Why conduct a pre-briefing in simulation?
Healthcare simulation pre-briefing is a crucial preparatory phase that sets the stage for effective learning and performance during simulated clinical scenarios. It serves as an essential component of the simulation experience, providing participants with the necessary context, expectations, and guidelines to optimise their engagement and learning outcomes.
During pre-briefing, facilitators introduce participants to the simulation environment, equipment, and objectives. They outline the scenario’s context, including patient information, clinical setting, and any specific roles or responsibilities assigned to participants. This information helps learners mentally prepare for the simulated experience and understand the relevance of the scenario to real-world clinical practice.
Moreover, pre-briefing fosters a supportive learning environment by establishing ground rules, emphasising the importance of teamwork, communication, and professionalism. By setting clear expectations for behaviour and participation, pre-briefing creates a sense of psychological safety, where participants feel comfortable taking risks, asking questions, and engaging in open dialogue.
Additionally, pre-briefing provides an opportunity for participants to clarify any uncertainties, ask questions, and share their expectations or concerns about the simulation. This open communication ensures that participants are fully informed and mentally prepared for the learning experience ahead, enhancing their readiness to actively engage and participate.
Furthermore, pre-briefing lays the groundwork for effective debriefing by introducing participants to the reflective learning process. Facilitators may discuss the objectives of the debriefing session, explain its purpose in promoting self-reflection and skill improvement, and encourage participants to actively participate in the post-simulation discussion.
In summary, healthcare simulation pre-briefing is a critical component that prepares participants for the simulated experience, fosters a supportive learning environment, and sets the stage for effective debriefing and skill enhancement. By investing time and effort into pre-briefing activities, educators can optimise the educational impact of healthcare simulation and enhance the competence and confidence of healthcare professionals.
The Pre-brief
The simulations are designed to provide you with a safe educational environment in which to experience a series of clinical activities that may challenge you and/or the team.
To explore the Organisational, team or individual factors that may enhance or challenge optimal, safe patient care in the clinical setting. This may be through the use of technical or non-technical (Human Factors) elements.
To develop the relationships between the inter-professional teams, individuals focusing on the skills and contributions of others and how they may dovetail into the working environment and complement patient care.
To explore latent threats within the clinical environment to ensure efficient and safe patient care. Examining both local and national policies and procedures, contributing to the risk management strategy of the Trust.
The Simulation activity
The Simulation activity has been designed to be as realistic as possible. With this in mind please note the follow recommendations:
Wear the uniform/clothing you would wear normally for your clinical shift – This allows for some immersion into the scenario and for some professions allows for identification of their role, it also allows you to feel more comfortable during the scenarios.
Treat the Simulation as a real situation, as much as possible – It can be difficult at times to replicate everything as it would be within the clinical setting, however, we do try to create a immersive environment to increase the fidelity of the activity, part of this is your ability to treat the patient/casualty as if they were real.
Please do not make up ‘activities or results’ – If your response to the patient/casualty’s condition would be to intubate, then please do intubate. If it would be to administer drugs, then please do administer the necessary medication. There may be some obvious areas where this may not be possible, but please note that any exception to this will be pointed out by the faculty during the event/pre-briefing.
Please take an active role – Simulation is a learning event that will work best in the inter-professional environment, if the simulation is taking place ‘in-situ’ (within the clinical area) please get involved if you can.
Simulation is NOT an assessment of skills/knowledge – Unless specifically designed as such, simulation is not an assessment, it is an opportunity to put into practice what you may have learnt or already be an expert in. The learning outcomes of the clinical faculty will guide the simulation event which may utilise your skills in line with your clinical role, this may at times challenge some individuals in order to encourage lateral thinking and draw out specific skills. It is NOT meant to be the ‘worst day ever’.
Simulation can, however, be used for assessments, but a specific set of outcomes and conduct is required to ensure that this remains a ‘safe environment’
Use any consumables you would normally use – For in-situ simulation, unless using consumables will leave the department/service short, please use any equipment you need to in order to carry out the actions to treat the patient/casualty. If it has been identified that this may be an issue the clinical faculty may offer you a simulated alternative.
Systems & Processes – Simulation is often used to test the systems and processes of the Organisation, and has been found to be extremely useful to identify latent threats and system errors.
A latent threat is something that has not yet been identified, but may have looked ok when designed. It isnt until it is actually used properly that issues are identified that will impact its planned usage, often related to patient safety. Our expert team have conducted many latent threat testing within Trusts, with changes made immediately to processes, equipment placement and education to enhance patient care.
Your participation in the debriefing process & After Action Report (AAR) is vital to ensure we are able to build a robust and comprehensive response.
Simulation Process
Pre-brief – This is allows the participants to understand the scenario and at what stage we will be entering it. It may be right from the start, it may be from a specific point depending on the learning outcomes.
Simulation – The execution of the simulation will follow the outline here and will dovetail into the SSH Healthcare Simulationists Code of Ethics
Debrief – The debrief is a key element of simulation, this is the opportunity to unpack the event and explore the varying activities that may have taken place, and to look at the factors that took place during the progression of the scenario. Non participants in the activity should ensure that they can view the event safely so that they can play an active role within the debriefing component.
Debriefing timings – There are no hard rules about the length of each stage, however, it is generally recognised that the Debriefing should be as long as the simulation itself, with many finding that it can take double the amount of time. This cannot be rushed and should allow for all participants, non participants and faculty to explore their views.
Debriefing hierarchy – Within the debrief it is important to understand that there is a flattened hierachy in place, this creates a safe space for the learner to explore the components of the simulation in a non-judgmental way, the language used will be con-confrontational and non-judgmental and all all learners to explore their (and others) actions.
Previous Experience in Simulation – Your experience of simulation is valuable to us, both positive and not so positive experiences informs your views of how we learn. At King’s Academy Simulation Service, we welcome feedback and expect evaluations of ALL simulation activities that we are involved in.
This allows us to form an idea of areas that we do well and areas that we can do differently. The service lead reads ALL feedback submitted and where necessary/able acts on this feedback to ensure that our faculty are not only informed, but also developed. Please engage in this feedback if you are asked to, ideally on the day of the event or close after.
We wish for your to have a positive experience with us that impacts and informs your learning, we can only do this with your assistance in completing any evaluation.
Faculty
Faculty, (Clinical & Technical) will be easily identifiable – In-Situ simulation, the sim team will be wearing a ‘Simulation Hi-Vis jacket’ these are black with silver strips, they contain the King’s Academy logo and have NHS Simulation printed in large letters on the back.
Faculty have invested a significant amount of time into the simulation – the faculty spend a lot of time preparing simulation to run either in-situ or in-suite, please utilise and listen to them where necessary. They will be facilitating a debriefing session following the simulation.