Wednesday, February 18, 2015

Debriefing: A critical step in the simulation process

We recently did a webinar "How to get the most out of simulation hours while using an EHR - in reference to recent NCSBN report" and discussed how you can be sure to do effective simulations as we move to more and more simulation hours in lieu of clinical opportunities. 

One of the big takeaways we'd like to share is a simple step that can greatly increase the quality of your simulations or skills done in your lab: debriefing. 

If your school has access to an EHR system or is using EHR Tutor, students can chart their activities while in the lab and practice a truly realistic work-flow. After all, nursing isn't just caring for a patient, it's recording what we did to care for that person. 

As they record what they're doing (taking vital signs, giving medications, etc.), they are creating a log that you can refer back to after the activity. Instead of sending students on their way immediately after the simulation ends, have students either come together as a group or meet one-on-one with the instructor running the simulation. Pull up the chart the student completed during the activity and review what was, and was not, an appropriate action to take. 

This is a great way to review mistakes. For example if a patient has a recorded Demerol allergy you could ask him or her, "In the Medication Administration Record I saw that you administered Demerol. Now that you have a chance to review the chart, do you see anything wrong with that?". Instead of simply giving them a criticism, you can involve the student in the debrief and create a discussion rather than a lecture on what happened. 

If you're able to debrief in a group, this is a great way to review different interventions with your students. For example, when a discussion starts about how students would prioritize care, you can always bring up a patients' chart to review what was happening with each scenario. No one has to rely on memory alone, which is great for visual learners or students who need a reminder during debrief discussions. 

Lastly, this is a great reference point if you're asking a student to run through what happened and what they were thinking. 

So for those of you using an EHR in your labs already - don't forget the debrief! It can be a simply 5-15 minute session after your simulation, and it can have huge benefits.