I am working on a concept analysis of prebriefing. It’s a thing you do as part of your research anyhow, and it’s for a class (of course). But I am getting a lot out of it. Much like my last post that talked about my why for this topic, I am now seeing my what– as in what do I want to do in this topic?
I have said before, I want to lay the ground work for a framework for prebriefing, much like there is for debriefing (there are many, in fact). As I review this literature, I am beginning to form an idea, and I need to write it down here. Bear in mind, I am brainstorming, so I am not citing all the great minds who have come before me in this field. But I will say there are a few names who pop up regularly in prebriefing- and as a baby novice researcher, I’d like to connect with at some point:
Donna S. McDermott, PhD, RN, CHSE
Anyhow back to me.
I think that while I might only be aiming to gather survey data about prebriefing (and participant preparation) practices in prelicensure nursing programs, I have a larger goal if I continue in research and in this field. I see that prebriefing is finally getting research attention. And while the INACSL Standards of Best Practice: SimulationSM continue to separate out the concepts of prebriefing and participant preparation, we need to move to a more integrated framework for the activities that take place before the simulation.
Once I collect data about what educators are actually doing in their simulations, I feel I can make the following proposal:
Best Practice is not just what everyone is doing, but sometimes what everyone is doing (especially in a field that is young, yet well established like simulation) might be a good starting point. I think we need to develop a framework that is supported by the experts, learning theories and the reality of practice to structure the elements of prebriefing. It must be more than an orientation or a speech about “safe space” It should be in phases. Each phase addresses a learning domain.
The preparatory phase (cognitive domain) where learners prepare by learning about the the content they will encounter in the simulation. They may review pathophysiology or medications. Or develop concept maps or care plans for their simulated patients. They will be accountable for this prep work. This phase allows the learner to develop a foundation on which to build their learning in the scenario.
The orientation phase (psychomotor) which allows the learners to hands on experiment with equipment, or examine the space the simulation will occur and become familiar with it. In this phase, they may even review skills that may be required in the simulation whether it is auscultation of the mannikin or insertion of a foley catheter. This phase allows the learner to gain some comfort and eliminate distractions so they can focus on their higher level actions and decisions in the scenario.
The prebriefing phase (affective) where the facilitators reviews the expectations, elements of psychological safety, fiction contract, the process of debriefing and other aspects that will provide a safe and respectful learning environment for the participants. This phase is intended to help alleviate the learner’s anxiety going into the simulation and give them a sense of self-efficacy.
Yeah so, that’s my idea.
Jocelyn Ludlow PhD RN CHSE CNE CMSRN 