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Table 1 Fostering learning through self-assessment in debriefing using Ross’ four-stage model

From: Embracing informed learner self-assessment during debriefing: the art of plus-delta

Stage Goal Activity Strategies
1. Define the criteria Clarify criteria used to judge performance Prebriefing - Solicit input from learners on potential performance criteria
- Review performance criteria—this can be general or specific (e.g., performance checklist or assessment tool)
2. Apply the criteria Teach learners how to apply criteria in context Debriefing - Conduct a plus-delta to obtain a learner self-assessment
- Highlight and discuss positive performance
- Use language to connect positive behaviors with performance criteria
- Review performance checklist or assessment tool relative to performance in simulation
- View expert modeled performance (e.g., pre-recorded on video)
3. Provide feedback Deliver feedback on their performance and reflect on self-assessments Debriefing - Identify perception mismatches
- Explore and discuss (i.e., focused facilitation) perception mismatches to uncover rationale driving perceptions
- Use external data (e.g., video, performance checklists, objective data) to inform feedback
- Provide feedback to close performance gaps
4. Develop goals and action plans Support learners to develop action plans that generalize learning to other contexts Debriefing - Discuss how key learning points can be generalized to other clinical contexts
- Identify and summarize key learning points/action plan