Pre Briefing in Medical Simulation, An Often Overlooked But Important Step

Orientation and pre briefing should be considered as two connected but independent functions of running successful healthcare simulation scenarios. Orientation should be provided as a core introduction to the simulation experience, covering everything from prebriefing, simulated scenario, equipment, manikin, a/v system, simulated medical supplies, process, and debriefing. (Watch our video on How to Create Your Own Orientation Video here). Prebriefing, however, is the pre-simulation scenario phase that re-introduces key equipment and room functionalities, but goes further to “set the stage” for learners, staff, and participants.  Today, we take a look at a new Prebriefing Page which helps to look closer at this crucial step of a successful simulation event.

The term Prebriefing is found extensively in healthcare simulation literature as a component of high fidelity simulation debriefing but its exact meaning varies. The International Nursing Association for Clinical Simulation and Learning showcases pre-briefing in their Facilitation Standard of Best Practice. Usually such briefings take place inside a Sim Lab of a Simulation Center.

INACSL Standard of Best Practice: Facilitation Prebriefing References

• The facilitator has familiarized his/herself with all aspects of the intended simulation-based experience. This includes being familiar with the prebriefing and preparatory resources, the simulation-based experience itself and methods for cueing, and the selected debriefing and evaluation methods.
• Facilitation methods before the simulation-based experience include preparatory activities and a prebriefing to prepare participants for the simulation-based experience.
• Hold a prebriefing at a designated time before the simulation-based experience in which the amount of time may vary depending on the modality and complexity of the simulation-based experience. Minimally, the prebriefing should include:
  • Discussing the detail and expectations of the simulation-based experience. The level of detail revealed depends on the purpose, goal, and/or objectives of the simulation-based experience.
  • Providing participants necessary background information about the simulation-based experience. ○An orientation of participants to the simulation environment, modality for delivery of the simulation, manikins, and the equipment that can be used or not used.
  • Providing clear descriptions of assigned roles for the scenario, whether as a direct care provider, as an observer, or as other assigned role characters.
  • Discussing the process to contact others (as needed) during the simulation, and if appropriate, ways to seek further information.
  • As appropriate, providing time for participants to prepare before the start of the simulation experience.

There are a handful of studies clearly indicate that prebriefing aids learners participating in Simulation Based Learning. The exact nature of these benefits and the best strategies to be used in prebriefing are still under discussion. Indeed, even the name of this component of simulation education has yet to be fully determined, but the new prebriefing page helps us begin to better understand. Below is one of the three examples explored from INACSL’s journal:

Chamberlain, J. (2015, July). Prebriefing in nursing simulation: A concept analysis using Rodger’s methodology. Clinical Simulation in Nursing, 11(7), 318-322.

1. Method: Concept analysis, utilizing Rodger’s evolutionary framework (1989).
2. 23 Nursing articles Reviewed.
3. Common processes identified:
   1. Orientation to manikin and equipment
   2. Completion of preparatory work including knowledge of simulation subject and expected nursing skills
   3. Providing information on debriefing
   4. Creating a safe learning environment
   5. Revealing student expectations.
4. Alternative terminology:
   1. Prescenario, presimulation, briefing, prescenario huddle, presimulation briefing, reflection-before-action.
5. Attributes
   1. Equipment review, behavioral expectations (roles and suspension of disbelief)
6. Synthesis.
   1. Scenario discussion, use of the nursing process and creation of a safe learning environment.
7. Outcomes of prebriefing
   1. Enhanced satisfaction and learning.
8. Key components of Prebriefing:
   1. Orientation
9. Author’s suggested definition:
   1. “Prebriefing is an educator designed phase of simulation that is implemented at a designated time prior to the ‘hands-on’ scenario and includes both orientation tasks and learner engagement activities that will enhance learner satisfaction, participation, and effectiveness of the simulation experience”.

Learn More on the New Prebriefing Page!

About the Author: Dr. Kim Baily

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Dr. Kim Baily, MSN, PhD, RN, CNE has had a passion for healthcare simulation since she pulled her first sim man out of the closet and into the light in 2002. She has been a full-time educator and director of nursing and was responsible for building and implementing two nursing simulation programs at El Camino College and Pasadena City College in Southern California. Dr. Baily is a member of both INACSL and SSH. She serves as a consultant for emerging clinical simulation programs and has previously chaired Southern California Simulation Collaborative, which supports healthcare professionals working in healthcare simulation in both hospitals and academic institutions throughout Southern California. Dr. Baily has taught a variety of nursing and medical simulation-related courses in a variety of forums, such as on-site simulation in healthcare debriefing workshops and online courses. Since retiring from full time teaching, she has written over 100 healthcare simulation educational articles for HealthySimulation.com while traveling around the country via her RV out of California.