When it comes to practicing clinical and cultural competencies, Standardized Patient (SP) scenarios can provide an effective, engaging learning experience for students and healthcare providers completing CMEs. The simulation itself lets learners put their competencies to the test and gain invaluable experience.
Afterward, the simulation debrief offers a crucial chance for reflection and feedback, supporting learners in their growth and development.
When establishing an SP program at your institution or incorporating an SP activity into your curriculum, these debriefing strategies and best practices can help ensure learners get the most value from their experience.
1. Set Clear Learning Objectives
Identifying the learning objectives before starting any educational scenario or simulation is critical. These objectives serve as a roadmap for facilitators and participants, guiding the direction and focus of the simulation and debrief.
Clear objectives ensure that all parties understand what is expected and what they should aim to achieve. When the simulation is complete, the previously identified criteria can help keep the debriefing on track to relevant subjects and ensure that the primary educational goals are met.
2. Decide on a Feedback Approach
While genuine and free-flowing conversations have their place and merits, facilitators can best serve their learners by choosing an established model or framework to guide their debriefing. Doing so adds consistency and structure to the session and keeps the discussion on track.
Here are a few reliable models:
Three-Phase Technique
This technique includes three phases:
- Reaction: Defusing emotions and capturing initial reactions.
- Analysis: Understanding actions and decisions made during the simulation.
- Summary: Highlighting lessons learned.
Bubble Briefs
The Bubble brief framework focuses on a scenario’s relevant non-technical skills and human factors. This model includes eight components, each highlighting interpersonal skills such as leadership, teamwork, communication, situational awareness, and decision-making.
The specific scenario and learning objectives should determine which “bubbles” (i.e., skills or factors) are addressed in a debrief. Each component provides suggested open-ended questions to steer the debrief. For example:
- What were some challenges you faced working independently, and how did you address them?
- Were there any internal conflicts or doubts? How did you resolve them?
- How did you manage stress during the scenario?
SHARP
The SHARP model is succinct and particularly useful when time is limited. It stands for:
- Set learning objectives you aim to achieve during the scenario.
- How did It go? Note both successes and challenges.
- Address concerns, providing a space to express thoughts and feelings about them.
- Review learning points and lessons gained from the scenario.
- Plan ahead, setting goals to enhance performance in similar situations.Foster a Safe Learning Space
Debriefings can often be emotionally charged as participants reflect on their performance during the simulation. Creating a psychologically safe learning environment is critical for an effective learning and debriefing experience. Honest reflection and discussion maximize growth potential and directly result from an atmosphere of trust and openness between participants.
Ways to promote a safe learning space include:
- Adopting The Basic Assumption™: All participants should assume that every learner is intelligent, capable, and committed to improvement.
- Embracing Mistakes: Understand that mistakes are part of learning.
- Encouraging Earnest Practice: Allow learners to practice without fear of judgment from instructors or harm to patients.
4. Use Open-Ended Questions
Open-ended questions are crucial for fostering self-reflection during and after a debrief. A thought-provoking line of questioning can encourage participants to think deeply about their actions and decisions, leading to more meaningful insights and better outcomes.
Questions can also promote a deeper understanding of cultural differences between provider and patient, which can impact medical decision-making and interpersonal interactions.
Some examples of questions that will prompt reflection include:
- What were your initial thoughts during the simulation?
- Can you explain why you made that decision?
- What information or event during the simulation gave you pause or caught you off-guard?
- Can you describe how your patient’s perspective or experience differs from your own?
5. Allow for Pauses
Silence can be powerful during debriefing sessions. Intentionally pausing allows participants to reflect, analyze, and formulate their thoughts. This reflective space can lead to deeper understanding and more thoughtful participation.
As learners can often be their own harshest critics, this self-reflection is essential to their personal and professional growth. Allow learners ample time for reflection so they can identify personally meaningful areas for improvement and goals for their future practice.
6. Include Feedback from Standardized Patients
Debriefing after a simulation generally only involves the learner and faculty. Beyond a basic survey from the SP, it’s not uncommon for learners to get very little direct feedback from the actual standardized patient they interacted with.
When vetting your SP partner program options or implementing a program of your own, consider soliciting more in-depth feedback or allowing several minutes of free-flowing conversation between the learner and SP after the simulation. This touchpoint, almost a miniature debrief of its own, encourages participants to reflect on the human and cultural aspects of the interaction before the clinical debrief with faculty.
We believe learners can find immense value in verbal feedback from the SP, especially when it comes to the more human aspects of providing care.
While this is not true for all SP platforms, Simclusive SPs are trained professionals with lived experience who can accurately and earnestly represent their culture, population, and disability status. At Simclusive, we value the integrity of our scenarios and the learning experience of our participants.
Our SPs are carefully selected to reflect the patient population at large, including those from often marginalized groups–like LGBTQ+ and BIPOC communities–and minority cultural or language groups. They receive extensive training in delivering effective feedback and guiding participants through self-reflective analysis that supports behavioral change.
Faculty, on the other hand, may not be able to provide this type of authentic cultural feedback during the debrief.
7. Provide Recordings
Memory alone can be unreliable, especially during a high-stress encounter like a learning simulation. Provide learners with a video or audio recording of their session and the subsequent debrief. Recordings allow participants to revisit their performance and feedback as often as needed.
Learners with a copy to reference and reflect on later can better reconnect to the material and simulation experience, further supporting their professional development.
8. Implement a Collaborative Review Structure
Why stop with one feedback source? Collaborative reviews foster a rich and comprehensive debriefing experience. When more than one facilitator or instructor is involved, the debriefing process can offer multiple perspectives from a more diverse pool of personal and professional experiences.
The key to successful debriefing is not just the structure used or the questions asked but also the reliability and depth of the feedback provided.
At Simclusive, our scenarios are led by SPs with lived experience, adding additional layers of authenticity and relevance that are difficult to achieve through traditional role playing alone. Reach out to an Educational Specialist today and learn how our program can elevate your training!
