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Utilization of a structured adverse event debrief framework to confront second-victim syndrome in OBGYN residents
Purpose: To analyze the effects of a structured framework on OBGYN residents’ skills in leading adverse event debriefs.
Background: Trauma and stress are reported by 75% of OBGYN residents. This leads to distress, sleep disturbances, reduced confidence, medical errors, and impaired work performance.
Methods: A 90-minute simulation framework to conduct debriefs was created. This included a didactic component, a video example, and practice sessions. A survey instrument was administered before and after the simulation which assessed experience with, knowledge of, and comfort with leading debriefs.
Results: Pre-surveys were completed by 109 OBGYN residents and post-surveys by 69 residents from five programs. In the prior month, 249 distressing events were reported (median 2 per resident) with only 17.6% (n=44) accompanied by a debrief. In the prior year, 939 stressful events were reported (median 5). The majority had never received training in debriefing (92.66%, n=101). Significant increases were noted in all 10 ten metrics measured pre- and post-simulation. These included increased knowledge of debrief components (2.32/5 to 4.10/5, p<0.0001), strategies to lead an effective debrief (2.26/5 to 4.05/5, p<0.0001), and comfort in leading a debrief (1.92/5 to 3.26/5, p<0.0001).
Discussion: OBGYN residents frequently experience stressful events with a small portion followed by debriefs that discuss their impact. A low-cost, structured 90-minute simulation of leading adverse event debriefs improves comfort and likelihood of leading debriefs, and the ability to identify the components of a debrief. This intervention can be deployed as part of a well-being program to reduce emotional distress and improve the clinical learning environment.
Topics:
SES, 2023,
