Suggested preparation for facilitators and students

Companion formative guide

Briefing

You have read the scenario or scenarios that you will explore during your HFCS activity, and you are about to begin your day at the simulation centre. The first step is the briefing meeting.

This meeting, which lasts about 20 minutes, is to clarify what you have learned during your personal preparation. This step is carried out with the instructor who will accompany you in the simulation, as well as the other participants.

Your instructor will ask you what you have learned and what you expect to happen in the simulation with the mannequin. Pay attention! The other participants may have thought of things that did not occur to you. Their ideas will help you gain some perspective about the different ways of seeing and approaching healthcare issues.

Debriefing

Debriefing is the last step of your HFCS experience. According to Renou (2012), “Debriefing is an intentional reflective learning process in which instructors and students go over the clinical situation together to stimulate the development of the learners’ clinical reasoning and assessment capacities” [translation]. This is a critical step, because it allows you to see, understand and correct any errors you may have made. During the debriefing, it is important to bear in mind the concepts of respect and confidentiality.

First, your instructor will give you the opportunity to talk about your first impressions. Then you will go over the clinical case history together and review the simulation objectives, that is, what was expected of the participants. The instructor will explain all the objectives that you were supposed to achieve during the simulation, as well as the standard of the best nursing practices. The instructor will guide the conversation, but the discussion will be driven by you and the other participants.

At the end of the debriefing session, always ask yourself:

• What changes should I consider in my practice?
• What were the biggest obstacles during the simulation?
• How can I get around these obstacles in the future?

Best Practices

Video capture

The simulation sessions are filmed for pedagogical purposes. The purpose of filming them is to provide the instructor with a tool for the debriefing. It should not be a major part of the debriefing, so the instructor should judiciously choose clips to support the message to be taught. The clips should be chosen to enrich the discussions and reflections on the action. The videos of the students’ performances will not serve as an summative evaluation tool or be distributed.

Confidentiality agreement and fiction contract

Simulation is an activity that draws on prior knowledge. This interactive approach facilitates the acquisition of specific competencies in a realistic environment in order to optimize the quality of care in a safe setting. From the beginning of the simulation, both parties—the instructor and the student—agree to uphold the confidentiality agreement and the fiction contract. The confidentiality agreement involves two important points. The students agree not to disclose or discuss the content and the scenario objectives with their peers outside the simulation sessions. As the subjects who will be filmed, the students also agree not to judge their peers’ performance. The fiction contract focuses on the simulation team’s responsibility to create, as realistically as possible, the care setting in which the students will be immersed. It must be remembered, however, that the simulation team is restricted by the limitations of the patient simulator. For example, the simulator cannot move. These limitations must be defined at the beginning of the simulation to avoid frustration on the part of the students and ensure the scenario progresses smoothly.

Active participation

The student’s active participation is essential to the simulation session. The achievement of the scenario’s learning objectives can only be optimized through dynamic interactive exchange.

Use of relevant terminology

To standardize the simulation issues, the use of uniform terminology is critical. Term standardization forms the basis of communication within a community of practice.

Reproduction of the hospital environment

The simulation sessions take place in an environment that faithfully reproduces a patient’s room or acute care unit. The realism of the environment is crucial to optimize the pedagogical objectives.

Reflective review of the experience

Debriefing is a structured synthetic analysis that immediately follows the simulation session. It entails three phases. The descriptive phase reviews the objectives and provides the opportunity to vent emotions. It is important for the instructor not to accept any judgments offered by the students, and for the discussions to be free from any sort of evaluation. The analysis phase allows the students to reflect on their actions and ask themselves about the choices they made. This is the longest part of the debriefing. The instructor guides the discussions in a healthy learning environment. The third phase, synthesis, focuses back on the situation and allows the students to reformulate the learning objectives, if necessary. The instructor revisits the events to ensure everyone has understood the objectives of the simulation. There is no ideal length for a debriefing session, but it should be about as long as the simulation session.