Healthcare debriefings have been primarily informed by theories and expert opinions but in this episode Ben explores with Michaela Kolbe how her team took on the remarkable endeavour to code over 18,000 debriefing micro-events from 50 simulation debriefings to uncover the quantitative mysteries inside ‘the black box of debriefing’. 
Join us as we explore the evolving evidence on what ‘Advocacy and Inquiry’ actually leads to in a debrief, as well as the surprising impact of praise, paraphrasing and guess what I’m thinking questions. 
The paper 
Kolbe M, Grande B, Lehmann-Willenbrock N, et al 
Helping healthcare teams to debrief effectively: associations of debriefers’ actions and participants’ reflections during team debriefings 
BMJ Quality & Safety Published Online First: 28 July 2022. doi: 10.1136/bmjqs-2021-014393 

164 Decoding the ‘Black Box’ of Debriefing with Michaela Kolbe

Ben and Vic round out the Simulcast Journal club year with 4 articles. Listed here with links to the full text versions.  
Vadla, M.S., Moshiro, R., Mdoe, P. et al. Newborn resuscitation simulation training and changes in clinical performance and perinatal outcomes: a clinical observational study of 10,481 births. Adv Simul 7, 38 (2022). 
Høllesli, L. J., Ajmi, S. C., Kurz, M. W., et al. (2022). Simulation-based team-training in acute stroke: Is it safe to speed up? Brain and Behavior, 12, e2814. 
Moore N, Ahmadpour N, Brown M, Poronnik P et al. (1, Supplement SRSIS 1). Designing virtual reality experiences to supplement clinician Code Black education. International Journal of Healthcare Simulation 2022 
Alyshah Kaba, Theresa Cronin, Walter Tavares, Tanya Horsley, Vincent J Grant, Mirette Dube. Improving team effectiveness using a program evaluation logic model: case study of the largest provincial simulation program in Canada. International Journal of Healthcare Simulation. 2022;:1-8. 
 
Thank you to all our listeners, and to the authors, reviewers and editors of the articles we’re reviewed. 
Happy holidays and see you in 2023 ! 

163 Simulcast Journal Club December 2022

Hierarchy is pervasive in healthcare, and current strategies to train providers to ‘speak up’ are not enough to overcome the intense challenges that hierarchy creates. In this episode, Vic talks with Taryn Taylor and Adam Garber about their recent articles in Advances in Simulation. Both studies explore the experience of practitioners working in teams managing obstetric emergences. Their studies use clever scenario design and delivery to re-create hierarchy and power gradients, as an example of ‘sociological fidelity’. 
Their insights are comprehensive, confronting but deeply resonant for healthcare professionals. We discuss their methods, their findings and what this might mean for simulation being part of the solution to addressing harms caused by hierarchy. 
The papers 
Pack, R., Columbus, L., Duncliffe, T.H. et al. “Maybe I’m not that approachable”: using simulation to elicit team leaders’ perceptions of their role in facilitating speaking up behaviors. Adv Simul 7, 31 (2022). 
Garber, A.B., Posner, G., Roebotham, T. et al. Facing hierarchy: a qualitative study of residents’ experiences in an obstetrical simulation scenario. Adv Simul 7, 34 (2022). 

162 Advances in Simulation: Exploring Hierarchy Through ”Sociological Fidelity”

More interesting work in healthcare simulation this month, including some from our friends and colleagues. 
Before that… A final reminder to register for Sim Reconnect ! – a 1 day seminar at Bond University on the Gold Coast. 
And – if you’re working in translational or systems focused simulation – consider enrolling in the Bond subject Translational Simulation in healthcare, stand alone or as part of a Masters of Healthcare Innovations. 
Now – the papers! 
Rao et al. Daily team introductions and simulation education to improve team performance. Great paper from our friends at Logan Hospital, including Sonia Twigg 
Roze des Ordons et al. Guiding, Intermediating, Facilitating, and Teaching (GIFT): A Conceptual Framework for Simulation Educator Roles in Healthcare Debriefing. From a team of thought leaders in simulation debriefing  
Tsang et al. Electronic Decision Support in the Delivery Room Using Augmented Reality to Improve Newborn Life Support Guideline Adherence. A Randomized Controlled Pilot Study. New frontiers in tech enabled clinical decision support from a group n the Netherlands 
Rochlen et al. Sequential Behavioral Analysis: A Novel Approach to Help Understand Clinical Decision-Making Patterns in Extended Reality Simulated Scenarios. More on the intersection of XR and our brains. 
Happy listening! 

