title: Value of debriefing during simulated crisis management: oral versus video-assisted oral feedback.
abstract: BACKGROUND
  The debriefing process during simulation-based education has been poorly studied despite its educational importance. Videotape feedback is an adjunct that may enhance the impact of the debriefing and in turn maximize learning. The purpose of this study was to investigate the value of the debriefing process during simulation and to compare the educational efficacy of two types of feedback, oral feedback and videotape-assisted oral feedback, against control (no debriefing).
  
  
  METHODS
  Forty-two anesthesia residents were enrolled in the study. After completing a pretest scenario, participants were randomly assigned to receive no debriefing, oral feedback, or videotape-assisted oral feedback. The debriefing focused on nontechnical skills performance guided by crisis resource management principles. Participants were then required to manage a posttest scenario. The videotapes of all performances were later reviewed by two blinded independent assessors who rated participants' nontechnical skills using a validated scoring system.
  
  
  RESULTS
  Participants' nontechnical skills did not improve in the control group, whereas the provision of oral feedback, either assisted or not assisted with videotape review, resulted in significant improvement (P < 0.005). There was no difference in improvement between oral and video-assisted oral feedback groups.
  
  
  CONCLUSIONS
  Exposure to a simulated crisis without constructive debriefing by instructors offers little benefit to trainees. The addition of video review did not offer any advantage over oral feedback alone. Valuable simulation training can therefore be achieved even when video technology is not available.
authors.affiliation: St. Michael's Anesthesia Research into Teaching Simulation Group, Department of Anesthesia, St. Michael's Hospital, University of Toronto, Ontario, Canada.
authors.forename: Georges L
authors.initials: GL
authors.lastname: Savoldelli
authors.forename: Viren N
authors.initials: VN
authors.lastname: Naik
authors.forename: Jason
authors.initials: J
authors.lastname: Park
authors.forename: Hwan S
authors.initials: HS
authors.lastname: Joo
authors.forename: Roger
authors.initials: R
authors.lastname: Chow
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Hamstra
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000193:education* / Q000592:standards; D003419:Crisis Intervention / Q000379:methods* / Q000592:standards; D003627:Data Interpretation, Statistical; D003657:Decision Making; D005246:Feedback; D005260:Female; D006323:Heart Arrest / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy; D008297:Male; D008348:Manikins; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D014743:Videotape Recording