Localized Student DASH to improve rating of faculty debriefing after simulation
Date
2025
Authors
Contributor
Advisor
Department
Instructor
Depositor
Speaker
Researcher
Consultant
Interviewer
Narrator
Transcriber
Annotator
Journal Title
Journal ISSN
Volume Title
Publisher
Volume
Number/Issue
Starting Page
Ending Page
Alternative Title
Abstract
Introduction
Debriefing is a crucial component of simulation-based education; the Debriefing Assessment for Simulation in Healthcare (DASH) is a behaviorally-anchored rating scale that evaluates debriefing quality within 6 elements. DASH was validated with trained raters evaluating simulation debriefings; the student version (DASH-SV) has not been validated. Reported DASH-SV scores cluster on the high end of the 7-point rating scale and may not accurately reflect debriefing quality.
Objective
We modified the DASH-SV with localized instructions to improve student understanding and rating accuracy (e.g. DASH-SV: “I felt that the instructor respected participants” vs. localized DASH-SV: “I felt that the instructor respected participants - Rate 4 or higher only if the instructor’s intention is to teach, instructor is respectful and curious about learner perspective, and asks open-ended questions”). We hypothesize that the localized version will lower score inflation, yielding more accurate scores and useful feedback for simulation faculty development.
Methods
Between June and September 2024, medical students at the University of Hawaii were sorted into two balanced groups based on their last name initial (Group A: A-K and Group B: L-Z). After participating in various routine faculty-facilitated simulation scenarios/debriefings, Group A completed the original DASH-SV and Group B completed the localized DASH-SV. These anonymous evaluations were completed via an online survey embedded in the standard post-course feedback form. Surveys included an attention-check question: “Please select 2 in the drop-down menu to show you are paying attention”. Data was analyzed using Fisher’s exact test for categorical variables, Wilcoxon rank sum test for continuous variables and for cases with more than 2 groups of comparison (such as when comparing students from three different medical years), and Kruskal-Wallis rank sum test for continuous variables. We report an interim analysis of this ongoing study.
Results
Group B (n = 63) rated debriefers lower than Group A (n = 66) across DASH behaviors 2a, 2c, 2d, 2e, 3b, 3c, 4a, 4b, 4c, 4e, 6b, and 6c (p<0.05). These behaviors comprise DASH debriefing elements of maintaining an engaging learning context, organizing the debriefing, promoting reflective discussion, and helping student performance. Group B answered the attention check question correctly at a higher rate (92%) compared to Group A (73%) (p<0.005). There was a significant difference across medical student years for correctly answering the attention check question - 94% of 1st year, 88% of 2nd year, and 48% of 4th year students answered correctly (p < 0.001). Fourth year medical students assigned a maximum score of 7 more often than 1st year medical students (p<0.05).
Discussion
Our localized DASH-SV resulted in lower scores compared to the original for select debriefing behaviors, suggesting reduced score inflation. Students who used the localized DASH-SV exhibited greater attentiveness. Upperclassmen were more likely to give maximum scores and fail the attention check, compared to 1st year students, suggesting less critical evaluation and engagement. The localized DASH-SV may be a more accurate tool for student assessment of debriefing quality and support meaningful faculty feedback to improve debriefing skill. Future direction will include methods to improve and validate rating accuracy and attentiveness, especially when surveying more senior medical students after simulation.
Target Audience
The findings of this study are particularly relevant to medical educators and faculty who oversee simulation-based education, simulation facilitators, medical education researchers, and medical students.
Description
Keywords
Citation
Extent
Format
Geographic Location
Time Period
Related To
Related To (URI)
Table of Contents
Rights
http://rightsstatements.org/vocab/InC/1.0/
Rights Holder
Local Contexts
Collections
Email libraryada-l@lists.hawaii.edu if you need this content in ADA-compliant format.