Q: I recently attended one of your workshops at SESAM on “Teaching, Coaching, or Debriefing with Good Judgment” and found it helpful. However, we didn’t have time to work through a situation I had trouble with: a while back I was running a simulation in which the learners were in the role of team leader during a rapid response. The team leader tried to do a recap of events, and it didn’t go well because they left out critical information and didn’t ask the rest of the team for input. I wasn’t sure if this called for some Coaching (maybe to highlight what was left out, suggest a better way, and have them redo it) or Debriefing (inquire about for their reasons for leaving out information and not asking the team for input). Debriefing didn’t seem like the right thing, because I think the learner just forgot since it’s such a new skill and there was so much on their mind. What do you recommend?
A: Such a great question! When trying to make that decision, there are two things to consider: (1) their level of experience with executing the skill they’re being asked to do and (2) the complexity of the skill. Going into the simulation, I have some level of knowledge about the learner group and the simulation case, so I should have some reasonable expectations about when the learners might struggle.
If they have only recently learned the skill and have had little or no time to practice it in a realistic context, I’d expect to do more coaching. If the skill is complex, I expect to coach as well, even if they’ve got experience with it. On the other hand, if I expect them to be able to execute a skill with little difficulty because I know they’ve had lots of opportunity to practice it, and/or it’s not very complex, then I’d be puzzled about the fact that they struggled, so I’d want to debrief it to find out what got in their way.
Let’s go back to your situation: Leading a team in a rapid response situation is a pretty complex skill with high intrinsic cognitive load. If these learners had only recently learned the principles and skills of leading a team, and they haven’t had opportunities to practice it, I would anticipate some struggles. When they happen, I’d go to coaching first.
On the other hand, if I’m working with an experienced emergency department team and that team leader struggled to lead the group, I’d be surprised and curious to know what was going on for them – so in that scenario I’d debrief.
-Mary Fey, Associate Director, CMS-ALPS
Resources:
•Teaching, Coaching, and Debriefing with Good Judgment Grand Rounds
•Teaching, Coaching, and Debriefing with Good Judgment Grand Paper
