At times, a healthcare simulation debrief can be an emotional space. As a debriefer in clinical simulation the role is to guide conversation, allow expression of these emotions by participants. As well as this, clinical simulation debriefers assist where able with sense making of actions and results from the clinical simulation experience through reflection. As such, emotions expressed (or masked) in the debrief circle can feel challenging for a healthcare simulation debriefer to manage. This article by Erin Carn-Bennett, RN, MSN will explore the management of emotions within a debrief circle environment.
Emotional Intelligence is Vital in the Healthcare Simulation Debrief Circle
Emotional intelligence is a crucial skill for those who work in healthcare simulation. Some people are more natural to employ emotional intelligence to read not only their own emotions but the emotions of others and respond effectively and with grace. This doesn’t mean that emotional intelligence skills can’t be acquired for those who feel that they need to up their skills in this area. These non technical skills that are required to be able to run a psychologically safe clinical simulation based education session are crucial and worth additional work to harness.
Psychological safety is everything in healthcare simulation. Debriefers won’t always get every action right, debriefers are also learners too. There is no weakness to admit mistakes as a facilitator of clinical simulation. As clinical simulation staff there should be advocacy for healthcare simulation participants to make mistakes in a safe environment. This should also be extended to clinical simulation staff within the debrief circle as well.
If a mistake is made in the way a question is framed in clinical simulation debrief, there should be no hesitation as a clinical simulation facilitator to own this error and to try again. Actions such as ownership of errors by clinical simulation debriefers will assist to build trust between staff and participants in the clinical simulation debrief circle. Everyone is human and can make mistakes, even the most experienced clinical simulation facilitators included. To demonstrate fallibility as a healthcare simulation facilitator will make clinical simulation participants more comfortable to come forward with their own errors with less shame and insight meaningful change.
View the LEARN CE/CME Platform Webinar From Good to Great: Leading with Emotional Intelligence in Clinical Simulation to learn more!
Debrief structure or a debrief framework has remained in clinical simulation debriefs despite what debrief methodology is used for critical reasons. Debrief structure is centered around maintenance of psychological safety and is also grounded heavily in adult learning theory. The main piece of advice in regards to debrief structure is to remember that each segment of debrief is present for a rationale centered around these two critical foundations. To trust the debrief structure and trust the debrief process as a debriefer can be hard, but is absolutely crucial especially when emotions are high in a debrief circle.
As healthcare staff, there can be an innate want to fix challenges for people and provide comfort. Emotions in a healthcare simulation debrief are no different in regards to the strong desire for healthcare workers to want to over reassure, brush off or make them go away. However, healthcare simulation debrief is a wonderful opportunity to practice holding space for clinical simulation participants’ emotions. Trust in the adult learner and allow the process of a structured debrief to move clinical simulation participants through a variety of emotions after a clinical simulation experience. Individuals move through their emotions in a number of different ways and as debriefers there needs to be not only an awareness of this but also trust in this too.
Closed Down Clinical Simulation Participants Experiences Should be Trusted
A closed down participant in a clinical simulation debrief, can be due to a multitude of reasons. There can be temptation to probe these participants for their frame of mind and to share what has caused them to close down. Different debrief methodologies have different methods and thoughts around participation in a clinical simulation debrief. However, for the most part if a healthcare simulation participant has minimal or no engagement in a debrief this does not mean that they are not in a process of reflection or learning.
Be cautious and trustworthy of the closed down clinical simulation participant. Some people are much more introverted than others, but they will often complete their own reflections internally and at their own pace. This doesn’t mean that these reflections are any less profound or deep than those healthcare simulation participants who process their reflections in an external manner.
A healthcare simulation participant in obvious distress, overcome with emotions or even crying can be an incredibly confronting experience as a clinical simulation debriefer. Again, the majority of healthcare workers have entered into this profession with an innate want to fix and help others. At times confronting emotions can feel like failure especially when in the facilitator role of a clinical simulation scenario.
There should primarily be consideration after a breakdown of a clinical simulation participant as to whether there were any psychological safety breakdowns and how to improve for next time. But also, clinical simulation participants do bring their own previous experiences as baggage to clinical simulation scenarios. A space for clinical simulation participants to have a human moment in a healthcare simulation debrief is more than ok.
Check in with any overly emotional healthcare simulation participants as to what their needs are and if they wish to stay continue with the debrief. A follow up one on one after the clinical simulation debrief can be useful. Mostly a trust in the adult learner to process their emotions and a strong psychological safety foundation which is in constant review will be a great start to support clinical simulation participants emotions in a debrief environment.
Anger can sometimes appear in a clinical simulation debrief. This can be anger at their individual performance or due to conflict actual or perceived amongst team members. Anger is generally a surface emotion and can have emotions below the surface of the anger such as: embarrassment, anxiety, shame, regret or exhaustion. A simple google image search of “anger iceberg” can be a useful demonstration of what emotions can be underneath the surface of emotions.
A strategy which can be useful can be to start a debrief question which is not so charged and is potentially not “the elephant in the room”. This can help to lower the heat in the debrief circle and allow the clinical simulation debrief process to assist participants to move through the reflective process of the debrief. Once the heat in the debrief circle has lowered this may be a better time to ask a more loaded question of the participants. However, the ability to figure out what to do in this situation comes with experience in the circle and skill acquisition in regards to emotional intelligence.
This article has discussed emotions and how to manage them as a clinical simulation debriefer.
A variety of emotions can be present from clinical simulation participants in a debrief and clinical simulation staff can feel responsible for the management of these for their clinical simulation participants. However, we are all human and are not robotic and able to turn off our emotions all of the time. The debrief circle should be a psychologically safe space where clinical simulation participants feel able to express their true emotions as they reflect on their clinical simulation performance and experience.
How to Infuse Emotional Intelligence Into A Clinical Simulation Program
