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Debriefing

PROMPT Practical Obstetric Multi-Professional Training For CSIG March 2014 Tina Hewitt, Midwifery Educator. Debriefing. “ The learner must make sense of the event as experienced in terms of their own world ” Fanning & Gaba 2007. “ In an ideal world….

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Debriefing

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  1. PROMPT Practical Obstetric Multi-Professional TrainingFor CSIG March 2014Tina Hewitt, Midwifery Educator

  2. Debriefing “The learner must make sense of the event as experienced in terms of their own world” Fanning & Gaba 2007

  3. “In an ideal world… “learners should be able to compare their own performance with a standard, and be able to diagnose their own strengths and weaknesses.” “A simulated learning environment should permit such self-criticism providing an atmosphere of trust and encouraging excellence” Ker and Bradley, 2010

  4. PROMPT Course Format • Short lectures and drills over one day • At our place using our equipment • Emphasis on teamwork • Emphasis on realism • Emphasis on keeping it “in-house” • Emphasis on staff “owning” course • Emphasis on fun

  5. Stage one: “Pre-briefing” • To ensure that participants are prepared for PROMPT scenarios, here are some examples of informational slides…..

  6. Drill Format • 2 Fully equipped birthing suite rooms • Patients will bleed, fit, scream, wail • Drill will start with a hand over • One team “performing”, one team observing

  7. Drill Format Do • Stay in your usual role • Communicate with patient • Take pulse, BP etc. • Take and send blood • Record notes. Use forms and stickers • Use the phone, emergency buzzer • Order (and get) drugs, blood, IV fluids

  8. Drill Format Don’t • Stick sharp needles into patient • Press the actual emergency button • Do a real vaginal examination!

  9. Performance Anxiety • Everyone is going through the same “performance anxiety” • Adrenaline can improve performance • Laugh and learn • Teamwork takes practice • Strive for perfection but learn from your mistakes • There is no formal assessment!!

  10. The Drills • Eclampsia • Maternal collapse • Postpartum haemorrhage • Shoulder dystocia

  11. Eclampsia - Handover

  12. Eclampsia – The fit

  13. Eclampsia - Teamwork

  14. Eclampsia - Feedback

  15. PROMPT debriefing • Take time to chat in groups about how you felt during scenario • Ask the actress how it felt for her • Ask the participants how it felt for them – what went well, any areas for improvement • Ask the observers to feedback on checklist on teamwork strategies

  16. Debriefing Frameworks Pendleton's rules: • Interviewer says what he or she thinks has been done well • Rest of the group then say what they think has been done well • Interviewer says what he or she thinks could have been done differently • The rest of the group then say what they think could have been done differently

  17. Boston Framework • Emotional “How did it feel?” • Cognitive “ What happened clinically?” • Facilitating learning “Did you all know what was going on?” “Did you know what you were doing?” “I saw this happen, can you help me understand why?” “How can we minimise this happening again?”

  18. Aim for the ideal… • Provide an atmosphere of trust and encourage excellence…..

  19. References • Fanning, R. & Gaba D. (2007) ‘The role of debriefing in simulation-based learning’Simulation in healthcare: the journal for the society of simulation in healthcare. 2 (2) pp 115-125 • Ker, J. & Bradley, P. (2010) ‘Simulation in medical education’Understanding Medical Education: Evidence, Theory and Practice. Edited by T Stanwick. Association for the study of medical education • Boston framework – kindly shared by Maggie Meeks, consultant neonatologist 2014 • Pendletons rules – taken from PROMPT trainers manual 2008

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