Impact of the PEARLS Healthcare Debriefing cognitive aid on facilitator cognitive load, workload, and debriefing quality: a pilot study

Advances in Simulation

Research

Audrey Sloma¹  Michael Meguerdichian²  Suzanne Bentley³  Rachel Ivanhoe⁴  Adam Cheng⁵  Katie Walker⁶  Brian Altonen⁷  Komal Bajaj⁸  Ariel de Roche⁹  Yiqun Lin^1,10 

[1] Department of Emergency Medicine at Jacobi Medical Center, Bronx, NY, USA;Department of Emergency Medicine at NYC Health+Hospitals: Harlem Hospital Center, 506 Malcolm X Blvd, 10037, New York, NY, USA;Columbia University School of Medicine, New York, NY, USA;NYC Health + Hospitals Simulation Center, Bronx, NY, USA;Department of Emergency Medicine, NYC Health + Hospitals: Elmhurst Hospital Center, Queens, NY, USA;Simulation Education, NYC Health + Hospitals: Elmhurst Hospital Center, in Queens, NY, USA;Mt. Sinai School of Medicine, New York, NY, USA;Department of General Surgery at Rutgers New Jersey Medical School, Newark, NJ, USA;Department of Pediatrics and Emergency Medicine at Alberta Children’s Hospital, Calgary, Alberta, USA;University of Calgary, Calgary, Alberta, USA;Mater Hospitals, Brisbane, Australia;NYC Health + Hospitals: Research Administration, New York, NY, USA;Obstetrics and Gynecology, NYC Health + Hospitals: Jacobi Medical Center, Bronx, NY, USA;Albert Einstein College of Medicine, Bronx, NY, USA;Simulation Coordinator at the Columbia University School of Nursing, New York, NY, USA;University of Calgary, Calgary, Alberta, USA;

关键词: Faculty development;    Cognitive aid;    Debriefing;    Cognitive load;    Workload;    Skill acquisition;   

DOI  :  10.1186/s41077-022-00236-x

 received in 2022-01-10, accepted in 2022-11-13,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe Promoting Excellence and Reflective Learning in Simulation (PEARLS) Healthcare Debriefing Tool is a cognitive aid designed to deploy debriefing in a structured way. The tool has the potential to increase the facilitator’s ability to acquire debriefing skills, by breaking down the complexity of debriefing and thereby improving the quality of a novice facilitator’s debrief. In this pilot study, we aimed to evaluate the impact of the tool on facilitators’ cognitive load, workload, and debriefing quality.MethodsFourteen fellows from the New York City Health + Hospitals Simulation Fellowship, novice to the PEARLS Healthcare Debriefing Tool, were randomized to two groups of 7. The intervention group was equipped with the cognitive aid while the control group did not use the tool. Both groups had undergone an 8-h debriefing course. The two groups performed debriefings of 3 videoed simulated events and rated the cognitive load and workload of their experience using the Paas-Merriënboer scale and the raw National Aeronautics and Space Administration task load index (NASA-TLX), respectively. The debriefing performances were then rated using the Debriefing Assessment for Simulation in Healthcare (DASH) for debriefing quality. Measures of cognitive load were measured as Paas-Merriënboer scale and compared using Wilcoxon rank-sum tests. Measures of workload and debriefing quality were analyzed using mixed-effect linear regression models.ResultsThose who used the tool had significantly lower median scores in cognitive load in 2 out of the 3 debriefings (median score with tool vs no tool: scenario A 6 vs 6, p=0.1331; scenario B: 5 vs 6, p=0.043; and scenario C: 5 vs 7, p=0.031). No difference was detected in the tool effectiveness in decreasing composite score of workload demands (mean difference in average NASA-TLX −4.5, 95%CI −16.5 to 7.0, p=0.456) or improving composite scores of debriefing qualities (mean difference in DASH 2.4, 95%CI −3.4 to 8.1, p=0.436).ConclusionsThe PEARLS Healthcare Debriefing Tool may serve as an educational adjunct for debriefing skill acquisition. The use of a debriefing cognitive aid may decrease the cognitive load of debriefing but did not suggest an impact on the workload or quality of debriefing in novice debriefers. Further research is recommended to study the efficacy of the cognitive aid beyond this pilot; however, the design of this research may serve as a model for future exploration of the quality of debriefing.

【 授权许可】

CC BY   
© The Author(s) 2022