January 9, 2024By Erin Carn Bennett

How to Use Non-Verbal and Body Language Cues in Clinical Simulation Debrief

Over 80% of communication comes from body language, which should be an especially helpful insight for clinical simulation educators. There is a plethora of rich information for healthcare simulation debriefers that can be used within the debrief environment, but the key to unlocking these insights is to know what to look out for. Knowledge of how to become aware and interpret other people through observation of body language can be incredibly useful, especially in clinical simulation scenarios and debrief environments. This article by Erin Carn-Bennett, MSN, RN, will explore common body language cues and how this can be used to maximize the experience within the clinical simulation scenario and debrief environments.

What to Monitor for in Arm and Leg Body Language in Debrief

Crossed arms and legs are a sign of a physical barrier, which suggests the person is not open to what is a topic in the conversation. When smiling and engaging in the conversation occurs alongside crossed arms and legs, this still suggests a closure to the topic being discussed. From a psychology perspective, crossed legs and/or arms are a signal that the person is mentally, emotionally, and physically blocked off from the current topic of conversation. This is not a conscious action, which is why this body language act is so useful to know about.

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As a clinical simulation debriefer, notice which participants display actions with their arms and legs. As a clinical simulation debriefer, this may be a useful gauge of how participants’ emotions and thoughts are in the clinical simulation debrief. Observation of these body language acts can assist in strategizing about which question will be best to be asked next or how the conversation will be guided with the most psychological safety.

What to Assess for With Eye Contact and Body Language

A long-held assumption is that if people are not communicating honestly, there will be an inability to hold eye contact. However, people often hold eye contact for longer than is comfortable. If in a debrief conversation with a person who holds eye contact until this feels uncomfortable, consider that the person may not be honest at that moment. As a debriefer in clinical simulation, this information is informative but doesn’t necessarily need to be questioned or addressed in the debrief circle. Consider if the debrief holds enough psychological safety for participants to be honest. Also, dishonesty may be incredibly complex for any number of reasons. To call this out in the debrief circle is not helpful; trust that the adult learner will reflect on the clinical simulation experience and learn for some time after the completion of the clinical simulation.

Raised eyebrows can be a body language sign of discomfort. These signs of discomfort may include emotions such as surprise, worry, and fear. In a relaxed, casual conversation, there is difficulty in raising the eyebrows. If eyebrows are raised in a debrief conversation when the topic is not expected to cause surprise, worry, or fear, then consider that there may be other factors at play for consideration. Take time to notice this body language act and let this guide the debrief conversation.

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Mirror Body Language is Not a Bad Thing

At times, people may mirror one another’s body language in a conversation. This may be observed through actions such as legs, or heads held the same way. This body language is actually a good sign. To mirror another person’s body language is another unconscious body language act that may occur when there is a connection that has been forged between those involved in the conversation. When there is a mirror of body language, this is a sign that the conversation is well received by the other person. This information can be incredibly useful in a clinical simulation debrief environment, as this shows that the other person is interested in the conversation and that a connection and engagement to the conversation has occurred. This can be a sign as a debriefer that the debrief is headed in a positive direction.

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Posture & Head Nods Can Tell Debriefers A Lot About Power

Posture is an incredibly important part of body language that is worth observation. An erect posture and gestures with the palms facing down is an open and expansive gesture that can signify a sense of being in charge. Psychologically, brains are built to recognize that power is equated by the amount of physical space people take up. This can also be demonstrated by a straight upright posture with shoulders back. This is also a power or authoritative position.

On the opposite end of the posture spectrum, when a person slouches, this takes up less space and, therefore, projects less power into the room. Good posture will command respect and also promote engagement, regardless of whether a leader or not. Posture as a power move in the workplace is a skill that many will learn as a strategy for both confidence and delivery of results. In the debrief and clinical simulation environments, body language related to posture can give valuable information as to how much power and confidence participants have on display or not. This can allow debriefers to tailor questions to reflect the body language on display in regard to the power and confidence that is evident.

If a participant in a clinical simulation debrief is nodding excessively, this can be connected from a body language perspective that the participant is worried about what the debriefer feels about them or that there is doubt in their ability to follow instructions given by others. This can be fairly common in a debrief environment, as when clinical practice is in question, this can be an anxious and insecure time for some clinical simulation participants. As a debriefer, this can be a sign to include more empathy and normalization for this participant’s psychological safety.

Clear Signs of Distress and Discomfort in Debrief

A clenched jaw/neck or a furrowed brow are body language signs of stress. Regardless of the topic, these body language signs are of considerable discomfort. The topic of conversation may delve into an anxious subject, or the participant’s mind may be elsewhere and indicate that there is stress around what is on their mind. Even though, as a debriefer, the cause of distress may not be disclosed, these signs of distress and discomfort are worth noticing and adapting the debrief course as necessary.

Even though one cannot read others’ exact thoughts, there is a lot to learn from body language and, in particular, when body language doesn’t match words. As clinical simulation debriefers, there is an innate desire to assist participants to reflect and make sense of the scenario that has been participated in. Body language is, for the most part, an unconscious act. This article has explored a number of body language acts to be aware of and use as an analysis for where the debrief should proceed next.

Learn More About How to Handle a “Difficult” Participant in Healthcare Simulation!

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