Simulation debriefing : improving team performance during prehospital trauma

Abstract

Introduction: Effective team performance is vital in prehospital trauma care, where rapid, coordinated actions are directly linked with patient survival. Prehospital nurses often encounter limited exposure to high-energy trauma cases, restricting their ability to maintain essential technical and non-technical skills. Simulation-based training helps bridge this gap, particularly through the reflective and experiential learning that takes place during simulation debriefing. Despite strong evidence supporting simulation training in life support and resuscitation, limited research has examined the impact of simulation debriefing on team performance, particularly in prehospital trauma management. Objectives: The aim of this study was to determine whether simulation debriefing following a prehospital traumatic scenario would improve team performance among emergency nurses with prehospital experience when compared to direct performance feedback. Research design and method: A quasi-experimental pre-test-post-test design was adopted. During three simulation workshops, participants were randomly assigned to either an intervention or a comparison group. Team performance was measured using the validated Performance Assessment of Emergency Teams and Communication in Trauma Care (P.E.R.F.E.C.T.) checklist. Furthermore, participants’ confidence and perceptions related to their performance during the simulation were assessed through a self-designed questionnaire. Both measures were conducted before and after the debriefing and feedback sessions. Participants: A total of 24 nurses with prehospital experience voluntarily participated in the study. Nurses were randomly allocated to the intervention group (n=12) and control group (n=12). Due to the small sample size, statistical analyses lacked the power to identify any statistically significant findings. Results: Results suggest improvements in participants’ confidence and in technical and nontechnical skills, following both interventions. These were marked by improved scenario management, improved technical procedural performance and reduced scenario completion time. Despite these descriptive improvements, particularly the group which received simulation debriefing, the differences between the two groups did not reach statistical significance. Conclusion: Simulation-based team training improves team performance, supporting the adaptability and educational value of both structured simulation debriefing and feedback. While recognising the study’s main limitation in recruitment, it showed positive trends in simulation debriefing, highlighting the need for further research with larger sample sizes. Main Recommendation: Despite the low statistical power carried by this study, the descriptive improvement noted in both the intervention and control groups supports the recommendation that simulation training followed by debriefing or feedback be adopted to enhance trauma-team performance. Furthermore, research with a larger sample size is recommended to determine which type of debriefing or feedback approach produces the best outcomes in specific trauma-scenarios.