Cheng Adam, Eppich Walter, Grant Vincent, Sherbino Jonathan, Zendejas Benjamin, Cook David A
Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada.
Med Educ. 2014 Jul;48(7):657-66. doi: 10.1111/medu.12432.
Debriefing is a common feature of technology-enhanced simulation (TES) education. However, evidence for its effectiveness remains unclear. We sought to characterise how debriefing is reported in the TES literature, identify debriefing features that are associated with improved outcomes, and evaluate the effectiveness of debriefing when combined with TES.
We systematically searched databases, including MEDLINE, EMBASE and Scopus, and reviewed previous bibliographies for original comparative studies investigating the use of TES with debriefing in training health care providers. Reviewers, in duplicate, evaluated study quality and abstracted information on instructional design, debriefing and outcomes. Effect sizes (ES) were pooled using random-effects meta-analysis.
From 10 903 potentially eligible studies, we identified 177 studies (11 511 learners) that employed debriefing as part of TES. Key characteristics of debriefing (e.g. duration, educator presence and characteristics, content, structure/method, timing, use of video) were usually incompletely reported. A meta-analysis of four studies demonstrated that video-assisted debriefing has negligible and non-significant effects for time skills (ES = 0.10) compared with non-video-assisted debriefing. Meta-analysis demonstrated non-significant effects in favour of expert modelling with short debriefing in comparison with long debriefing (ES range = 0.21-0.74). Among studies comparing terminal with concurrent debriefing, results were variable depending on outcome measures and the context of training (e.g. medical resuscitation versus technical skills). Eight additional studies revealed insight into the roles of other debriefing-related factors (e.g. multimedia debriefing, learner-led debriefing, debriefing duration, content of debriefing). Among studies that compared simulation plus debriefing with no intervention, pooled ESs were favourable for all outcomes (ES range = 0.28-2.16).
Limited evidence suggests that video-assisted debriefing yields outcomes similar to those of non-video-assisted debriefing. Other debriefing design features show mixed or non-significant results. As debriefing characteristics are usually incompletely reported, future debriefing research should describe all the key debriefing characteristics along with their associated descriptors.
汇报是技术增强模拟（TES）教育的一个常见特点。然而，其有效性的证据仍不明确。我们试图描述TES文献中如何报道汇报情况，确定与改善结果相关的汇报特征，并评估汇报与TES结合时的有效性。
我们系统检索了包括MEDLINE、EMBASE和Scopus在内的数据库，并查阅了以前的参考文献，以寻找在培训医疗保健提供者时使用TES并进行汇报的原始比较研究。评审人员进行了重复评估，评估研究质量，并提取了关于教学设计、汇报和结果的信息。效应量（ES）采用随机效应荟萃分析进行汇总。
从10903项可能符合条件的研究中，我们确定了177项研究（11511名学习者），这些研究将汇报作为TES的一部分。汇报的关键特征（如持续时间、教育者的在场情况和特征、内容、结构/方法、时间安排、视频的使用）通常报告不完整。对四项研究的荟萃分析表明，与非视频辅助汇报相比，视频辅助汇报对时间技能的影响可忽略不计且无统计学意义（ES = 0.10）。荟萃分析表明，与长时间汇报相比，短时间汇报的专家建模效果不显著（ES范围 = 0.21 - 0.74）。在比较终端汇报与同步汇报的研究中，结果因结果测量和培训背景（如医疗复苏与技术技能）而异。另外八项研究揭示了对其他与汇报相关因素（如多媒体汇报、学习者主导的汇报、汇报持续时间、汇报内容）作用的见解。在比较模拟加汇报与无干预的研究中，汇总的ES对所有结果都有利（ES范围 = 0.28 - 2.16）。
有限的证据表明，视频辅助汇报产生的结果与非视频辅助汇报相似。其他汇报设计特征显示出混合或无统计学意义的结果。由于汇报特征通常报告不完整，未来的汇报研究应描述所有关键的汇报特征及其相关描述。