161 Simulcast Journal Club November 2022

Great articles this month, including some from our friends and colleagues. 
Before that… A reminder to register for Sim Reconnect ! – a 1 day seminar at Bond University on the Gold Coast. 
And – if you’re working in translational or systems focused simulation – consider enrolling in the Bond subject Translational Simulation in healthcare, stand alone or as part of a Masters of Healthcare Innovations. 
Now – the papers! 
Sarah Janssens et al. Coleadership in Maternity Teams, a Randomized, Counterbalanced, Crossover Trial in Simulation. 
Kara Allen et al. Eight years of CRASH: A bi-national initiative helping critical care doctors return to work.  
Sandra Abbleglen et al. Debriefing interaction patterns and learning outcomes in simulation: an observational mixed-methods network study 
Pete Snelling et al. PRE-scripted debriefing for Paediatric simulation Associated with Resuscitation EDucation (PREPARED): A multicentre, cluster randomised controlled trial 
Díaz-Agea, José et al. To Clap or Not to Clap: Relevance of “Applause” in Simulation-Based Learning Sessions 
Happy listening 

160 Simulcast Journal Club October 2022

The August Journal Club is here, with Ben and Vic talking about 4 papers relevant to our simulation practice.  How do simulation fellows learn some ‘tech skills’? Ahmed et all help us out with Development of a simulation technical competence curriculum for medical simulation fellows, with lessons about learning tech and about how to develop a curriculum. Then we consider ‘arts based pedagogy ‘ in Patrea Andersen’s A Nursing Simulation Pilot Study Comparing Art-Enhanced Debriefing and Traditional Debriefing. A fascinating way to try and enrich debriefing conversations using art cards. Translation of learning to practice is the subject of Jye Gard’s phenomenological study on Simulation translation differences between craft groups. We finish the episode with a review of the delightful editorial from IJoHS from Paul Murphy and Debra Nestel on Healthcare simulation terms: promoting critical reflection 
Happy listening! 
 

159 Simulcast Journal Club August 2022

“How can we push the boundaries of healthcare simulation research, leading to new insights and innovations?”
 Advances in Simulation has announced a new thematic series. Methodological Innovations in Healthcare Simulation Research is “seeking manuscripts that challenge our collective thinking about how to conceptualise, frame, study, and theorise simulation in health and social care article type, in order to help advance our thinking about simulation research.”
 In this short episode, Vic speaks with Professor Walter Eppich about the thematic series, and explores examples of methodologic innovations in simulation. A deeper dive can also be found in the accompanying editorial from Walter and Advances Editor in Chief Gabriel Reedy. We look forward to reading and discussing the submissions in this series!
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158 Methodological Innovations in Healthcare Simulation Research

Ben and Vic offer a short discussion about the self development modules created by a global team of simulation fellows. Ben explains his motivation in leading the project, and explains how simulation practitioners can use the modules for their own professional development. Peer learning, collaboration, and more. Modules can be found here, and feedback and reflections welcome. 

157 Simulcast Self Development Modules

Ben and Vic were back for the July Simulcast Journal Club, with four interesting articles.  
Imposters was our first topic – and the prevalence of imposter syndrome among simulation faculty. (and take the chance to look at the IJOHS while you’re on their site) We followed with a paper about anxiety and performance in pre-hospital care students undergoing simulation based assessment. 
We enjoyed talking about the nuanced challenges and strategies for debriefing interprofessional simulation, and finished with a discussion of calculating cost effectiveness for simulation-based quality improvement projects. 
As mentioned on the podcast – express your interest for our Simulation:Reconnect event in November. Registrations open in August. 
Happy listening 
 
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156 Simulcast Journal Club July 2022

Most of us would like to improve our simulation debriefing skills, but data informed feedback on our debriefing performance is hard to find. Maybe Andrew Coggins and colleagues are helping us change all that? Maybe there are metrics and measures of our debriefing performance that can help? 
In this conversation, Vic speaks with Andrew Coggins about his recent Advances article Immediate faculty feedback using debriefing timing data and conversational diagrams. In this work, the team “explored the use of recording length of contributions during debriefings and use of conversational diagrams as a means of assessment of debriefing performance”. 
They build on work from Peter Dieckmann in 2009 who described “The art and science of debriefing in simulation: Ideal and practice” relationships in diagram form between participants, as well as a simple chess clock for the timing data. 
This is an interesting chat that might just change your debriefing practice. 
Happy listening 
 
