LAUSR

Background An incredible challenge exists in the development and retention of faculty to support simulation-based education. Effective faculty development is critical to ensure the quality standards advocated by ASPIH are met. It is well documented that debrief is the most important element of simulation. Inadequately trained facilitators can have a negative impact on learning. Most centres take responsibility for their own development, with no standardised model of debrief recommended. Equally each centre is unique in terms of set-up, funding stream and resources. UHCW has held a bespoke faculty development course for ten years. The debrief model taught is ‘advocacy with enquiry’. Most candidates attending this course are experienced clinicians and educators but have limited experience of non-judgemental debrief techniques. Therefore, is it possible to teach an old dog new tricks? Summary of work Our course has been adapted over time to support the needs of our educators. Initially this involved a more didactic traditional approach with lecture-based teaching on adult learning theory and human factors. The emphasis is now on the practical application of debrief skills supported by peers and expert faculty. Pre-course learning material is provided to reinforce adult learning theory, and human factors. On-going support is provided for candidates following the course. Summary of results Our observation of candidates suggests there are discrepancies in initial understanding of effective debrief. Many candidates are experienced clinicians but have been trained using traditional methods of feedback including the ‘sandwich’ model, and those used in resuscitation courses. The concept of being non-judgemental can be challenging, and difficult to grasp, and clinical experience does not always equate to ability to debrief effectively. Offering a course with a largely practical component supports overcoming these challenges by offering candidates maximal opportunity to practice. In some cases candidates are less responsive to change, and revert back to didactic methods of feedback despite support from the course. All courses evaluate positively. A clear concern and lack of confidence in educators’ ability to debrief effectively has been noted. Differences in teaching methods are acknowledged, and the importance of on-going practice and development. Discussion, conclusions and recommendations We recognise there are clear challenges that exist around faculty development. This course is only the beginning of teaching old dogs new tricks. Experienced educators require self-awareness, commitment and regular practice to develop effective skills for debrief. We feel that the structure of the course now meets our objectives and local need.