Prebriefing

The term Prebriefing is found extensively in healthcare simulation literature as a component of high fidelity simulation debriefing but its exact meaning varies. The Healthcare Simulation Dictionary from the Society for Simulation in Healthcare suggests three different definitions for the term “Pre briefing” along with another two definitions under the term “Brief (Briefing)” and yet another two under the term “Orientation”. 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. A free pre briefing template check list template is provided below!

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.

Download the Printable Infographic and Learn more about the INACSL Standard for Facilitation here.

Healthcare Simulation Dictionary Definitions of Prebriefing (SSH)

1. “An information or orientation session held prior to the start of a simulation activity in which instructions or preparatory information is given to the participants. The purpose of the prebriefing is to set the stage for a scenario, and assist participants in achieving scenario objectives”.
2. “The time used by educators, researchers, facilitators, or staff to plan their roles prior to the simulation; suggested activities in a prebriefing include an orientation to the equipment, environment, manikin, roles, time allotment, objectives, and patient situation. For example: Before starting the simulation session, there is a prebriefing where the equipment and its capabilities are reviewed and they are reminded of the equipment available to them in the room (INACSL, 2013)”.
3. “The collaboration and planning of co-facilitators/co-debriefers prior to the simulation activity”.
4. Learn more about the Healthcare Simulation Dictionary.

Prebriefing Template by HealthySimulation.com

Download the free prebriefing template checklist from HealthySimulation.com, developed by Dr. Kim Baily. This checklist can serve as a reminder about the core functionalities and steps required to ensure for successful simulation activities. Items range from reviewing the code of conduct and confidentiality of simulation scenario, describing roles and expectations of roles to be assigned including confederates, reviewing required video or other audiovisual materials, as well as covers orientation to the manikin, sim room, equipment, supplies, medication administration/scanning equipment, and many more! Have other major areas that one should consider to add for a pre briefing checklist? Leave a comment below to share your best practices!

Download the HealthySim Prebriefing Template PDF Here!

Medical Simulation (hands on scenario component), debriefing reviews and research articles are found extensively in the literature. Less research is found related to prebriefing. Recently, three authors have addressed the concept of pre briefing and have suggested new or revised definitions for the term. This article provides a brief summary of those findings. These studies below clearly indicate that prebriefing aids learners participating in SBL. 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 determined. But then, what’s in a name!

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”.

Page-Cutrara, K. (2015, July). Prebriefing in nursing simulation: A concept analysis. Clinical Simulation in Nursing, 11(7), 335-340.

1. Method: Concept Analysis, utilizing Walker and Avant (2011).
2. 31 Nursing articles reviewed.
3. Common processes identified:
   1. Identifying scenario objectives
   2. Orientation to equipment
   3. Proving information on patient situation
   4. Roles and tasks for learners.
   5. Providing meaningful learning environments
   6. Identifying nursing faculty role:
      1. Leading discussions and answering questions
      2. Conveying information only
      3. Perceiving the meaning of the scenario information
4. Antecedents
   1. Learners current level of learning must be identified.
   2. Information provided to learners prior to simulation must e matched to the learner’s level of understanding.
   3. Prebriefing strategies enable learners to plan patient care.
   4. Learning objectives must be clearly identified.
5. Consequences of concept.
   1. Engagement of students in learning activities.
   2. Improvement of learner performance.
6. Alternative terminology:
   1. Pre briefing, briefing and presimulation
7. Key components of prebriefing:
   1. “Considering the situation, perceiving meaning and anticipating a plan”.
8. Page-Cutrara suggests that prebriefing does not exist in the literature as a structured learning activity however inclusion of the identified attributes of her study would link reflection-before-action, reflection-in-action and reflection-on-action
9. Author proposes enhancing the INACSL definition:
   1. “Prebriefing should include information and activities that are provided to learners in consideration of their level of knowledge, learning needs, and prior experiences; structured for anticipatory reflection and planning; and facilitated by a qualified nursing simulation educator to support decision making, psychological safety, and debriefing activities”.

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McDermott, D. S. (2016, June). The prebriefing concept: A Delphi study of CHSE experts. Clinical Simulation in Nursing, 12(6), 219-227.

1. In this informative article, the author sought to:
   1. Research expert simulation educators’ perspectives on prebriefing in relation to simulation education.
   2. Develop guidelines for debriefing.
2. Method: A three round modified electronic Delphi.
3. Subjects: Certified Healthcare Simulation Educators (CHSE)
4. Benchmark was set a 70% level of consensus
5. Initial qualitative round led to quantitative statements that were then used for remaining two rounds.
6. Panelists reached consensus on 83 statements related to prebriefing. Examples:
   1. Learners should be informed about the type of evaluation (100% consensus)
   2. Budget for faculty development key (100% consensus).
   3. Establish a safe environment (100% consensus).
7. Every panelist agreed that the simulation educator played a crucial role in preparing students for simulation.
   1. Prebriefing should be conducted by educator knowledgeable in simulation education.
8. Study suggests that prebriefing should be considered a three-stage process – planning, briefing, and facilitating.
9. The panelists rated various strategies for preparing learners for simulation.
   1. Not all suggestions reached consensus. Examples:
      1. Viewing a model case of same clinical situation
      2. Skills stations on the same day as simulation.
      3. Using a prequiz
   2. Strategies reaching consensus:
      1. Showing videos prior to simulation day (94%)
      2. Receiving patient report on simulation day (92% consensus)
      3. Review of simulated patient chart (78%)
10. Author’s suggested definition:
11. “Prebriefing is an essential three phase process of planning, briefing, and facilitating that occurs prior to the SBL experience based upon the purpose/learning objectives of the scenario. Prebriefing should be planned and facilitated by a qualified simulation facilitator/educator who is familiar with characteristics of the SBL learner regarding level, program, and profession. Strategies should be employed to promote learner success and confidence in the simulated experience and to encourage reflective practice in debriefing”. (SBL – Simulation Based Learning).

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