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155 Advances in Simulation: Data Informed Debriefing with Andrew Coggins

Who is @sim_brick on Twitter?  
Vic, Ben and Jess discuss the big issues on the May Simulcast Journal Club.  
We started on a more serious note – and discussed articles on working with simulated patients to assess the quality of healthcare, and using Forum Theatre to help healthcare professions manage patients who have suffered domestic abuse. We then talked about learning curves, and a systemic review looking at their use and reporting in healthcare simulation research. For another review of that article pop over to the Key Lime podcast for their take. 
We finished up with a paper highlighting the use of Lego Serious Play for training in debriefing. And that led us to wonder #whois@sim_brick … 
 
Happy listening! 
 
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154 Simulcast Journal Club Podcast May 2022

Disclaimer: We discuss a commercially available product in this episode. Simulcast nor any of the team received any incentive, financial or otherwise, for hosting, recording or producing this episode and were not influenced in the questions selected.
 
I was thrilled to be joined by two amazing guests to explore a space in the expanding world of virtual simulation for nursing education. Welcome to Simulcast Julie Stegman Vice President of the Nursing Segment of the Health Learning, Research & Practice (HLRP) business at Wolters Kluwer, and Professor Jacqueline Semaan, Simulation and Nursing Skills Lab Coordinator and Nursing Faculty at Lake Superior School of Nursing.
 
We discussed the socio-political context around gaps and need in nursing education and then dived into the development and early evaluation of the vSim package, all the while drawing extensions to broader opportunities.
 
Enjoy the chat. Cheers, Jesse

153 Virtual Simulation in Nursing Education

Deception was one theme in our Simulcast Journal Club for April. We started with a conceptual paper discussing ‘positive’ deception in simulation, and considering the relationship between deception and fidelity in our simulation design. We followed with an RCT on ‘speaking up’ in anaesthesia crises which sought to explore how deception might be necessary or justified if we need ‘sociological fidelity’ (recreating hierarchies and power dynamics) in our scenarios. 
 We then discussed an article on 360 degree VR sim, the use of measures of parasympathetic stimulation, and the nuances of non-inferiority studies.  Our last paper looked at research priorities for healthcare simulation, using a Delphi methodology. 
Thanks to those who contributed this research. 
Happy listening ! 
 
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152 Simulcast Journal Club Podcast April 2022

Simulcast Journal Club March 2022 
 
Ben and Vic talk through 4 papers this month; Ethical considerations when conducting active short simulations in healthcare, computer modelling simulations for COVID public health policy, professional identity formation during a neonatology boot camp (with clarification that is not a training session for babies to do push ups), and the INACSL standards of best practice in scenario design. 
Happy listening!  

151 Simulcast Journal Club Podcast March 2022

Vic speaks with Eve Purdy about their recent paper in Advances in Simulation - Taking simulation out of its “safe container”—exploring the bidirectional impacts of psychological safety and simulation in an emergency department. We talk about the shared experience of many simulation educators that led to the research question – How does psychological safety in the workplace affect that experienced in the ‘sim space’ and how does that leak back in turn? Eve describes the methods and findings, and refers to the wealth of literature on psychological safety in simulation that this paper builds upon – research by Roison O’Donovan, Jenny Rudolph’s foundational ‘safe container article, Michaela Kolbe’s work on the ‘dynamic balancing act’ in simulation debriefing and more. 
 
The episode includes quotes and audio snippets from simulation colleagues – Ben Symon, Chris Roussin, Jenny Rudolph, Walter Eppich and Michaela Kolbe. 
 
For more on psychological safety in simulation and the workplace – these prior simulcast episodes on the ‘safe container’ and ‘rapport’ might be of interest, together with Eve’s recent talk to RCEM on psychological safety in emergency medicine. 
 
