Understanding Perceptions of the Postsimulation Debriefing Learning Environment in Paediatric Trainees

Simulation within medical education develops knowledge, skills and attitudes without risk of patient harm. Debriefing, a two-way feedback process between learner and facilitator, consolidates learning through a reflective process. Creating a safe learning environment where learners feel comfortable exposing knowledge gaps is essential. Different learners likely perceive the learning environment in unique ways. Although facilitators may strive to create psychological safety, educators and learners can interpret feedback interactions in different ways. The aim of this research was to provide insight into how trainees perceived the postsimulation learning environment. Purposeful, comparison-focused sampling was utilised to recruit participants with varying self-reported levels of ability, according to the Dreyfus model of skill acquisition, and contrasting perspectives of the debrief. Following random stratification of anonymised survey responses, eight learners participated in semi-structured interviews. Interviews were transcribed and inductively analysed following a six-step reflexive thematic analysis process. Four themes were revealed, which portrayed learner perceptions of the debrief. Feelings and emotions associated with debriefing were both positive and negative, although a fear of judgement prevailed. Safe and unsafe learning environments were described. Feedback was perceived as polite, but not always honest. The impact of both imposter syndrome and cultural norms emerged as unexpected findings. Differences were observed in how those with more experience responded to feedback compared with less experienced colleagues. Although learners perceived strengths and weaknesses within the postsimulation learning environment, maintaining psychological safety whilst providing honest and credible feedback remains a challenge for educators.