TABLE 3.
Itemized Responses of the Delphi Results for Each Round of the Survey
| Round I | Round II | Round III | ||
|---|---|---|---|---|
| 1. | Verbal and non-verbal communication | |||
| Avoids judgment of learner performance | 3.86 (.38) | 3.64 (.92) | Removed | |
| Reflects open-ended questions back to the group | 3.86 (.38) | 3.91 (.30) | 3.88 (.35) | |
| Effectively uses silence | 3.86 (.38) | 3.64 (.67) | 3.88 (.35) | |
| Sensitive to learners’ non-verbal behaviors. | ||||
| Changed to: Attends to learners’ non-verbal behaviors (e.g., tone, facial expression, body language) | 3.57 (.79) | 3.73 (.47) | 3.88 (.35) | |
| Displays appropriate and professional non-verbal behavior (e.g., tone, facial expression, body language) | 4.00 (.00) | |||
| 2. | Setting the stage and ground rules for the debriefing session | |||
| Articulates goals clearly | 4.00 (.00) | 3.73 (.65) | 3.67 (.71) | |
| Sets the grounds rules (e.g., confidentiality, respect for others, freedom to ask questions) | 4.00 (.00) | 4.00 (.00) | 4.00 (.00) | |
| Reiterates the use of simulation for learning | 3.43 (.79) | 3.27 (1.01) | 3.22 (1.3) | |
| Answers learner questions before beginning | 4.00 (.00) | 3.55 (.93) | 3.22 (1.3) | |
| Explains debriefing format | 3.86 (.38) | 3.82 (.40) | 3.78 (.44) | |
| Creates a safe learning environment | 4.00 (.00) | |||
| Clarifies roles and expectations for the debriefing | 3.89 (.33) | |||
| 3. | Talking about defusing (releasing emotion/de-roling) | |||
| Avoids judgment statements regarding learner performance | 3.86 (.38) | 3.64 (.92) | 3.89 (.33) | |
| Makes sure all learners have an opportunity to discuss emotions | ||||
| Changed to: Engages all learners in discussion of emotions and feelings regarding events | 4.00 (.00) | 3.64 (.67) | 3.44 (1.13) | |
| Validates emotions as real and acceptable | 4.00 (.00) | 4.00 (.00) | 4.00 (.00) | |
| Places debriefing topics from learners in “parking lot” until transition made | ||||
| Changed to: Appropriately tables untimely topics and returns to them for a later discussion | 3.57 (.53) | 3.64 (.92) | 3.56 (1.01) | |
| 4. | Recapping the simulation experience | |||
| Recaps events factually and in an orderly manner | 4.00 (.00) | 3.55 (.93) | 3.56 (1.03) | |
| Identifies points for discussion | 4.00 (.00) | 3.82 (.60) | 3.89 (.33) | |
| Uses simulation objectives or developed evaluation tool as discussion guide | ||||
| Changed to: Uses simulation objectives and/or learner assessment rubric as a discussion guide | 3.86 (.38) | 3.45 (.93) | 3.33 (1.12) | |
| Facilitates learner reflection to recap events | 4.00 (.00) | 4.00 (.00) | 4.00 (.00) | |
| Allows peer feedback to clarify events that happened in the simulation experience (obtains member agreement) | 3.78 (.67) | |||
| 5. | Reflecting on action (analysis) | |||
| Uses innovative techniques and prompts (video, learner questions, SP feedback) to facilitate learner’s reflection on reasons for their behavior | 3.86 (.38) | 3.45 (.69) | 2.89 (1.17) | |
| Assists learners with assimilating new with previous knowledge | 4.00 (.00) | 4.00 (.00) | 3.78 (.44) | |
| Promotes peer-to-peer interaction and feedback | 3.86 (.38) | 3.73 (.65) | 3.56 (.88) | |
| Focuses on key elements related to learning objectives | 3.86 (.38) | 3.73 (.90) | 3.67 (1.00) | |
| Enables learners to self-identify strengths and areas for growth | 3.86 (.38) | 3.45 (.69) | 4.00 (.00) | |
| 6. | Facilitating learner’s connection of knowledge to practice | |||
| Conduct learner-centric “needs assessment” | 3.86 (.38) | 3.27 (1.01) | Removed | |
| Integrates simulation experience with clinical practice | 4.00 (.00) | 4.00 (.00) | 3.89 (.33) | |
| Encourages learners to reflect upon application of new information for future clinical practice | 4.00 (.00) | 3.91 (.30) | 4.00 (.00) | |
| Reviews all items that arose during discussion to ensure all questions/concerns of learners are addressed during debriefing process | ||||
| Changed to: Reviews key items identified during discussion to ensure questions/concerns of learners are addressed during debriefing process | 3.86 (.38) | 3.55 (.69) | 3.78 (.67) | |
| Encourages learners to integrate prior knowledge and apply new information gained in simulation experience | 4.00 (.00) | |||
| 7. | Summarizing: providing key take away points for the learner | |||
| Encourages learner to restate the learning objectives and the lessons learned | 3.43 (.79) | 3.18 (1.08) | 3.33 (1.00) | |
| Ensures all questions/concerns of learners are addressed during the debriefing process | 3.71 (.49) | 3.73 (.65) | 3.78 (.67) | |
| Provides key take away points for the learner | 4.00 (.00) | 3.60 (.70) | Removed | |
| Provides information for any further simulation reflection assignments | 3.57 (.79) | 3.55 (.52) | 3.11 (1.17) | |
| Offers learners remediation/additional experience if appropriate | 4.00 (.00) | 3.70 (.95) | 3.56 (1.01) | |
| Encourages ongoing self-reflection of learner’s individual performance | 3.82 (.60) | 3.89 (.33) | ||
| 8. | Time management before, during, and after simulation | |||
| Appropriately sets up the debriefing environment before the simulation | 4.00 (.00) | 3.73 (.65) | 3.33 (1.00) | |
| Starts simulation on time | ||||
| Changed to: Adheres to the schedule for debriefing or adjusts the schedule as appropriate with group buy-in | 3.86 (.38) | 3.18 (.87) | 3.00 (1.00) | |
| Appropriately stops simulation | 3.86 (.38) | Removed | Removed | |
| Allows enough time for de-roling | ||||
| Changed to: Allows enough time for dealing with the emotional aspects of the simulation | 3.86 (.38) | 3.45 (.69) | 3.67 (1.00) | |
| Allows enough time for recap | 3.86 (.38) | 3.64 (.50) | 3.56 (1.00) | |
| Allows enough time for analysis | 4.00 (.00) | 3.82 (.40) | 3.67 (1.00) | |
| Allows enough time for learners to connect knowledge to practice | 3.86 (.38) | 3.91 (.30) | 3.67 (1.00) | |
| Allows enough time for summary | 4.00 (.00) | 3.27 (1.01) | 3.33 (1.00) | |
| Finishes any evaluative paperwork and put it in correct place | ||||
| Changed to: Finishes any evaluative paperwork and forwards to appropriate parties | 3.57 (.79) | 3.00 (1.10) | 3.11 (1.05) |
Data given as mean (SD). Participants were asked to rate each objective under each of the eight headings on a scale 1–4 from not important to important. Italicized wording shows the changes that were made to the initial instrument via the Delphi process and represent the final instrument.