From: Cognitive Load Theory for debriefing simulations: implications for faculty development
Drivers of load | Mitigation strategies | |
---|---|---|
Intrinsic load: Related to task difficulty and debriefer expertise | Quantity of information: • Number of learners • Number of learning objectives • Various learner types/professions | Match debriefer expertise to size of groups and number of professions Use of whiteboard or flip chart for noting topics of discussion Share decision making with learners Co-debriefing to share cognitive load |
Emotional state of learners | Prebriefing to establish a “safe container” for learning | |
Insufficient time for debriefing | Schedule adequate time Do not allow the scenario to run longer than scheduled | |
Debriefer clinical expertise | Provide debriefers with detailed notes about clinical content Consider inviting a content expert (co-debriefing) | |
Debriefer experience | Debriefing scripts for novice debriefers can help structure debriefing Debriefing assessment tools can function as “pre-learning” around expected facilitation skills | |
Extraneous load: Imposed by poor instructional design and not relevant for learning | Scenario realism needs to be addressed | Establish fiction contract prior to the simulation |
Debriefing going off topic | Debriefing framework can help organize debriefing for both the debriefer and for the learner Use previewing statements to introduce next topic of discussion | |
Physical space: • Comfort • Ambient noise • Interruptions | Arrive early to set up debriefing space Seating arrangement for optimal eye contact Limit interruptions, coming and going of learners or observers | |
Performance anxiety | Co-debriefing for back-up Establish a safe container for facilitators | |
Difficult learner dynamic | Co-debriefer can monitor members of the group for distress /participation Facilitators can learn schemata for common learner dynamics (e.g. how to engage the quiet learner) | |
Video review | Co-debriefer can be tasked to run video Strategic and selective use of video | |
Co-debriefing • Interruptions • Competing priorities | Facilitator pre-brief to set expectations/roles/goals Co-debriefers utilize strategies such as open negotiation and permissible interruptions | |
Evaluation of learners | Only add concomitant learner evaluation for very experienced facilitators | |
Germane load: Conscious, effortful attempts to learn from the debriefing experience | Reflection in action: • Are all learners engaged? • Are all of the objectives covered? | Do not be afraid to pause to make a mental or physical note of a successful strategy used or pitfall to avoid |
Reflection on action: • Review of learner feedback • Make notes for future debriefing structure, content or approach | Peer to peer coaching in a safe learning environment Obtain debriefing feedback from learners Make use of published tools for assessing debriefing Provide protected time for reflection to occur |