Prebriefing Considerations

There are a number of considerations for the educator to address when planning a virtual simulation prebrief:

When to Prebrief?

Prebriefing is usually provided as close to the enactment of the simulation as possible. As a result it is often the day of the simulation or immediately in advance of the simulation.

How much time should be spent on the prebrief?

Approximately 5-10% of the time for the entire simulation experience should be spent in prebriefing. The amount of time will depend on the level of learner and their experience with simulation. It is important not to overwhelm learners with too much information; focus on ‘need to know’.

What should be included in the prebrief?

A briefing script may be used to ensure that all participants consistently hear the same information (INACSL Standards Committee, McDermott, et al., 2021). There are several important topics or points for educators to review in the prebrief. These include:

• The fiction contract.
• Rules of engagement.
• Ground rules regarding learner expectations. Learners need to know if it is okay to make mistakes and if it is those mistakes will be discussed during debriefing. This gives learners  the opportunity to learn from their mistakes and improve.
• Confidentiality regarding the performance of other learners and the scenario content. Clarify what information from the simulation may be shared with others versus what needs to be kept confidential to protect the integrity of the simulation for future learners or evaluations.
• The virtual environment: what to expect and orientation to the technology and flow.
• Simulation learning objectives.
• Recording the session: Clarify whether or not the session will be recorded.
• Simulation environment/equipment: The following is applicable if the virtual simulation is being completed through web conferencing. Review the appropriate use of video, microphone and chat. Recommend learners find a quiet space to enhance their sense of psychological safety. Encourage learners to use their video to foster engagement through non-verbal communication, however, acknowledge that some learners are uncomfortable turning on their video due to their personal circumstances or their environment (i.e. at home or work).
• Sensitive content: Virtual simulations portraying sensitive situations require a more in-depth prebrief. The prebrief is a balancing act: educators want to prepare learners, particularly for disturbing content, however, they don’t want to “give too much away”. Learners should be advised that resources are available if they would like to talk with someone about their experience.

Examples in Action: Fiction Contract

During the following virtual simulation, you will interact with different actors depending on the specific scenario. Virtual simulation fosters an environment for active engagement in a relatively safe environment.  As the developers of the virtual simulations, we do all we can to make the simulation as real as possible. We do recognize that in this scenario the (input what is not realistic) is not realistic. We ask you to engage in the simulation with healthcare professionals and the patient as if they were real. This approach will give you the best possible active learning opportunity.

Examples in Action: Confidentiality

During the virtual simulations, we ask you to be non-judgmental, to be open to learning from others in your group, and from the simulation. It is important to remember that what happens in the discussion stays within the group. By maintaining confidentiality related to the virtual simulation experience, other learners’ choices/comments, and the summary report, you help to create a psychologically safe learning environment and an effective experience for all learners. Does everyone agree to maintain confidentiality related to the class discussion? (Ask for permission to record any part of the virtual simulations if you plan on recording it).

Examples in Action: Psychological Safety

Some of the virtual simulations deal with potentially disturbing content, for example, suicide, and domestic violence content in a virtual simulation. It is important to address this with learners in the prebrief. Explain that the virtual simulation is designed for mature learners who are healthcare workers. Advise learners that if they have any unsettled feelings before, during, or after the virtual simulation, they should talk with their educator or contact counseling services at their institution.

Other factors to consider:

Timing

• Most educators conduct the prebrief right before the virtual simulation. It can be conducted the day or the week before the virtual simulation if necessary, however, prebriefing as close to the start of the simulation as possible is recommended.

Where to Prebrief?

• The prebrief can be conducted using different formats: online (i.e. Zoom, Blackboard, Teams), recorded in advance or, held in person (face-to-face), written in a document, prior to the virtual simulation.

Types of Prebriefing

There are several types of prebriefing strategies including self asynchronous, synchronous and self. Each of these strategies is outlined below.

• Self asynchronous: the learner is provided with written, audio or video information to prepare them for the simulation environment, scenario, participant roles, and learning objectives without facilitation. As there is no synchronous facilitation, this approach does not provide the opportunity to clarify the process. The participant can engage in the prebriefing separately from the simulation.
• Synchronous: The prebriefing is staged to occur just prior to the simulation and can be held in different ways: written, audio, video or facilitated from a distance.
• In person: the prebriefing is conducted in real time by a facilitator.

Expert’s Corner: Prebriefing

In the video below, Elizabeth Horsley MSMS, RN, CHSE, discusses best practices for prebriefing.

Click here to download an accessible PowerPoint copy of the video below.