It is well known that scenario based simulation education is one of effective experimental learning methods. Debriefing, facilitated or guided reflection in the cycle of experimental learning, is usually led by facilitator. However, “Self” or “instructorless” formative debriefing using a checklist guide is a form of deliberate practice, scripted collaboration, or reflection within a grading framework. Self debriefing can improve efficiency of simulation based instruction, and may be as effective as instructor led debriefing. This study is comparing the pre-post simulation results of personal and team assessment, in “checklist enabled self-debriefing” and “traditional instructor led-debriefing” groups.

   Study design: prospective, controlled educational cohort intervention study.
Subjects:  4th grade medical students and PGY1 residents in Hawaii.
Method:  132 medical students and residents were assigned to 36 clinical teams, each of which completed 4 scenarios in the same sequence. The scenarios are from a course conducted the first month of PGY1 training. We randomly assigned teams to 17 control facilitator led debriefing (F-DB) groups or 19 intervention self debriefing(S-DB) groups on alternating day. Just after having brief overview by the facilitator at the end of each scenario, the S-DB group moved to next room and started self-guided debriefing with checklist. By contrast, the F-DB group continued bed side facilitator-guided debriefing. After the first and last scenario, all learners rated their personal and team performance using global rating score (GRS). Facilitators rated each group’s team performance using GRS.  To ensure the fairness of education, we had didactic lecture about teaching points of every scenarios at the end.

  There is no conflict of interest which needs to be disclosed.

• We sought to provide learners a more effective learning process, through use of a self assisted formative debriefing method, using a checklist. In teamwork and personal assessment, both F-DB and S-DB groups increased pre-post scores.
• The improvement of team performance score was not significantly different between learner’s perspective and facilitator’s perspective. This suggests there is good potential for self-guided formative debriefing compared to facilitator-led debriefing for teamwork performance.
 

1:Ruth M. Fanning, and David M. Gaba. The Role of Debriefing in Simulation-Based Learning: Simulation Healthcare 2007;2:115-125
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