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- Karlgren, K, et al.
(author)
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Eye-opening facilitator behaviours: an Interaction Analysis of facilitator behaviours that advance debriefings
- 2020
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In: BMJ simulation & technology enhanced learning. - : BMJ. - 2056-6697. ; 6:4, s. 220-228
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Journal article (peer-reviewed)abstract
- Analyses of simulation performance taking place during postsimulation debriefings have been described as iterating through phases of unawareness of problems, identifying problems, explaining the problems and suggesting alternative strategies or solutions to manage the problems. However, little is known about the mechanisms that contribute to shifting from one such phase to the subsequent one. The aim was to study which kinds of facilitator interactions contribute to advancing the participants’ analyses during video-assisted postsimulation debriefing.MethodsSuccessful facilitator behaviours were analysed by performing an Interaction-Analytic case study, a method for video analysis with roots in ethnography. Video data were collected from simulation courses involving medical and midwifery students facilitated by highly experienced facilitators (6–18 years, two paediatricians and one midwife) and analysed using the Transana software. A total of 110 successful facilitator interventions were observed in four video-assisted debriefings and 94 of these were included in the analysis. As a starting point, the participants’ discussions were first analysed using the phases of a previously described framework, uPEA (unawareness (u), problem identification (P), explanation (E) and alternative strategies/solutions (A)). Facilitator interventions immediately preceding each shift from one phase to the next were thereafter scrutinised in detail.ResultsFifteen recurring facilitator behaviours preceding successful shifts to higher uPEA levels were identified. While there was some overlap, most of the identified facilitator interventions were observed during specific phases of the debriefings. The most salient facilitator interventions preceding shifts to subsequent uPEA levels were respectively: use of video recordings to draw attention to problems (P), questions about opinions and rationales to encourage explanations (E) and dramatising hypothetical scenarios to encourage alternative strategies (A).ConclusionsThis study contributes to the understanding of how certain facilitator behaviours can contribute to the participants’ analyses of simulation performance during specific phases of video-assisted debriefing.
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| 2. |
- MacKinnon, RJ, et al.
(author)
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Self-motivated learning with gamification improves infant CPR performance, a randomised controlled trial
- 2015
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In: BMJ simulation & technology enhanced learning. - : BMJ. - 2056-6697. ; 1:3, s. 71-76
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Journal article (peer-reviewed)abstract
- Effective paediatric basic life support improves survival and outcomes. Current cardiopulmonary resuscitation (CPR) training involves 4-yearly courses plus annual updates. Skills degrade by 3–6 months. No method has been described to motivate frequent and persistent CPR practice. To achieve this, we explored the use of competition and a leaderboard, as a gamification technique, on a CPR training feedback device, to increase CPR usage and performance.ObjectiveTo assess whether self-motivated CPR training with integrated CPR feedback improves quality of infant CPR over time, in comparison to no refresher CPR training.DesignRandomised controlled trial (RCT) to assess the effect of self-motivated manikin-based learning on infant CPR skills over time.SettingA UK tertiary children's hospital.Participants171 healthcare professionals randomly assigned to self-motivated CPR training (n=90) or no refresher CPR training (n=81) and followed for 26 weeks.InterventionThe intervention comprised 24 h a day access to a CPR training feedback device and anonymous leaderboard. The CPR training feedback device calculated a compression score based on rate, depth, hand position and release and a ventilation score derived from rate and volume.Main outcome measureThe outcome measure was Infant CPR technical skill performance score as defined by the mean of the cardiac compressions and ventilations scores, provided by the CPR training feedback device software. The primary analysis considered change in score from baseline to 6 months.ResultsOverall, the control group showed little change in their scores (median 0, IQR −7.00–5.00) from baseline to 6 months, while the intervention group had a slight median increase of 0.50, IQR 0.00–33.50. The two groups were highly significantly different in their changes (p<0.001).ConclusionsA significant effect on CPR performance was demonstrated by access to self-motivated refresher CPR training, a competitive leaderboard and a CPR training feedback device.
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| 3. |
- Sheshadri, Veena, et al.
(author)
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Simulation capacity building in rural Indian hospitals : A 1-year follow-up qualitative analysis
- 2021
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In: BMJ Simulation and Technology Enhanced Learning. - : BMJ. - 2056-6697. ; 7:3, s. 140-145
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Journal article (peer-reviewed)abstract
- Introduction: The benefits of simulation-based medical training are well described. The most effective way to plant and scale simulation training in rural locations remains undescribed. We sought to plant simulation training programmes for anaesthesia emergencies in two rural Indian hospitals. Methods: Two Indian consultant anaesthetists without experience in medical simulation underwent a 3-day course at the Boston Children's Hospital's (BCH) Simulator Program. They returned to their institutions and launched simulation programmes with an airway manikin and mock patient monitor. The 1-year experience was evaluated using individual, in-depth interviews of simulation facilitators. Three staff members (responsible for facilitating medical simulations over the prior year) at two rural hospitals in India were interviewed. None attended the BCH training; instead, they received on-the-job training from the BCH-trained, consultant anaesthetist colleagues. Results: Successes included organisational adoption of simulation training with exercises 1 year after the initial BCH-training, increased interdisciplinary teamwork and improved clinical competency in managing emergencies. Barriers to effective, local implementation of simulation programmes fell into three categories: time required to run simulations, fixed and rigid roles, and variable resources. Thematic improvement requests were for standardised resources to help train simulation facilitators and demonstrate to participants a well-run simulation, in addition to context-sensitive scenarios. Conclusion: An in-person training of simulation facilitators to promote medical simulation programmes in rural hospitals produced ongoing simulation programmes 1 year later. In order to make these programmes sustainable, however, increased investment in developing simulation facilitators is required. In particular, simulation facilitators must be prepared to formally train other simulation facilitators, too.
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