High Fidelity Simulation as a Learning Tool: The Staff's Perspective

Objective

To obtain the staff perspective regarding utilization of simulation principles incorporating prebriefing, video recorded simulation, and debriefing with guided reflection and self-evaluation.

Methods

A Likert survey was conducted pre- and post-simulation to obtain impressions before and evaluations after a simulation experience. Fifty-two critical care providers participated with the surveys during seventeen sessions in 2023. Responses were voluntary, results were anonymous. Prebriefing consisted of introduction to the simulator, video recording equipment, the recording process, monitoring equipment, and medical equipment. Objectives were reviewed prior to the simulation. The simulation targeted participant understanding and treatment traumatic brain injury. The debriefing process included video review with the participants utilizing protocols for self-evaluation of success with guided reflection. Compilation of data occurred after all sessions. The data specifically looked at comfort level with video recording, the ability to ask questions and receive constructive feedback, and the ability to analyze learner behaviors during the experience. In addition, learners were asked if they felt the experience was specific to their level and if they deemed it a tool that promoted learning.

Results

The results of the survey showed that the mean scores increased between pre-simulation and post-simulation at all data points. Video recording results demonstrated the most change. The mean score increased from 3.0 to 4.2, with decreased variability in responses after the experience. The mean increased in the ability to ask questions from 3.6 to 4.7, and the report on the constructive feedback mean changed similarly from 3.6 to 4.8. Variability for both was minimal in responses before and after the experience, focused on just two responses. Learners reported a mean score of 3.4 for the ability to analyze their behavior before, and 4.8 after the experience, with limited variability that centered on only two answers. The mean for specificity to the level of practice was reported to be 2.6 before the experience and 4.8 afterward, with responses centered around two responses. The mean for learning promotion increased from 3.5 to 4.8 from the pre-experience to post-experience with initial variability of three responses and post-experience of two responses.

Conclusions

Impressions to pre-Likert surveys were moderate. Concerns were specific to video recordings, especially whom had access. Only the specific participants would have access to the recording; only used for educational purposes, without impact on annual performance appraisal. Participants response to all questions noted overall increase in confidence in the post-simulation Likert. Anecdotal reports included appreciating review of the simulator capabilities and equipment before beginning the simulation and isolation of the videos. Many participants noted behaviors beyond the expectations of the objectives, including pump challenges and screen changes on the ventilator. Most participants reported feeling more comfortable and confident utilizing this educational process, using the simulator, and improving their practice by the end of the experience, evidenced by increased mean scores.

The results of these surveys convey that participants view the prebriefing-simulation-debriefing process as valuable and applicable to their learning and practice. The implication is that simulation can be more than an evaluative tool, but also a learning process, extending additional bridges between knowledge, confidence, and competence. Additional research is needed in the application of video recorded simulation for transport professionals. Future steps include expansion of the simulation program including multiple service lines.