Simulation Supervisor Guide
“Over the past decade, it has become increasingly clear that exposure to patients in a clinical environment with ad hoc educational sessions is not sufficient to create competent healthcare practitioners. Furthermore, it is evident that there is a need for curriculum standardization, deliberate skills practice, structured exercises, and outcomes-based evaluation with feedback. Training without these components leaves competency largely up to chance. Given the high-risk nature of medical practice, and that the outcomes directly impact patients’ health and livelihoods, this is less than acceptable. The growing and sustained focus on medical error reduction and patient safety, and the need to provide safe, learner-centered and ethical training, lead us to a model that incorporates simulation-based health education.” Ivette Motola et al. (2013)
Must Know Concepts - Executive Summary
The following are concepts that every trainee who has completed this block should be able to address or explain.
Concept 1: Learning Theories - Kolbs Cycle
- What are the 4 key aspects of experiential learning that lead to improved performance/functioning.
- Kolb’s cycle of learning involves experience, reflection, conceptualisation, and active experimentation.
Concept 2: Learning Theories - Deliberate Practice
- How is deliberate practice different from practice?
- Reflecting on your own development as a physician, how do we promote deliberate practice of clinical skills in our learners? Does our environment allow us to do this? How does simulation promote and/or not promote deliberate practice?
Concept 3: Debriefing
- Tell me about your approach/philosophy to providing feedback (especially critical feedback)? What are the pros/cons?
- How do you incorporate “debriefing with good judgement” into your feedback philosophy? What is the PEARLS framework?
- How do your learners and their specific characteristics influence your approach to debriefing?
Concepts in Depth – For each of the above topics, please complete the following grid:
Concept 1: Learning Theory - Deliberate Practice
Suggested Prompts:
- How is deliberate practice different from practice?
- Reflecting on your own development as a physician, how do we promote deliberate practice of clinical skills in our learners? Does our environment allow us to do this? How does simulation promote and/or not promote deliberate practice?
- Why do some people become experts where most of us only become competent at certain skills?
Key readings about this topic that a faculty supervising a trainee should read or be familiar with:
- Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Acad Med. 2004;79(1):S70–81
Other related concepts that trainee(s) might want to know:
- Mastery Learning
Other suggested readings or resources:
- https://ed.ted.com/lessons/how-to-practice-effectively-for-just-about-anything-annie-bosler-and-don-greene#review
Concept 2: Learning Theory - Kolb's Cycle of Learning
Suggested prompts:
- Where does Kolb’s learning cycle happen in medicine?
- How do you promote reflection on concepts/skills in your own practice/clinical environment?
- How would you structure a simulation session (standardized patients, theatre based, task trainer) to leverage the concepts of Experiential learning?
Key readings about this topic that a faculty supervising a trainee should read or be familiar with:
- Becker, L.R., Hermosura, B.A. (2019). Simulation Education Theory. In: Deering, S., Auguste, T., Goffman, D. (eds) Comprehensive Healthcare Simulation: Obstetrics and Gynecology. Comprehensive Healthcare Simulation. Springer, Cham. https://doi.org/10.1007/978-3-319-98995-2_2
- McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Medical education featuring mastery learning with deliberate practice can lead to better health for individuals and populations. Acad Med. 2011;86(11):e8–9
Other related concepts that trainee(s) might want to know:
- Rapid Cycle Deliberate Practice – combining mastery learning and deliberate practice into a novel simulation teaching session to learn basics of resuscitation
Other suggested readings or resources:
- Hunt, E. A., Duval-Arnould, J. M., Nelson-McMillan, K. L., Bradshaw, J. H., Diener-West, M., Perretta, J. S., & Shilkofski, N. A. (2014). Pediatric resident resuscitation skills improve after “Rapid Cycle Deliberate Practice” training. Resuscitation, 85(7), 945–951
Concept 3: Debriefing
Suggested prompts:
- Tell me about your approach/philosophy to providing feedback (especially critical feedback)? What are the pros/cons?
- How do you incorporate “debriefing with good judgement” into your feedback philosophy?
- How do your learners and their specific characteristics influence your approach to debriefing?
Key readings about this topic that a faculty supervising a trainee should read or be familiar with:
- Fanning RM, Gaba DM. The role of debriefing in simulation-based learning.SimulHealthc. 2007;2(2):115–25.
- Rudolph, J. W., Simon, R., Rivard, P., Dufresne, R. L., & Raemer, D. B. (2007, June). Debriefing with Good Judgment: Combining Rigorous Feedback with Genuine Inquiry. Anesthesiology Clinics
Other related concepts that trainee(s) might want to know:
- PEARLS Framework of Debriefing
Other suggested readings or resources:
- Eppich, W., & Cheng, A. (2015). Promoting excellence and reflective learning in simulation (PEARLS): Development and rationale for a blended approach to health care simulation debriefing. Simulation in Healthcare, 10(2), 106–115.
- Sawyer, T., Eppich, W., Brett-Fleegler, M., Grant, V., & Cheng, A. (2016). More Than One Way to Debrief. Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, 11(3), 209–217