Learner discomfort during the healthcare simulation debriefing process is inevitable. While healthcare simulation is an incredibly powerful tool for healthcare professionals, the true value lies in the reflection of the experiential learning experience in debrief that follows. At times, clinical simulation can be an incredibly uncomfortable space for both the clinical simulation educator and participant. This article by Erin Carn-Bennett, RN, MSN will explore the concept of why there is great importance to get comfortable with discomfort as a clinical simulation facilitator, particularly in the debrief environment.
Discomfort in Debrief is Part of Healthcare Simulation
For the healthcare simulation debrief process to be highly effective, healthcare simulation participants must mostly be able to sit with and also engage with their discomfort through the healthcare simulation debrief process. The feelings of discomfort may include but also not be limited to: emotional, intellectual, or professional. Feelings of discomfort in healthcare simulation debrief occurs commonly and is often an unavoidable part of the clinical simulation experience.
In experiential learning experiences such as with healthcare simulation this can often be an indicator of how far along the learning curve clinical simulation participants are. Dependant on clinical skill levels, healthcare simulation scenarios involve placement of participants on an appropriate steep edge of their learning curve. This comes with a lot of responsibility on the clinical simulation facilitator as damage can quite easily be done to the clinical simulation participant if miscalculated.
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The process to make critical and sometimes life or death decisions under extreme pressure, handling of difficult interpersonal interactions can bring on feelings of anxiety, inadequacy and frustration easily for clinical simulation participants. There is also often discomfort in the debrief process. Healthcare simulation participants can feel vulnerable in the process to both receive feedback and also reflect on their individual and team based performances. This can be particularly true if this process places some highlights on mistakes or gaps in knowledge.
Fears of judgment by colleagues of the healthcare simulation faculty as well as failure can cause an inability for clinical simulation participants to engage in effective learning at times. Embracement of this discomfort as well as a safe space to practice skills to overcome this discomfort in clinical care is crucial to be able to spin these difficulties into professional development growth opportunities.
Discomfort In Healthcare Simulation Can Inspire Professional Development
When discomfort is managed effectively, this can become a catalyst for professional development for both the healthcare simulation facilitator and participant. Discomfort in healthcare simulation often arises when participants reflect that clinical and team based decisions in the healthcare simulation could have been to a higher standard. The process for participants to reflect is essential as this allows participants to analyse decision making processes and make changes in future practice.
Healthcare simulation debriefs can commonly reveal gaps in clinical simulation participants’ knowledge where individuals within the teamwork structure may have acted impulsively or reflexively. In healthcare simulation debriefs at times participants can, if debriefers are brave and skilled enough, be encouraged to confront assumptions, biases and considerations to any alternative approaches to clinical care. This often very uncomfortable process to critically assess clinical care and actions can lead to more profound insights and improve clinical decision making and teamwork based skills.
Healthcare staff require a high level of emotional intelligence in order to manage difficult conversations with patients and colleagues effectively. Exposure through healthcare simulation to difficult emotions in a psychologically safe environment can lead to clinical simulation participants (and faculty) to become more comfortable with these emotions. These educational experiences allow people to reflect on how to manage difficult feelings and also build resilience and emotional intelligence.
Embracement of Discomfort in Clinical Simulation Matters
Embracement of discomfort in the healthcare simulation debrief environment can assist to cultivate a growth mindset and to also instill safe reflective and self care practices for healthcare staff. Once healthcare simulation staff become aware that the clinical simulation debrief process is to look at team work principles rather than individual performances there is an increased likelihood that mistakes will be viewed as educational and growth opportunities rather than failures and a measure of self worth.
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Healthcare simulation facilitators can assist with participant discomfort through normalization and to also frame discomfort as a valuable learning tool which is worthwhile to lean towards. When clinical simulation participants understand that feelings of discomfort are normal and expected parts of clinical simulation training and can lead to growth, they are more likely to be able to embrace the experience. Clinical simulation facilitators can also share stories of their own clinical experiences of discomfort to role model vulnerability and also demonstrate how discomfort has led to personal growth.
Healthcare simulation educators should set up participants well in the pre brief phase of clinical simulation so that participants are able to go into the scenario and debriefs with a mindset of curiosity rather than judgement. When participants are aware that healthcare simulation is about team work rather than individual performance this allows them to stay open to constructive criticism.
Healthcare simulation educators can often feel a lot of discomfort in debrief and carry a lot of responsibility if participants are distressed or have not had an enjoyable experience in the healthcare simulation experience. However, the intention of clinical simulation debrief is to move participants from uncomfortable emotions through to more regulated and relaxed states. There can be difficulty for more junior facilitators to be able to trust in this process and this can take a lot of time to occur. Healthcare simulation facilitators need to trust in their own learning experiences as well as they gain experience to deliver clinical simulation debriefs.
In healthcare simulation, discomfort should not be aspired to as a feeling to be avoided. There is a lot of depth to learning by the process to sit through and also explore discomfort for all involved in healthcare simulation experiences. This article has explored discomfort from both a healthcare simulation participant and facilitator’s perspective. There is so much to be learnt in the process to become comfortable with discomfort in healthcare simulation.
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