Prevent the negative

I ran a short collapse in the practice sim this am before consulting, an arrest requiring CPR then debfirillation. All went well but the hardest component is stopping participants being so negative in their self assessment during debrief!

I have been using the Diamond debrief as being an arrant beginner I find some of the scripts useful.

I really need to focus on letting the facts of the simulation be discussed and reluctantly interrupting the more negative self reflection. Lots to improve for me!

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Author: gpsimulation

urban general practitioner in Melbourne, Australia

3 thoughts on “Prevent the negative”

  1. Whilst I like the ‘description-analysis-application’ flow of the diamond, I would still encourage the opener of ‘How did it feel?’

    People often start to talk about what they did wrong. Stop them. Keynit back to emotion…to feeling….

    …and you may uncover things like ‘I felt overwhelmed’ ‘i felt uncertain’ ‘I felt scared’ – a great start to exploring cognitive overload, performance under pressure as opposed to classroom and bandwidth.

    Then segue into either diamond or (if running multiple short sims) thenpkus/delta model (what went well? what would you change?)

    Often times we see that performance in a crisis isnt so much about clinical knowledge and skills, more about how we mitigate our own (and team) catecholamine surge, how our performance suffers under pressure and how communication andnuse of cognitive aids can help

    …which then leads to application in real world eg : designing action cards for practice staff in event of an arrest (clear wait room, call ambulance, get defib, provide access, get Drs bag etc) as well as the provision of quality CPR/defib by team members….

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    1. …as one repeats scenarios for candidates, using the tools of effective communication (sharing the mental model, closed loop communication) AND gain confidence in both skills/knowledge and performance in a crisis (appropriate cognitive aids), it is gratifying to see the ‘How do you feel?’ answers change to ‘I felt stressed, but competent’ ‘I felt in control’ ‘I felt calm’ ‘I felt more relaxed’ etc

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    2. Thanks Tim. I’ll investigate the Plus/Delta model.

      I absolutely agree that the clinical knowledge is not the deficit but the ability to get the resus flowing – the personel, equipment movements and timing. This can only be practiced in situ, no point going to RACGP house for a weekend course for this.

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