This is the latest in our Simulcast collaboration with Advances in Simulation – an open access Simulation Journal. Thanks also to the teams at Gold Coast Health Emergency Department and to the Emergency Medicine Research Foundation who provided grant funding for the study  
 
 

150 Advances in Simulation: Lifting the lid on the ‘safe container’ of healthcare simulation

Calling for help by junior medical staff is frequently a focus of healthcare simulation activities, but our first paper highlights how the impact is perhaps more complex than we have previously realised, and there is real risk of harm. We then looked at a paper describing the development of the marvellous LIFE App for neonatal resuscitation in LMIC countries – including drawing upon human centred design principles and project management methodology.  Simulation Fellowships and the advantages and disadvantages of accreditation came under the spotlight in a debate article that reported on a session from the 2022 IMSH conference.  
And we finished with a fascinating look at ‘team neurosynchrony’ during laparoscopic surgical simulation – high performing teams tend to have synchronous pupillary dilatation during surgery, likely evidence of a shared understanding of the cognitive load at any moment. Yes really! 
Happy listening! 

149 Simulcast Journal Club Podcast February 2022

Simulation based education involves thinking, but also feeling. Emotions are pervasive and powerful, and they impact on performance and learning – in both healthcare simulation and of course in the real world. 
In this episode we talk with Vicki LeBlanc and Glenn Posner about the research on emotions, cognitive processes and learning, and their narrative overview on this topic just published in Advances in Simulation. 
We discussed the inadequacies of simplistic models like Russel’s circumflex model of emotion or the Yerkes Dodson curve that many simulation educators draw upon. We take a deeper dive into literature drawn from many contexts about how emotions impact attention, memory, motivation and learning.  
Using an example from Glenn’s practice, we consider how this applies to our simulation design, delivery and debriefing 
The article is full of references to those looking for more on the topic, and look out for more from this team! 
 
Happy listening! 
 
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148 Advances in Simulation: Emotions in Simulation-Based Education: Friends or Foes of Learning?

Simulation can provide an opportunity to experience life/ experiences other than our own, and this can include experience of ill health – diseases, conditions and treatments. Hot off the press from Advances in Simulation, Walking in the shoes of our patients is a scoping review in which the authors sought to understand the ways that simulation can allow healthcare professionals or students to experience ill health, and what impact that has on their empathy .. 
In this episode Vic was joined by first author Milda Karvelyte – a Bachelor of Science in Human Biology graduate from Queen’s University Belfast and current medical student at the University of Aberdeen – and by senior author (and long-time friend of Simulcast) Gerry Gormley - a practicing GP and Professor in Simulation at Queen’s University Belfast. Gerry is a socio-cultural researcher and has an interest in broadening the reach of simulation across health and social care professions. 
We spoke about the challenges of experiencing and demonstrating empathy, about the process of the scoping review, the findings and what this means for simulation educators and researchers. 
We reflected on the unintended consequences of this type of simulation activity and – as usual – encourage thoughtful application to practice. 
 
Happy listening! 
 
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147 Advances in Simulation: Walking in their shoes

Simulcast Journal Club New Year’s Edition 2022 Vic & Jesse
Jesse was unable to join the rest of the Simulcast Team Christmas Edition so this is the consolation prize ep!! In this podcast Vic and Jesse discuss 2 publications from 2021.
 
Paper 1. recommended by Tim Mason
“Advancing Team Cohesion: Using an Escape Room as a novel approach”
Cohen and colleagues
Journal of Patient Safety and Risk Management 2021
 
Core premise – exploring the utility of an escape room in improving perception of cohesion within health care teams. Link to patient safety is some association between improved safety and quality of care outcomes in higher team cohesion settings.
 
 
Paper 2. Recommended by Sarah Janssens
“Cardiac Arrest Nurse Leadership (CANLEAD) trial: a simulation-based randomised controlled trial implementation of a new cardiac arrest role to facilitate cognitive offload for medical team leaders”
Pallas and colleagues
Emergency Medicine Journal 2021
 
Core Premise - This simulation-based study explored whether the introduction of a dedicated ’nursing team leader’ is an effective way of cognitively offloading medical team leaders of cardiac arrest teams. It was hypothesised that reduced cognitive load may allow medical team leaders to focus on high-level tasks resulting in improved team performance.

146 Simulcast Journal Club New Year’s Edition 2022 Vic & Jesse

Ben, Vic and Jess offer a bumper holiday episode for your healthcare simulation listening enjoyment. 
Transformative faculty development, suspension of disbelief in simulation, emotional activation for observers and participants, SPs or SPs – what’s in a name?, a taxonomy of non-technical skills, and lessons from the Fat Duck ……. 
Thanks to those who nominated articles for our discussion. Always welcome. 
Happy listening and happy holidays to our Simulcast community 
 
Vic, Ben, Jesse and Jess 

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