Resident- as- Debriefer Curriculum: A Novel Approach to the Senior Resident Teaching Role in Simulation Medicine

摘要

Background: The integration of healthcare simulationinto EM residency curriculum is rapidly becoming thestandard. Traditionally, residents have largely participated insimulation as learners. The ACGME describes the importanceof resident competency in teaching, evident in severalresidency milestones (PC7/9/10, ICS1, PBLI1/2). To date,there is no standardized curriculum utilizing simulation toengage residents in the teacher role.Educational Objectives: 1.Evaluate the effectivenessof a novel interactive debriefing curriculum to train seniorEM residents in developing skills as educators for a 3rd yearmedical student simulation curriculum, 2. Analyze and comparethe residents’ debriefing skills pre and post- debriefing course.Curricular Design: Traditional teaching methodsoften fail to uncover a learner’s cognitive frame to close aspecific knowledge gap. The goal is to apply evidence-basededucational strategies from debriefing theory in simulationto improve senior resident teaching skills. Four EM trainedsimulation experts designed a 2-hour interactive debriefingcourse for the 11 PGY4 EM residents rotating through thesimulation center over the 2015/16 academic year. The courseconsists of a didactic component outlining a stepwise approachto effective debriefing. This is followed by a post-scenariodebriefing practicum after which the course instructors debriefthe resident’s debriefing. Residents facilitate debriefings for3rd year medical student (learners) simulation sessions over a2-4 week period. After each debriefing, they are assessed bythe learners using the ‘DASH Student Version’, a validateddebriefing assessment instrument. Data was collected pre andpost-course and analyzed using unpaired t-test analysis.Impact/Effectiveness: We plan to create a sustainableresident debriefing curriculum that is readily applicable toteaching in the simulation and clinical setting. From Augustto November 2015, 5 PGY4 residents participated in thecourse which focuses on techniques related to Element 4 ofthe DASH assessment instrument; guiding learners to identifyand close knowledge gaps. Three out of five residents showedstatistically significant improvement (p< 0.05) sustained overtime in Element 4. Data collection for 6 more residents (totaln=11) and video analysis of resident debriefing by expertsimulation faculty are ongoing.