Boston Children’s Simulator Program is designed especially to meet the unique needs of each learner. This Curriculum Development Rubric illustrates how our courses are structured to provide the right level of faculty involvement, technology and hands-on learning.
Applying Debriefing to the Range of Simulation Experiences “Signal to Noise”:
Model should meet the needs of the learner.
Pure technical skills, E-learning, Virtual Reality.
Automatic, Haptics, Metrics, Report Cards.
Clinical competencies, Algorithms, Technical aspects
Direct feedback, Mentored teaching, “Pause Principle”
Longitudinal curricula, “Boot camps,” Contextualize training, “Mock codes”
“Plus Delta,” Direct Feedback, (“Pause Principle”)
Crisis resource management, Human factors, Systems analysis
“Molecules,” Open-ended curiosity, Normalization, Learner-centered structure.
Real-life Event Video Capture (Non-SIM)
Human Factors, “Molecules”, “Normalization”, Team-based/learner centered
Debrief focuses on mechanics (clinical actions and consequences)
“what we do and how we do it.” Perfect for clinical skills training.
Debrief focuses on the underlying mental model, assumptions, biases, human factors that guide and dictate our actions, and thus, their consequences -- “why we choose to do what we do”. The findings are typically shared (generalizable) and reach across disciplines, to the larger audience.
Scenario may be interrupted at specific intervals to pause the action and explore learning and decision making directly within clinical context. Important to balance pauses/teaching carefully while maintaining emphasis on experiential learning to most fully leverage the methodology.
Allow the scenario to continue to nurture the organic nature of the relationships. This will provide hearty substrate for “Why” questions.
Faculty remains near-by participant/student to provide facilitation “in-situ”.
Faculty remains disconnected from the action. To allow for greatest vantage point, may include remaining physically in room, but uninvolved in the scenario itself.
Focus on clinical actions and consequences. Remediation is at level of action. “You did A and B happened. Next time modify A to prevent B. OK, let’s try again.”
Focus on underlying mental model and human factors that guide and dictate our actions. Change is produced at level of assumptions, biases to fill performance gaps at level of individual and team. “I observed you did A, I’m concerned because it (may have) led to B (which was not intended), let’s explore (in a safe/supported environment) why you chose A”.
Education contract -- that implicit in these activities and environment, we agree all involved are well-trained, are committed to do their best, and see room for lifelong learning and improvement.”
Novice in training, novice in simulation, novice in debriefing.