Alert 2014-new-mullan2

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1) The study aims to compare the efficacy of participant-led debriefing versus facilitator-led debriefing after simulated resuscitations. 2) Medical providers will be randomly assigned to participate in either participant-led or facilitator-led structured debriefings after two simulated resuscitation scenarios. 3) The primary outcomes measured will be changes in clinical and team performance during a second simulated resuscitation, identification and addressing of key performance gaps, and provider satisfaction with the debriefing process.

Education Health & Medicine Technology

Randomized Trial To Compare the Efficacy
of Participant-Led vs
Facilitator-Led Debriefing
Paul Mullan (Children’s National Medical Center)
Adam Cheng (University of Alberta), David Kessler (Columbia)
INSPIRE @ IMSH 2014: San Francisco

International Network for Simulation-based Pediatric Innovation, Research and Education

Background
• Debriefing resuscitations is recommended
– Frontline providers: rarely done (6-27%)1,2,3

• Multiple debriefing models exist
– American Heart Association, 3D Model, Plus/Delta, SHARP,
DISCERN, Debriefing with Good Judgment, Advocacy/Inquiry,...

• Debriefing barriers4:
– Time (90%) & lack of trained facilitators (45%)

Can we get frontline providers to debrief in a consistent, timely, and effective
manner without any training in debriefing?
1Sandhu,

2013. 2Ireland, 2008. 3Hayes, 2007. 4Sandhu, 2013.

International Network for Simulation-based Pediatric Innovation, Research and Education

PICO Question
• P: For medical providers after a simulated resuscitation,
• I: is a participant-led structured debriefing significantly different
• C: than a facilitator-led structured debriefing at
• Outcomes:
1.Improving clinical & behavioral team performance (in a second
simulated resuscitation)
2. Identifying & addressing key performance gaps
3. Achieving provider satisfaction with the debriefing

International Network for Simulation-based Pediatric Innovation, Research and Education

Design
• Multi-center (3-6 institutions?)

• Subjects: pediatric providers (attendings, trainees, & nurses)
– Participant-led: physician team leader + nurse team leader
– Facilitator-led: simulation instructors

• Setting: simulation center or in-situ
• Scenarios: two cardiac arrests in the emergency department
• Debriefing model: standardized form (no video review)1
– Scripted ground rules
– Plus (“What went well?”)
– Delta (“What could have gone better & what would we need to change?”)

• Debriefing training: none
1Mullan,

2013

International Network for Simulation-based Pediatric Innovation, Research and Education

Intervention & Randomization
• Participant-Led Debrief (PLD) or Facilitator-Led Debrief (FLD)
• Randomization into two groups, 5 segments:
– Group A: Arrest #1  PLD  Arrest #2  FLD  Survey
– Group B: Arrest #1  FLD  Arrest #2  PLD  Survey
• Duration:
– 10 minutes per segment
– 1 hour total allotted time

International Network for Simulation-based Pediatric Innovation, Research and Education

Design: Outcomes
• Performance: Blinded video review
• Clinical performance : Clinical Performance Tool (CPT)1
• Teamwork/CRM performance: Team Emergency Assessment Measurement
(TEAM) tool2 or Behavioral Assessment Tool (BAT)3

• Debriefing quality: un-blinded review
•
•

Debriefing Assessment for Simulation in Healthcare (DASH)4; modifications?
Addressing performance gaps identified in the performance measures above

• Qualitative assessment: survey or interviews:
•

Debriefing tool usability, satisfaction, sustainability, safety/harms

• Process measures:
•

Debriefing duration, degree of team participation in debriefing, others…
1Donoghue,

2011, 2Cooper, 2010, 3LeFlore, 4Rudolph, 2007

International Network for Simulation-based Pediatric Innovation, Research and Education

Contact Information
Name:

Paul C. Mullan, MD, MPH

Institution:

Children’s National Medical Center / GW

E-mail:

mullan20@gmail.com

Phone:

+1-713-855-4827

Collaborators: Adam Cheng, MD (University of Alberta)
David Kessler, MD, MSc (Columbia University)

International Network for Simulation-based Pediatric Innovation, Research and Education

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Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction. This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.

ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...

