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Simulation-Based Education: Developing Scenarios and the Importance of Debriefing
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Simulation-Based Education: Developing Scenarios and the Importance of Debriefing



Presented at the 2008 Midwest Human Patient Simulation Network - Chicago, IL

Presented at the 2008 Midwest Human Patient Simulation Network - Chicago, IL



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Simulation-Based Education: Developing Scenarios and the Importance of Debriefing Simulation-Based Education: Developing Scenarios and the Importance of Debriefing Presentation Transcript

  • Simulation-Based Education: Developing Scenarios and the Importance of Debriefing Eric Bauman, PhD, RN, Paramedic Faculty Associate Department of Anesthesiology The University of Wisconsin School of Medicine and Public Health  Bauman 2008 – No duplication or use of this presentation is allowed without proper citation and/or permission of the author
  • Disclosures
    • Health Sciences Educational Consultant
      • Vernon Memorial Healthcare
      • Town of Madison Fire Department
  • Objectives
    • Learn the importance of objective driven scenario development
    • Identify variables that influence situated learning environments
    • Explore the importance of debriefing as it relates to simulation-based education
  • Objective Driven Scenario Development
    • Poorly written or executed scenarios are confusing and frustrating at best
    • Worse - they may instill poor practice habits and allow learners to misinterpret important cues relevant to future practice
  • Picking your objectives
    • What is it you want your students to learn?
    • Who is your audience?
    • Can or should a scenario have different objectives or more than one objective
  • Tease out the objective
    • The high-fidelity learning environment is best suited facilitating behavioral change
      • Do not try to make the scenario excessively hard or tricky
      • Scenarios should be realistic
      • Scenarios should be engaging - promoting interaction
  • The Novice Learner
    • Consider scenarios that focus on just ONE objective
      • Calling for Help
      • Administering a medication
      • Maintaining the airway
      • Assessing the patient
  • Intermediate & Advanced Learner
    • Consider the introduction of events that focus on serial objectives rather than multiple “All-At-Once” events
      • Overly complicated scenarios are difficult to evaluate
        • Unpredictable
        • Often lack fidelity
        • Can be very confusing for learners - and are often not believable
  • Who is your Audience
    • Your scenario and the objectives you hope to introduce must be appropriately situated for your audience
    • Know your audience and situate the clinical back fill and created environment to their world
  • One Scenario - Various Objectives
    • Good Scenarios take time to develop
    • Good scenarios often evolve over time
    • Your Objectives can be audience dependent
      • Same Scenario - different objectives for different audiences
  • Traditional Pedagogy
    • Experiential Learning
      • Kolb’s Learning Cycle
      • Benner: Thinking-in-action
      • Schon: thinking-on-action
      • While these theories predate modern
      • simulation,they do share the common and
      • useful theme of experiential learning
    Kolb’s Learning Cycle
  • Situated Learning Environments Contemporary Theories for Simulation-Based Education
    • Created or Designed Environments
      • Environmental Fidelity Drives Psychological Fidelity
    • Situated Learning Spaces
      • Embodied Experience
    • Created and Situated Spaces are
    • Dynamic & Interactive
    Bauman, 2007; Gee, 2003; Squire, 2006
  • Fidelity
    • Theatrical or contextualized fidelity increases psychological fidelity
    Environmental Fidelity Psychological Fidelity Engagement Meaning
  • Prime your students for success! Simulation to Practice Pathway Bauman, 2007
  • The Power of Simulation
    • Poorly designed and executed simulation may be worse than no simulation at all
    • Good simulation provides a powerful platform experiential learning
    • Simulation-based learning scenarios may rival actual experience
  • Higher Order Simulation
    • Moves Beyond Task Training
    • Engages Behavioral aspects of learning
    Critical Thinking Team Dynamics Leadership Distributed Knowledge
  • Why is the Behavioral gain or change so important when it comes to clinical education?
    • Cognitive knowledge without the ability to apply it in an actual environment is not clinically useful - Simulation allows us to test the waters
    • Even when cognitive knowledge is deficient, it may be possible for students or clinicians to provide safe and effective care if they have the behavioral ability to succeed
  • Debriefing: Learning
    • Debriefing is the reflective part of the learning experience
    • Debriefing facilitates peer-to-peer evaluation
    • The teacher acts as a guide to facilitate learning through reflection
  • Debriefing: Emotional Safety
    • Debriefing allows the facilitator to check in with the participants
    • The debriefing allows the facilitator to set the record straight
      • This is an important wtih simulations that involve High-Risk, Low-Incidence Scenarios that may involve deception or become emotionally charged
  • After Implementation
    Opportunities for change Things that went well +
  • References
    • Bauman, E. (2007). High fidelity simulation in healthcare. Ph.D. dissertation, The University of Wisconsin – Madison, United States. Dissertations & Thesis @ CIC Institutions database. (Publication no. AAT 3294196)
    • Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice . Menlo Park, CA: Addison-Wesley.
    • Gee JP: What video games have to teach us about learning literacy. New York, Palgrave MacMillan, 2003
    • Glavin, R. J., & Maran, N. J. (2003). Integrating human factors into the medical curriculum. Medical Education, 37 (Suppl. 1), 59-64.
    • Merriam, S. B., & Caffarella, R. S. (1999). Learning in adulthood: A compressive guide (2 nd ed.) . San Francisco: Jossey-Bass.
    • Squire, K. (2006). From content to context: Videogames as designed experience. Educational Researcher. 35(8), 19-29.
    • Stewart, L. (1992). Ethical issues in postexperimental and postexperiential debriefing. Simulation and Gaming, 23 (2), 196-211.
    • Thiagarajan, S. (1992). Using games for debriefing. Simulation and Gaming, 23 (2), 161-173.