Screen Shot 2013-06-17 at 3.03.29 PMI just completed the 4 day intensive Center for Medical Simulation Institute for Medical Simulation Instructor Course.  The title of the course is a mouthful and just as intense and high yield as the actual course was itself.  The chief purpose of the course is to develop debriefing skills as a medical instructor. The structure and nature of the course seemed so effortless and fluid, and yet at the end of the 4 days, I knew that the debriefing skills I had learned were ingrained into my brain. I highly recommend this course to any medical educator with simulation interest.  In this post, I want to share with you a few of the highlights and encourage everyone to learn more.

The course that I took was held at the beautiful NYSIM Simulation Center in Manhattan, NY. The instructors were primarily Drs. Robert Simon, Demian Szyld, and Grace Ng RN, with Jenny Rudolph present for a short while.  The other learners were highly accomplished professionals that ranged from MDs, RNs, RN educators, and PAs with a variety of backgrounds in simulation.  Although the days were long and grueling at times (10 hr days!), they were interspersed with significant time for reflective and thoughtful discussion with the instructors and the participants.  The group activities were plenty and provided opportunity to practice the debriefing and simulation skills we gained.

A few stand out concepts discussed1–4

  • The basic assumption
  • Debriefing structure – reactions phase / understanding phase / summary phase
  • The importance of curiosity, advocacy, and inquiry within debriefing
  • Uncovering frames of mind to change actions and obtain different results
  • Crisis resource management

No simulation nor education course would be complete without theory and application, and this course was no different.

Theories discussed

  • Kolb Experiential Learning Cycle
  • Lewin Theory of Change
  • Emotional Learning
  • Andragogy
  • Deliberate Practice

Bloom’s Taxonomy

The theory that stood out to me the most was Bloom’s Taxonomy, because in a sense the course felt like it was structured to follow the Bloom’s Taxonomy as illustrated:

Bloom's taxonomy

  • Creating – we created our own simulation from start to finish with a lively debriefing session
  • Evaluating – we debriefed our debriefs
  • Analyzing –  we played many mini games
  • Applying –          ”             “
  • Understanding – had overview of educational theory
  • Remembering – group discussions to review concepts

I told Dr. Robert Simon at the conclusion of the course that the 4 days felt like magic. What I meant was that the teaching they imparted onto me felt naturally acquired into my brain and at the end I felt in awe of what I had learned.  I hope to one day be able to emulate these great instructors in debriefings that I conduct.

Rudolph J, Simon R, Rivard P, Dufresne R, Raemer D. Debriefing with good judgment: combining rigorous feedback with genuine inquiry. Anesthesiol Clin. 2007;25(2):361-376. [PubMed]
Rudolph J, Simon R, Raemer D, Eppich W. Debriefing as formative assessment: closing performance gaps in medical education. Acad Emerg Med. 2008;15(11):1010-1016. [PubMed]
Rudolph J, Simon R, Dufresne R, Raemer D. There’s no such thing as “nonjudgmental” debriefing: a theory and method for debriefing with good judgment. Simul Healthc. 2006;1(1):49-55. [PubMed]
Rudolph J, Simon R, Raemer D. Which reality matters? Questions on the path to high engagement in healthcare simulation. Simul Healthc. 2007;2(3):161-163. [PubMed]
Nikita Joshi, MD

Nikita Joshi, MD

ALiEM Chief People Officer and Associate Editor
Clinical Instructor
Department of Emergency Medicine
Stanford University
Nikita Joshi, MD


Emergency Medicine Doctor Associate Editor of ALiEM Gun Sense Advocate #FOAMed #Docs4GunSense #MomsDemandAction Tweets represent my own views and opinions