Dickinson Karen J, Kimbrough Mary Katherine, Young Amanda, Goddard Clayton, Urban Kelly, Kalkwarf Kyle J, Bhavaraju Avi, Margolick Joseph
Office of Interprofessional Education, University of Arkansas for Medical Sciences, Little Rock, AR USA.
Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, USA.
Global Surg Educ. 2022;1(1):11. doi: 10.1007/s44186-022-00013-4. Epub 2022 Mar 28.
Psychological safety is key to effective debriefing and learning. The COVID-19 pandemic necessitated rapid adaption of simulation events to virtual/hybrid platforms. We sought to determine the effect of utilizing the Community of Inquiry framework (CoI) for debriefing virtually connecting interprofessional learner teams on the psychological safety experienced during trauma simulations.
General surgery (GSR), emergency medicine (EMR) residents, trauma nurses/nurse practitioners and medical students participated in multiple simulation events designed to improve teamwork and leadership skills. Pre-course materials were provided before the event for learners to prepare. Briefings delineating expectations emphasized importance of and strategies employed to achieve psychological safety. Four unique clinical scenarios were run for each simulation event, with a debrief after each scenario. Virtual team-to-team debriefings were structured using the Community of Inquiry (CoI) conceptual framework. All learners completed pre-/post-assessments utilizing Inter-professional Collaborative Competencies Attainment Survey (ICCAS).
Twenty-five learners participated (13 GSR, 5 EMR, 3 medical students, 2 trauma APRNs and 2 trauma RNs). Learner assessment found 88% (22) "agreed"/"strongly agreed" that virtual team-to-team debriefing had social, cognitive and educator presence per the CoI domains. However, one GSR and two nurse learners "strongly disagreed" with these statements. Most learners felt the debriefing was effective and safe. All participants "strongly agreed"/"agreed" the simulation achieved ICCAS competencies.
Debriefings utilizing a virtual platform are challenging with multiple barriers to ensuring psychological safety and efficacy. By structuring debriefings using the CoI framework we demonstrate they can be effective for most learners. However, educators should recognize the implications of social identity theory, particularly the effects of hierarchy, on comfort level of learners. Developing strategies to optimize virtual simulation learning environments is essential as this valuable pedagogy persists during and beyond the COVID-19 pandemic.
心理安全是有效进行总结汇报和学习的关键。新冠疫情使得模拟活动需要迅速适应虚拟/混合平台。我们试图确定利用探究社区框架（CoI）对跨专业学习者团队进行虚拟连接的创伤模拟总结汇报，对所体验到的心理安全的影响。
普通外科（GSR）、急诊医学（EMR）住院医师、创伤护士/执业护士和医学生参与了旨在提高团队协作和领导技能的多次模拟活动。在活动前为学习者提供了课前材料以便准备。明确期望的简报强调了实现心理安全的重要性和所采用的策略。每次模拟活动运行四个独特的临床场景，每个场景后进行总结汇报。虚拟团队间的总结汇报采用探究社区（CoI）概念框架进行组织。所有学习者使用跨专业协作能力达成调查（ICCAS）完成课前/课后评估。
25名学习者参与（13名GSR、5名EMR、3名医学生、2名创伤高级实践注册护士和2名创伤护士）。学习者评估发现，88%（22名）“同意”/“强烈同意”虚拟团队间的总结汇报在CoI领域具有社会、认知和教育者在场感。然而，一名GSR和两名护士学习者“强烈不同意”这些表述。大多数学习者认为总结汇报是有效且安全的。所有参与者“强烈同意”/“同意”模拟活动实现了ICCAS能力。
利用虚拟平台进行总结汇报具有挑战性，存在确保心理安全和有效性的多重障碍。通过采用CoI框架组织总结汇报，我们证明了它们对大多数学习者是有效的。然而，教育者应认识到社会认同理论的影响，尤其是等级制度对学习者舒适度的影响。随着这种有价值的教学方法在新冠疫情期间及之后持续存在，制定优化虚拟模拟学习环境的策略至关重要。
