June 2013

Deconstructing Debriefing for Simulation-Based Education

Author Affiliations

Author Affiliations: Section of Hospital Medicine and Simulation Center (Dr Edelson) and Center for Professional Practice and Research (Ms LaFond), University of Chicago Medicine, Chicago, Illinois.

JAMA Pediatr. 2013;167(6):586-587. doi:10.1001/jamapediatrics.2013.325

Simulation-based education has become increasingly popular in medicine, especially for rare, complex, and high-risk events such as cardiac resuscitations. Championed by the patient safety movement and supported by technological advances in patient simulators, it is difficult to find training programs today that do not use the technique in some form. However, the implementation of simulation often varies so widely, both across and within institutions, that the findings are difficult to generalize and variables, such as the level of realism, experience of the instructor, and content of the debriefing, are often insufficiently described to replicate. That was not the case with the Examining Pediatric Resuscitation Education Using Simulation and Scripted Debriefing (EXPRESS) trial, an ambitious multicenter, randomized study, the results of which are published in this issue of JAMA Pediatrics.1 In it, the investigators developed a debriefing script for leading Pediatric Advanced Life Support instructors through a postsimulation debrief, covering both medical management and team dynamics, and demonstrated that its use, in the hands of novice instructors, was associated with greater improvements in knowledge and subsequent team leader performance. In addition, the trial demonstrated no benefit to high realism simulator technology. This study affirms the relative importance of debriefing in simulation-based education and establishes a roadmap for generalized dissemination of the technique in a reproducible format.

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