Monthly Archives: August 2014

Clinical Bedside Teaching Can Benefit from “Simulation Style Debriefing”

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I recently had a great opportunity to do bedside teaching in the REAL Emergency Department of Wan Fang Hospital, which is one of the major teaching hospitals of Taipei Medical University in Taipei, Taiwan where I hold an appointment as a Visiting Professor.

It is amazing to realize the similarities between bedside teaching usual actual patients and the learning that can be facilitated through effective structured communications that encourage reflective learning. Yes, indeed those of you not so subtly reading between the lines recognize I am saying that I was implementing classic debriefing methods to help facilitate learning critical thought process while utilizing the experience of real patients.

We did case discussions of two actual patients with junior and senior level medical students. We reviewed case details, patient examination, hypothesis testing, clinical testing and diagnosis. During the two hour sessions I was relying upon the structured and supporting debriefing model (GAS Model) to facilitate the discussion.

The GAS model is one of the most common methods of simulation used throughout the world and was created by my Colleague Dr. John O’Donnell of WISER and University of Pittsburgh School of Nursing, Chair of the Department of Nurse Anesthesia in conjunction with the American Heart Association. 

In recent years John, I, and others have discovered the advantages of using “simulation style” structured debriefing used in the clinical teaching setting. The model encourages active reflection and self discovery through a structured model supported by supplemental learning materials and focusing on the participants readiness to learn.image[1]

Implementing the GAS Model during this exciting, but challenging opportunity to actualize bedside clinical teaching in an environment with participants who do not speak English as a primary language was hugely successful for the students judging by the feedback that I have received.

The model of debriefing can be expanded and contracting for varying levels of complexity and molded to support any learning encounters that benefit from active reflection with a goal of prompted discovery. It is easily learned through structured education sessions and workshops.

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