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Abstract Details

Quality of Structured Debriefing of Simulation by Near-peers versus Faculty Instructors: A Mixed Methods Analysis from a Multicenter Randomized Controlled Non-inferiority Trial
Â鶹´«Ã½Ó³»­, Research, and Methodology
P7 - Poster Session 7 (8:00 AM-9:00 AM)
15-015
To compare the quality of near-peer versus faculty debriefing in simulation-based education.
Faculty availability limits expansion of simulation-based education. Near-peer facilitators may address this barrier. However, whether residents perceive differences in the quality of near-peer versus faculty debriefing remains unclear.
We performed a convergent mixed methods analysis of survey data and semi-structured interview transcripts from the Trial of Peer Leaders in Neurology Â鶹´«Ã½Ó³»­ (TOPLINE). We randomized neurology junior residents at four academic centers to a faculty or near-peer (senior resident) simulation debriefer after individually completing a status epilepticus case. Following debriefing, residents completed the Debriefing Assessment for Simulation in Healthcare–Student Version (DASH-SV). The overall score of the DASH-SV and individual elements were tested for non-inferiority (inferiority margin 10% or 0.7 points on a 7-point scale). In parallel, residents were interviewed about their debriefing experience using questions designed to complement the core domains of DASH-SV. Exploratory thematic analysis of transcripts was performed by three blinded coders. Quantitative and qualitative data were analyzed separately but integrated during interpretation. 
32 residents completed the DASH-SV; 19 completed interviews. Overall quality of near-peer debriefing was not perceived to be non-inferior to faculty debriefing (6.24 vs 6.56, difference -0.32, CI -0.76-0.11). Near-peers were perceived non-inferior to faculty for maintaining an engaging learning environment (6.44 vs 6.56, difference -0.12, CI -0.50-0.25) and identifying what participants did well or poorly (6.38 vs 6.44, difference -0.08, CI -0.55-0.43). Preliminary thematic analysis identified debriefer characteristics and actions which promote psychological safety, as well as foster metacognition, identify specific improvements, and reinforce key learning points.
Near-peer debriefings were overall not non-inferior compared to faculty, though they were non-inferior for creating an engaging learning environment and giving specific feedback. Thematic analysis of residents’ experiences may clarify why near-peers were not non-inferior to faculty debriefers and guide future debriefer training for near-peers.
Authors/Disclosures
Shyam Bhagat, MD
PRESENTER 		Dr. Bhagat has nothing to disclose.
Galina Gheihman, MD (Brigham & Women's Hospital) Dr. Gheihman has nothing to disclose.
Rameez A. Merchant, MBBS Dr. Merchant has nothing to disclose.
Sarah C. Parauda, MD (Westchester Medical Center) Dr. Parauda has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Panter, Panter & Sampedro.
Salma Said Elkolaly, MD (Missouri University Hospitals) Dr. Elkolaly has nothing to disclose.
Terry Park, MD (Westchester Medical Center) Dr. Park has nothing to disclose.
Sean L. Thompson (Emory University School of Medicine) Dr. Thompson has nothing to disclose.
Zachary T. Lazzari, MD Dr. Lazzari has nothing to disclose.
Rose C. Healy, MD (Boston Medical Center) Miss Healy has nothing to disclose.
Kelly E. Knolton, DO (Medstar Georgetown, Dept of Neurology) Dr. Knolton has nothing to disclose.
Shalane A. Morales-Nunez, MD Dr. Morales-Nunez has nothing to disclose.
Harry Sutherland, MD (Yale School of Medicine) Dr. Sutherland has received publishing royalties from a publication relating to health care.
Yara Mikhaeil-Demo, MD (Northwestern University, Feinberg School of Medicine) Dr. Mikhaeil-Demo has nothing to disclose.
Nicholas A. Morris, MD, FÂ鶹´«Ã½Ó³»­ (University of Maryland Medical Center) The institution of Dr. Morris has received research support from National Institute of Neurological Disorders and Stroke. The institution of Dr. Morris has received research support from Â鶹´«Ã½Ó³»­. The institution of Dr. Morris has received research support from National Institute of Neurological Disorders and Stroke. Dr. Morris has received personal compensation in the range of $500-$4,999 for serving as a Webinar Speaker with Kreg Therapeutics. Dr. Morris has a non-compensated relationship as a Editorial Board Member with Â鶹´«Ã½Ó³»­ that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Morris has a non-compensated relationship as a Editorial Board Member with Neurocritical Care Society that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Casey S. Albin, MD, FÂ鶹´«Ã½Ó³»­ (Emory Healthcare) Dr. Albin has received personal compensation in the range of $0-$499 for serving as a Consultant for Azurity Pharmaceutical. Dr. Albin has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Continuum: Life Long Learning in Neurology. Dr. Albin has received research support from Â鶹´«Ã½Ó³»­. Dr. Albin has received publishing royalties from a publication relating to health care.
Daniel S. Harrison, MD (Boston Medical Center) Dr. Harrison has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Glass Health. Dr. Harrison has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Diedrich & Donohue, LLP.