ha mostrado ser la herramienta educativa mas efectiva para la adquisición y retención de habilidades en el tiempo. Presentamos una revisión narrativa de los objetivos de aprendizaje que persigue el MRC describiendo la utilidad educativa de la simulación y el proceso de integración de esta metodología al currículo de anestesiología de la Pontificia Universidad Católica de Chile.(AU)
An actuated management of critical situations in medicine requires an intricate cognitive process to generate "on target" actions under narrow margins of error; however, the achievement of this goal is often complex and represents an absolute challenge to traditional medical education. In this context, the use of simulation for crisis resource management (CRM) has proven to be the most effective teaching approach for the acquisition and retention of skills over time. We present a narrative review of the learning objectives pursued by CRM, describing the utility and integration process of this technique into the curriculum of anesthesiology at Pontificia Universidad Católica de Chile.(AU)
Subject(s)
Humans , Male , Female , Education , Data Collection , Disaster Planning , AnesthesiologyABSTRACT
PURPOSE: This was a cross-sectional descriptive study in which an exploration was done of how nursing students perceive debriefing and what they think are the most effective debriefing methods for simulation-based nursing education. METHODS: A convenience sample of 296 sophomore, junior and senior nursing students from three universities and who had attended simulation classes participated in this study. Survey data garnered was analyzed using descriptive analysis and χ² test. RESULTS: A high majority of the participants (98.3%) saw debriefing as “learning from mistakes”, while 62.8% considered it more important than simulations/scenarios. They also perceived debriefing to be effective when they analyzed their colleagues'and their own performances and received feedback. Sophomore students preferred writing a reflection paper as an effective debriefing method compared to junior and senior students. CONCLUSION: The study findings indicate that debriefing is an important component of simulation-based education and should be considered part of the teaching strategies with debriefing methods dependent on themes and scenarios and what is needed to achieve learning outcomes.
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Humans , Education , Education, Nursing , Learning , Methods , Nursing , Patient Simulation , Students, Nursing , WritingABSTRACT
Background: The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm. Aims: We began using live capture to record a new procedure shortly after starting these cases in our institution. This has provided continued assessment and evaluation of live procedures. The goal of this was to improve human factors and situational challenges by review and debriefing. Setting and Design: B‑Line Medical’s LiveCapture video system was used to record successive transcatheter aortic valve replacement (TAVR) procedures in our cardiac catheterization/laboratory. An illustrative case is used to discuss analysis and debriefing of the case using this system. Results and Conclusions: An illustrative case is presented that resulted in long‑term changes to our approach of these cases. The video capture documented rare events during one of our TAVR procedures. Analysis and debriefing led to definitive changes in our practice. While there are hurdles to the use of this technology in every institution, the role for the ongoing use of video capture, analysis, and debriefing may play an important role in the future of patient safety and human factors analysis in the operating environment.
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RESUMO Objetivo: traduzir e validar para língua portuguesa a Debriefing Experience Scale junto a indivíduos que utilizaram a simulação de alta fidelidade na sua formação. Método: estudo do tipo metodológico, exploratório de tradução e validação de instrumento. Para o processo de validação criou-se o evento: III Workshop Brasil - Portugal: Atendimento ao Paciente Crítico. Resultados: participaram 103 enfermeiros. A validade e fidelidade da escala, o padrão de correlação entre as variáveis, o teste de adequação amostral e o teste de esfericidade apresentaram bons resultados. Por não haver nexo entre os agrupamentos estabelecidos na análise fatorial exploratória optou-se por seguir a divisão estabelecida pela versão original. Conclusão: o instrumento foi denominado: Escala de Experiência com o Debriefing. Os resultados constataram boas propriedades psicométricas e um bom potencial de utilização, porém futuros trabalhos contribuirão para consolidar a validade da escala e reforçar o seu potencial de utilização.
RESUMEN Objetivo: traducir y validar para el portugués la Debriefing Experience Scale con individuos que utilizaron la simulación de alta fi delidad en su formación. Método: estudio metodológico, exploratorio de traducción y validación de instrumento. Para el proceso de validación, se organizó el evento III Workshop Brasil – Portugal: Atención del Paciente Crítico. Resultados: Participaron 103 enfermeros. La validez y fidelidad de la escala, el estándar de correlación entre las variables, el test de adecuación muestral y el test de esfericidad expresaron buenos resultados. Por no existir nexo entre los agrupamientos establecidos en el análisis factorial exploratorio, se optó por seguir la división determinada por la versión original. Conclusión: el instrumento fue retitulado como Escala de Experiencia con el Debriefing. Los resultados constataron buenas propiedades psicométricas y buen potencial de utilización, aunque trabajos futuros contribuirán a consolidar la validez de la escala y reforzarán su potencial de utilización.
ABSTRACT Objective: to translate and validate to Portuguese the Debriefing Experience Scale jointly with individuals that used high-fidelity simulation in learning. Method: methodological and exploratory study for an instrument translation and validation. For the validation process, the event "III Workshop Brazil - Portugal: Care Delivery to Critical Patients" was created. Results: 103 nurses attended. Validity and reliability of the scale, the correlation pattern among variables, the sampling adequacy test, and the sphericity test showed good results. Since there was no relationship among the groups established in the exploratory factor analysis, the option was to follow the division established by the original version. Conclusion: the version of the instrument was called Escala de Experiência com o Debriefing. The results showed good psychometric properties and a good potential for use. However, further studies will contribute to consolidate the validity of the scale and strengthen its potential use.