Simulation Training Clinical Trial
Official title:
Comparison Between a Team Debriefing With an Instructor and a Team Debriefing Without an Instructor, on Improving Non-technical Skills (TEAM Score) After Simulating a Vital Emergency in a Multidisciplinary Team as Part of the Initial Training
Comparison between a team debriefing with an instructor and a team debriefing without an instructor, on improving non-technical skills (TEAM score) after simulating a vital emergency in a multidisciplinary team as part of the initial training
In spite of the enthusiasm that the simulation raises, its use remains rather complicated in
the training of the interns in anesthesiologists-resuscitators (DESAR) and nursing
anesthesiologists (EIADE) . Its development has two main limitations: financial and human.
Indeed, it mobilizes the medical and paramedical staff already in place, which is a
difficulty in a context of demographic constraints.
A simulation session typically takes place in 3 stages: briefing, simulation and debriefing.
The debriefing, the pedagogical pillar of the sessions, demonstrated its influence on the
improvement of participants' performances. Different works have tried to define the ideal
debriefing method , but its modalities are yet to be defined. To reduce this time Boet and al
proposed the assisted video debriefing without instructor. Its principle is that the team of
learners will debrief themselves, watching the video recording of their performance. Learners
have as a teaching aid a grid that recalls the principles of team work and the technical
recommendations of the pathology addressed. This debriefing would therefore reduce the
training time and facilitate access to the simulation. However, its pedagogical effectiveness
has not been compared to the "gold standard" instructor-team debriefing on initial training
and long-term acquisition. The objective of this study is therefore to demonstrate the
non-inferiority of a method of debriefing without an instructor (SI) compared to a method of
debriefing of team with instructor (AI) on the improvement of a score of non-technical
competence (TEAM score) after simulation of a vital emergency in a multidisciplinary team as
part of the initial training.
All the DESAR (except the 1st years) and EIADE of the participating centers are eligible.
After information on the study and collection of their written consent, the binomials (DESAR
+ EIADE) will be constituted by drawing lots and randomized by stratification by center,
either in debriefing AI or SI.
At D1, they will have a first simulation followed by a debriefing (AI or SI) according to
their randomization and immediately after this debriefing, a second simulation. There will be
no systematic debriefing behind this second session, but a team of trainers will be able to
debrief the binomials that wish to do so. Six months later, the last simulation will take
place, followed for all the pairs of an AI debriefing.
The pairs will be evaluated a posteriori, blinded by trained evaluators, for the 3 sessions
on a non-technical competence score the TEAM Score and a technical skill score specialized in
the pathology encountered. Finally learners will give their self-efficacy before and after
each debriefing, and before the 3rd session.
Throughout the course of the study psychological care will be provided: a clearly identified
person who is specialized in this pedagogical technique will be present and each participant
will have his / her telephone contact details and the usual structures during a psychological
distress.
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