Telementoring for remote simulation instructor training and faculty development using telesimulation

Abstract

Introduction: Simulation-based training is essential for high-quality medical care, but it requires access to equipment and expertise. Technology can facilitate connecting educators to training in simulation. We aimed to explore the use of remote simulation faculty development in Latvia using telesimulation and telementoring with an experienced debriefer located in the USA.

Methods: This was a prospective, simulation-based longitudinal study. Over the course of 16 months, a remote simulation instructor (RI) from the USA and a local instructor (LI) in Latvia cofacilitated with teleconferencing. Responsibility gradually transitioned from the RI to the LI. At the end of each session, students completed the Debriefing Assessment for Simulation in Healthcare (DASH) student version form (DASH-SV) and a general feedback form, and the LI completed the instructor version of the DASH form (DASH-IV). Outcome measures were the changes in DASH scores over time.

Results: A total of eight simulation sessions were cofacilitated of 16 months. As the role of the LI increased over time, the debrief quality measured with the DASH-IV did not change significantly (from 89 to 87), although the DASH-SV score decreased from a total median score of 89 (IQR 86-98) to 80 (IQR 78-85) (p=0.005).

Conclusion: In this study, telementoring with telesimulations resulted in high-quality debriefing. The quality-perceived by the students-was higher with the involvement of the remote instructor and declined during the transition to the LI. This concept requires further investigation and could potentially build local simulation expertise promoting sustainability of high-quality simulation.

Keywords: instructor development; near-peer coaching; simulation; telesimulation.

Figure 1

Dash median scores over time. Plot showing total DASH scores for DASH-IV (dashed line) and DASH-SV (solid line) over the course of the study. The blue shaded areas represent the per cent leadership from the local instructor over time, beginning at 0% effort from the local instructor (100% effort from the remote instructor) in the first telesimulation to 100% effort from the local instructor in the last telesimulation. Error bars for DASH-SV represent SEMs. Error bars for DASH-IV were not calculated since there was only one data point per session. DASH, Debriefing Assessment for Simulation in Healthcare; DASH-IV, DASH instructor version; DASH-SV, DASH student version.