Psychological Safety in Prebriefing: What's the RISK?

What is the risk when ignoring psychological safety in clinical simulation prebriefing?

The concept of stress can be very mystifying as stress can affect everyone differently. In the simulation environment no one task has been shown to add to cognitive work effort or a person’s overall stress level. Some amount of stress in the clinical environment can be beneficial, but too much can be overwhelming, and can impair one’s ability to perform and overall psychological safety.

 There is limited information on the use of formal checklists for pre-simulation experiences. However, there is evidence to support the value of formal checklists in healthcare and aviation.

Promoting the utilization of formal checklists for pre-briefing in simulation holds great promise for the future. Learners in simulation need to be challenged to develop critical thinking skills in a safe environment. For the novice, it is recognized there can be some benefit for allowing repeat simulation experiences so that students can learn to manage their stress levels while mastering key concepts.

However, the numbers of participants and constraints of the different simulation centers may not allow repeat simulation activities. Integrating a methodical simulation checklist at the time of the prebriefing can allow the facilitator to prepare the learners or participants about the planned simulation activity. With more knowledge about the expected learning outcomes of the simulation, learners are more likely to learn new content with less stress or anxiety. Some amount of stress can be inherent, however, as medication usage, age, personality tendencies, and genetics can all have an impact on how participants may react to stress at any given time. Incorporating a checklist in the planning and preparation of the simulation day can help to ease stress levels and allow participants to have a better experiential learning experience.

The checklist likely includes expectations in the center, discussion about a fiction contract, safe communication, and an overview of the simulation environment. Example checklist template included!