PECB

Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency. Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor. His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects. What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results. Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment. Date: May 29, 2024 Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR ------------------------------------------------------------------------------- Find out more about ISO training and certification services Training: ISO/IEC 27001 Information Security Management System - EN | PECB ISO/IEC 42001 Artificial Intelligence Management System - EN | PECB General Data Protection Regulation (GDPR) - Training Courses - EN | PECB Webinars: https://pecb.com/webinars Article: https://pecb.com/article ------------------------------------------------------------------------------- For more information about PECB: Website: https://pecb.com/ LinkedIn: https://www.linkedin.com/company/pecb/ Facebook: https://www.facebook.com/PECBInternational/ Slideshare: http://www.slideshare.net/PECBCERTIFICATION

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Alert 2014-new-mullan2

1. Randomized Trial To Compare the Efficacy of Participant-Led vs Facilitator-Led Debriefing Paul Mullan (Children’s National Medical Center) Adam Cheng (University of Alberta), David Kessler (Columbia) INSPIRE @ IMSH 2014: San Francisco International Network for Simulation-based Pediatric Innovation, Research and Education

2. Background • Debriefing resuscitations is recommended – Frontline providers: rarely done (6-27%)1,2,3 • Multiple debriefing models exist – American Heart Association, 3D Model, Plus/Delta, SHARP, DISCERN, Debriefing with Good Judgment, Advocacy/Inquiry,... • Debriefing barriers4: – Time (90%) & lack of trained facilitators (45%) Can we get frontline providers to debrief in a consistent, timely, and effective manner without any training in debriefing? 1Sandhu, 2013. 2Ireland, 2008. 3Hayes, 2007. 4Sandhu, 2013. International Network for Simulation-based Pediatric Innovation, Research and Education

3. PICO Question • P: For medical providers after a simulated resuscitation, • I: is a participant-led structured debriefing significantly different • C: than a facilitator-led structured debriefing at • Outcomes: 1.Improving clinical & behavioral team performance (in a second simulated resuscitation) 2. Identifying & addressing key performance gaps 3. Achieving provider satisfaction with the debriefing International Network for Simulation-based Pediatric Innovation, Research and Education

4. Design • Multi-center (3-6 institutions?) • Subjects: pediatric providers (attendings, trainees, & nurses) – Participant-led: physician team leader + nurse team leader – Facilitator-led: simulation instructors • Setting: simulation center or in-situ • Scenarios: two cardiac arrests in the emergency department • Debriefing model: standardized form (no video review)1 – Scripted ground rules – Plus (“What went well?”) – Delta (“What could have gone better & what would we need to change?”) • Debriefing training: none 1Mullan, 2013 International Network for Simulation-based Pediatric Innovation, Research and Education

5. Intervention & Randomization • Participant-Led Debrief (PLD) or Facilitator-Led Debrief (FLD) • Randomization into two groups, 5 segments: – Group A: Arrest #1  PLD  Arrest #2  FLD  Survey – Group B: Arrest #1  FLD  Arrest #2  PLD  Survey • Duration: – 10 minutes per segment – 1 hour total allotted time International Network for Simulation-based Pediatric Innovation, Research and Education

6. Design: Outcomes • Performance: Blinded video review • Clinical performance : Clinical Performance Tool (CPT)1 • Teamwork/CRM performance: Team Emergency Assessment Measurement (TEAM) tool2 or Behavioral Assessment Tool (BAT)3 • Debriefing quality: un-blinded review • • Debriefing Assessment for Simulation in Healthcare (DASH)4; modifications? Addressing performance gaps identified in the performance measures above • Qualitative assessment: survey or interviews: • Debriefing tool usability, satisfaction, sustainability, safety/harms • Process measures: • Debriefing duration, degree of team participation in debriefing, others… 1Donoghue, 2011, 2Cooper, 2010, 3LeFlore, 4Rudolph, 2007 International Network for Simulation-based Pediatric Innovation, Research and Education

7. Contact Information Name: Paul C. Mullan, MD, MPH Institution: Children’s National Medical Center / GW E-mail: mullan20@gmail.com Phone: +1-713-855-4827 Collaborators: Adam Cheng, MD (University of Alberta) David Kessler, MD, MSc (Columbia University) International Network for Simulation-based Pediatric Innovation, Research and Education

Editor's Notes

Good morning everyone, my name is Paul Mullan and I am an emergency physician at Children’s National. Adam, David, and I have brainstormed a new study together titled a “Randomized Trial to Compare the Efficacy of Participant-Led vs Facilitator-Led Debriefing”. We are very excited to hear your constructive feedback15 seconds

Alert 2014-new-mullan2

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