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Table 1 Dynamic elements. Dynamic elements are different strategies which can be introduced throughout the debrief in different phases and in combination with one another. Time and learner needs will dictate which elements receive greater emphasis

From: Dynamic Plus-Delta: an agile debriefing approach centred around variable participant, faculty and contextual factors

Dynamic element

Phase

Description

Allow reactions

Explore emotions

Opening Plus-Delta

Initial reactions and emotions will be related to the simulation scenario, the simulated bed space, entering the clinical environment, and related to the pandemic and may surface during different phases. Emotions will differ for those experienced in intensive care settings compared to participants who may have never worked in healthcare. When time permits, it is important to normalise and explore emotions as other participants in the group are likely to share similar emotions.

Probe participants and deconstruct statements for benefit of all

Plus-Delta

To facilitate shared learning, a deeper exploration of the underlying thought processes and perspectives is required. This is vital both when there is a positive assessment provided and if there are suggestions for change. This is a strategy which may be used if participants begin to discuss learning objectives or group-specific content.

Focus on learning objectives including protocols and processes

Plus-Delta

There are likely to be specific learning objectives related to the clinical context including new protocols and processes. These can be discussed in detail as they arise, or faculty may choose to specifically raise these as topics for discussion. Some content may be delivered in short microteachings, particularly when time is limited.

Focus on roles and responsibilities

Plus-Delta

Different coloured groups will have different roles and responsibilities, and time can be spent clarifying what these are for participants and the expected roles and responsibilities of other staff in the clinical environment.

Short microteachings

Plus-Delta

These may be used to recap the standardised information from previous sessions or deliver group-specific content. This element can also be introduced if there is a need to cover core learning objectives or group-specific information, especially if time is limited.

Targeted application

Summary

An opportunity for participants to conceptualise working in the clinical environment by practising new knowledge or concepts or to re-try actions from the scenario. Examples include getting participants to structure a SBAR handover, calling for help or envisaging how protocols would logistically be executed in the clinical environment.