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JournalISSN: 1559-2332

Simulation in healthcare : journal of the Society for Simulation in Healthcare 

Lippincott Williams & Wilkins
About: Simulation in healthcare : journal of the Society for Simulation in Healthcare is an academic journal. The journal publishes majorly in the area(s): Debriefing & Teamwork. It has an ISSN identifier of 1559-2332. Over the lifetime, 1266 publications have been published receiving 23152 citations.


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Journal ArticleDOI
TL;DR: The aim of this paper is to critically review what is felt to be important about the role of debriefing in the field of simulation-based learning, how it has come about and developed over time, and the different styles or approaches that are used and how effective the process is.
Abstract: The aim of this paper is to critically review what is felt to be important about the role of debriefing in the field of simulation-based learning, how it has come about and developed over time, and the different styles or approaches that are used and how effective the process is. A recent systematic

1,351 citations

Journal ArticleDOI
TL;DR: The approach helps instructors manage the apparent tension between sharing critical, evaluative judgments while maintaining a trusting relationship with trainees and draws on theory and empirical findings from a 35-year research program in the behavioral sciences on how to improve professional effectiveness through “reflective practice.”
Abstract: We report on our experience with an approach to debriefing that emphasizes disclosing instructors’ judgments and eliciting trainees’ assumptions about the situation and their reasons for acting as they did. To highlight the importance of instructors disclosing their judgment skillfully, we call the approach “debriefing with good judgment.” The approach draws on theory and empirical findings from a 35-year research program in the behavioral sciences on how to improve professional effectiveness through “reflective practice.” This approach specifies a rigorous self-reflection process that helps trainees recognize and resolve pressing clinical and behavioral dilemmas raised by the simulation and the judgment of the instructor. The “debriefing with good judgment” approach is comprised of three elements. The first element is a conceptual model drawn from cognitive science. It stipulates that the trainees’ “frames”—comprised of such things as knowledge, assumptions, and feelings— drive their actions. The actions, in turn, produce clinical results in a scenario. By uncovering the trainee’s internal frame, the instructor can help the learner reframe internal assumptions and feelings and take action to achieve better results in the future. The second element is a stance of genuine curiosity about the trainee’s frames. Presuming that the trainee’s actions are an inevitable result of their frames, the instructor’s job is that of a “cognitive detective” who tries to discover, through inquiry, what those frames are. The instructor establishes a “stance of curiosity” in which the trainees’ mistakes are puzzles to be solved rather than simply erroneous. Finally, the approach includes a conversational technique designed to bring the judgment of the instructor and the frames of the trainee to light. The technique pairs advocacy and inquiry. Advocacy is a type of speech that includes an objective observation about and subjective judgment of the trainees’ actions. Inquiry is a genuinely curious question that attempts to illuminate the trainee’s frame in relation to the action described in the instructor’s advocacy. We find that the approach helps instructors manage the apparent tension between sharing critical, evaluative judgments while maintaining a trusting relationship with trainees. (Simul Healthcare 2006;1: 49‐55)

807 citations

Journal ArticleDOI
TL;DR: The PEARLS framework and debriefing script fill a need for many health care educators learning to facilitate debriefings in simulation-based education and offers a structured framework adaptable fordebriefing simulations with a variety in goals.
Abstract: Summary StatementWe describe an integrated conceptual framework for a blended approach to debriefing called PEARLS [Promoting Excellence And Reflective Learning in Simulation]. We provide a rationale for scripted debriefing and introduce a PEARLS debriefing tool designed to facilitate implementation

604 citations

Journal ArticleDOI
TL;DR: It is argued that certain practices create a psychologically safe context for learning, a so-called safe container, that allows learners to engage actively in simulation plus debriefings despite possible disruptions to that engagement such as unrealistic aspects of the simulation.
Abstract: Summary statement: In the absence of theoretical or empirical agreement on how to establish and maintain engagement in instructor-led health care simulation debriefings, we organize a set of promising practices we have identified in closely related fields and our own work. We argue that certain practices create a psychologically safe context for learning, a so-called safe container. Establishing a safe container, in turn, allows learners to engage actively in simulation plus debriefings despite possible disruptions to that engagement such as unrealistic aspects of the simulation, potential threats to their professional identity, or frank discussion of mistakes. Establishing a psychologically safe context includes the practices of (1) clarifying expectations, (2) establishing a "fiction contract" with participants, (3) attending to logistic details, and (4) declaring and enacting a commitment to respecting learners and concern for their psychological safety. As instructors collaborate with learners to perform these practices, consistency between what instructors say and do may also impact learners' engagement.

567 citations

Journal ArticleDOI
TL;DR: Mannequin-based simulations that try to recreate clinical cases to address issues of crisis resource management, and the concepts also apply or can be adapted to other forms of immersive or simulation techniques are introduced.
Abstract: Simulation is a complex social endeavor, in which human beings interact with each other, a simulator, and other technical devices. The goal-oriented use for education, training, and research depends on an improved conceptual clarity about simulation realism and related terms. The article introduces concepts into medical simulation that help to clarify potential problems during simulation and foster its goal-oriented use. The three modes of thinking about reality by Uwe Laucken help in differentiating different aspects of simulation realism (physical, semantical, phenomenal). Erving Goffman's concepts of primary frames and modulations allow for analyzing relationships between clinical cases and simulation scenarios. The as-if concept by Hans Vaihinger further qualifies the differences between both clinical and simulators settings and what is important when helping participants engage in simulation. These concepts help to take the social character of simulation into account when designing and conducting scenarios. The concepts allow for improved matching of simulation realism with desired outcomes. It is not uniformly the case that more (physical) realism means better attainment of educational goals. Although the article concentrates on mannequin-based simulations that try to recreate clinical cases to address issues of crisis resource management, the concepts also apply or can be adapted to other forms of immersive or simulation techniques.

467 citations

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Performance
Metrics
No. of papers from the Journal in previous years
YearPapers
202151
202091
201960
201859
201758
201669