May 13, 2022By Lance Baily

Research: A Prebriefing Guide for Online, Virtual, or Distant Simulation Experiences

Prebriefing is a critical component of healthcare simulation and can be employed prior to online, virtual, or distant simulation experiences. An educator-designed phase of simulation that is implemented at a designated time prior to the ‘hands-on’ scenario, this practice includes both orientation tasks and learner engagement activities that will enhance learner satisfaction, participation, and effectiveness of the simulation experience. During the pandemic, virtual and distant modalities became an emergent means to provide clinical simulation education and training. This article focuses on research published in Clinical Simulation in Nursing that discusses how to prebrief specifically for these modalities.

According to authors, Donna S. McDermott, Ph.D., RN, CHSE, and Jocelyn Ludlow, Ph.D., RN, CHSE, CNE, CMSRN, little research has been conducted on how to prebrief specifically for these modalities. Thus, they chose to employ best practices in simulation design and prebriefing to create a step-by-step guide for preparing learners for multiple types of distant learning in a synchronous or asynchronous learning environment.

From their research, the new Healthcare Simulation Standard of Best Practice Prebriefing: Preparation and Briefing were published for all simulation modalities without regard to one specific type such as virtual simulation. This prebriefing guide for online, virtual, and/or distant simulation experiences is cross-referenced with the new HSSOBP to demonstrate how the standard can be used to support any modality.

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This publication provides a prebriefing guide for online, virtual, and/or distant simulation experiences, and demonstrates a practical application for use of this standard for virtual and online modalities. From this research, the authors share that more research is indicated to augment the prebriefing evidence for distance simulation education

Clinical Simulation in Nursing is an international, peer-reviewed journal published online monthly. Clinical Simulation in Nursing is the official journal of the International Nursing Association for Clinical Simulation & Learning (INACSL) and reflects its mission to advance the science of healthcare simulation.

More About INACSL Standards of Best Practice: Prebriefing | Preparation & Briefing

Prebriefing is an essential part of healthcare simulation and may enhance debriefing and reflection by providing learners with the information and knowledge they need to be fully prepared for clinical simulation education. Further, healthcare simulation prebriefing helps to establish the ground rules for each healthcare simulation-based experience.

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To help provide a standard for prebriefing best practices, the International Nursing Association for Clinical Simulation and Learning (INACSL) released the “Healthcare Simulation Standards of Best Practice Prebriefing: Preparation and Briefing.” This article discusses the organization’s standards of best practice as they relate to prebriefing and preparation.

Before the release of this standard of best practice, the preparation phase of prebriefing was part of the “INACSL Standards of Best Practice: Simulation Design.” Although prebriefing remains a crucial component of clinical simulation design, the practice is independently vital to each healthcare simulation-based experience. Research shows that high-quality simulation requires simulationists and educators who are knowledgeable in pedagogy, which includes the prebriefing phase.

According to the most current literature review by INACSL, prebriefing is referred to as both preparation activities and briefing activities. The organization further explains that, for the purposes of this prebriefing standard, prebriefing refers to the activities prior to the start of the clinical simulation including the preparation and briefing aspects of the simulation-based experience. INACLS further notes that the guidelines for this standard apply to both preparation and briefing, and then each of those components has its own guidelines to ensure they are met.

INACSL divides this standard and the term “prebriefing” into two distinct components (preparation and briefing) and refers to all activities that occur before the clinical simulation scenario. Prebriefing activities are intended to establish a psychologically safe learning environment by:

1) Situating the learners into a common mental model and preparing learners for the educational content of the healthcare simulation-based experience (preparation).
2) Conveying important ground rules for the simulation-based experience (briefing).

Additional Standards of Best Practice

Debriefing: Learning is dependent on the integration of experience and reflection. The evidence is clear that essential learning occurs in the debriefing phase of the simulation-based experience.Reflection is the conscious consideration of the meaning and implication of an action, which includes the assimilation of knowledge, skills, and attitudes with pre-existing knowledge. Reflection can lead to new interpretations by the participants; cognitive reframing is essential to learning. The skills of the debriefer are important to ensure the best possible learning outcomes.

Integration of the debriefing process into simulation-based experiences enhances learning and heightens participant self-awareness and self-efficacy. Debriefing promotes understanding and supports transfer of knowledge, skills, and attitudes with a focus on best practices to promote safe, quality patient care, and development of the participant’s professional role.

Facilitation: Facilitation of a simulation-based experience requires a facilitator who has the education, skill, and ability to guide, support and seek out ways to assist participants in achieving expected outcomes. To maintain skill as an effective facilitator, one must pursue continuing education and assessment of his/her facilitation skills. The selection of a facilitation method is guided by theory and research. Facilitation methods may vary based on the levels of the participants, the simulation objectives, and the context of the simulation-based experience while considering cultural and individual differences that affect participants’ knowledge, skills, attitudes, and behaviors.

Facilitation methods may differ whether the simulation is conducted between faculty and participants interacting in real-time or whether participants interact individually with a computer-assisted simulation. Through the use of facilitation methods, the facilitator’s role is to help participants in their skill development and explore their thought processes in critical thinking, problem-solving, clinical reasoning, clinical judgment, and apply their theoretical knowledge to patient care in a range of health care settings.

More About INACSL

The INACSL is the global leader in transforming practice to improve patient safety through excellence in healthcare simulation. INACSL is a community of practice for healthcare simulation where members can network with clinical simulation leaders, educators, researchers, and industry partners. INACSL also provides the INACSL Standards of Best Practice: Simulation, an evidence-based framework to guide simulation design, implementation, debriefing, evaluation, and research.

Read the Full Prebriefing Guide Research Article

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