Runnacles Jane, Thomas Libby, Sevdalis Nick, Kneebone Roger, Arora Sonal
Department of Paediatrics, Royal Free London NHS Foundation Trust, London, UK.
Simulated and Interactive Learning Centre, King's College, London, UK.
Postgrad Med J. 2014 Nov;90(1069):613-21. doi: 10.1136/postgradmedj-2012-131676. Epub 2014 Sep 8.
Simulation is an important educational tool to improve medical training and patient safety. Debriefing after simulation is crucial to maximise learning and to translate the lessons learnt to improve real clinical performance, and thus to reduce medical error. Currently there are few tools to improve performance debriefing and learning after simulations of serious paediatric situations.
The purpose of this study was to develop a tool to guide and assess debriefings after simulations of serious paediatric situations, applying the current evidence base and user-based research.
A literature review and semistructured interviews (performed in 2010) to identify important features of a paediatric simulation debriefing. Emergent theme analysis was used to identify key components of an effective debriefing which could be used as a tool for assessing debriefing effectiveness.
The literature review identified 34 relevant studies. Interviews were carried out with 16 paediatricians, both debriefing facilitators and learners. In total, 307 features of a debriefing were identified. These were grouped into eight dimensions representing the key components of a paediatric debriefing: the facilitator's approach, learning environment, engagement of learners, reaction, descriptive reflection, analysis, diagnosis and application. These eight dimensions were used to create a tool, the Objective Structured Assessment of Debriefing (OSAD). Each dimension can be scored on a five-point Likert scale containing descriptions for scores 1, 3 and 5 to serve as anchors and aid scoring.
The study identified the important features of a paediatric simulation debriefing, which were developed into the OSAD tool. OSAD offers a structured approach to paediatric simulation debriefing, and is based on evidence from published literature and views of simulation facilitators and learners. OSAD may be used as a guide or assessment tool to improve the quality of debriefing after paediatric simulation.
模拟是改善医学培训和患者安全的重要教育工具。模拟后的总结汇报对于最大化学习效果以及将所学经验应用于改善实际临床操作从而减少医疗差错至关重要。目前，针对严重儿科情况模拟后的表现总结汇报及学习提高的工具很少。
本研究的目的是运用当前的证据基础和基于用户的研究，开发一种工具，用于指导和评估严重儿科情况模拟后的总结汇报。
进行文献综述和半结构化访谈（于2010年开展），以确定儿科模拟总结汇报的重要特征。采用主题分析来确定有效总结汇报的关键组成部分，这些部分可作为评估总结汇报有效性的工具。
文献综述确定了34项相关研究。对16名儿科医生进行了访谈，包括总结汇报引导者和学习者。总共确定了307个总结汇报的特征。这些特征被归为八个维度，代表儿科总结汇报的关键组成部分：引导者的方法、学习环境、学习者的参与度、反应、描述性反思、分析、诊断和应用。这八个维度被用于创建一个工具，即总结汇报客观结构化评估（OSAD）。每个维度可根据五点李克特量表评分，量表包含1、3和5分的描述作为锚点并辅助评分。
该研究确定了儿科模拟总结汇报的重要特征，并将其开发成OSAD工具。OSAD为儿科模拟总结汇报提供了一种结构化方法，且基于已发表文献的证据以及模拟引导者和学习者的观点。OSAD可作为一种指导或评估工具，以提高儿科模拟后总结汇报的质量。
