Michaela Kolbe

Last Name

Kolbe

First Name

Michaela

ORCID

0000-0001-6654-6370

Organisational unit

01359 - Lehre Management, Technologie u. Ök.

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Publications 1 - 10 of 28

Improving compliance with isolation measures in the operating room: a prospective simulation study comparing the effectiveness and costs of simulation-based training vs video-based training
Stutz, Linda; Koertgen, B.; Scheier, Thomas; et al. (2023)
Journal of Hospital Infection
Background: Different isolation measures are required according to the routes of transmission of pathogens. Few studies have compared different forms of hygiene training in terms of efficiency and/or improvement of perception towards hygiene measures. This study aimed to evaluate the benefits of different forms of isolation training in the operating room, and their respective effects on the perception of hygiene measures by comparing simulation training with video-based training. Methods: This multi-centre, prospective, randomized, controlled trial compared hygiene knowledge, psychological safety and perception of training among healthcare workers after in-centre simulation training and conventional video-based training. Results: Neither type of training led to a significant improvement in knowledge or perceived psychological safety (F=0.235, P=0.629, η2=0.003). Participants in the simulation group reported higher levels of willingness to speak up in the depicted scenario compared with participants who received video-based training. Participants perceived the simulation-based training significantly more positively than the video-based training. Conclusion: Clear definition of the goals of training based on the pre-existing level of knowledge of the participants is crucial. For future studies, it would be interesting to investigate the long-term effect and continuing benefits concerning the implementation of hygiene regulations after different types of training.
Helping clinicians debrief themselves: a simple how-to guide
Kolbe, Michaela; Symon, Benjamin (2024)
British Journal of Anaesthesia
The operating theatre is a dynamic and challenging environment where effective teamwork is essential. Routine clinical debriefings, which involve brief reflections on collaboration to identify successes and areas for improvement, have proved to enhance teamwork, particularly in the operating theatre. However, barriers such as time constraints, conflicting priorities, and a lack of standardised debriefing processes hinder their regular use. Implementation of TALK©, a voluntary self-debriefing method, showed significant improvements in debriefing performance and integration of debriefing into routine practice, although long-term consistency remains a challenge.
Debriefing Methods for Simulation in Healthcare: A Systematic Review
Duff, Jonathan P.; Morse, Kate J.; Seelandt, Julia; et al. (2024)
Simulation in Healthcare
Debriefing is a critical component in most simulation experiences. With the growing number of debriefing concepts, approaches, and tools, we need to understand how to debrief most effectively because there is little empiric evidence to guide us in their use. This systematic review explores the current literature on debriefing in healthcare simulation education to understand the evidence behind practice and clarify gaps in the literature. The PICO question for this review was defined as "In healthcare providers [P], does the use of one debriefing or feedback intervention [I], compared to a different debriefing or feedback intervention [C], improve educational and clinical outcomes [O] in simulation-based education?" We included 70 studies in our final review and found that our current debriefing strategies, frameworks, and techniques are not based on robust empirical evidence. Based on this, we highlight future research needs.
Medical Students' Speak-Up Barriers: A Randomized Controlled Trial with Written Vignettes
Dybdal Kayser, Jesper; Kjær Ersbøll, Annette; Kolbe, Michaela; et al. (2024)
Journal of Patient Safety
Objectives Little is known about medical students’ speak-up barriers upon recognizing or becoming aware of risky or deficient actions of others. Improving our knowledge on these helps in preparing student to function in actual health care organizations. The aim was to examine medical students' perceived reasons for silence in respect to different speak-up situations (i.e., vignette content) and to test if vignette difficulty had an effect on reasons indicated. Methods This study was a randomized, controlled, single-blind trial, with text-based vignettes to investigate speak-up barriers. Vignette contents described speak-up situations that varied systematically with respect to speak-up barrier (i.e., environmental norm, uncertainty, hierarchy) and difficulty (i.e., easy, difficult). For each vignette, participants indicated which speak-up barriers they regarded as important. Descriptive analysis was performed for the study population, the numbers of barriers perceived and rating of vignette difficulty. Logistic regression analysis was used to examine the association between barriers perceived and vignette contents, designed vignette difficulty and subjectively rated vignette difficulty. Results A total of 265 students were included. The response rate was 100%. Different barriers were relevant for the different vignettes and varied in a consistent way with the theme of the vignette. Significantly more speak-up barriers were indicated for participants with the difficult version for vignette 1 (not an environmental norm) and vignette 3 (hierarchy) with odds ratio (OR) = 1.52 and 95% confidence interval (95% CI: 1.33–1.73) and OR = 1.25 (95% CI: 1.09–1.44). For (OR) estimates, confidence intervals were rather large. Conclusions Perceived barriers for speak-up vary consistently with the characteristics of the situation and more barriers preventing speak-up were related to the difficult versions of the vignettes.
Helping healthcare teams to debrief effectively: associations of debriefers' actions and participants' reflections during team debriefings
Kolbe, Michaela; Grande, Bastian; Lehmann-Willenbrock, Nale; et al. (2023)
BMJ Quality & Safety
Background Debriefings help teams learn quickly and treat patients safely. However, many clinicians and educators report to struggle with leading debriefings. Little empirical knowledge on optimal debriefing processes is available. The aim of the study was to evaluate the potential of specific types of debriefer communication to trigger participants’ reflection in debriefings. Methods In this prospective observational, microanalytic interaction analysis study, we observed clinicians while they participated in healthcare team debriefings following three high-risk anaesthetic scenarios during simulation-based team training. Using the video-recorded debriefings and INTERACT coding software, we applied timed, event-based coding with DE-CODE, a coding scheme for assessing debriefing interactions. We used lag sequential analysis to explore the relationship between what debriefers and participants said. We hypothesised that combining advocacy (ie, stating an observation followed by an opinion) with an open-ended question would be associated with participants’ verbalisation of a mental model as a particular form of reflection. Results The 50 debriefings with overall 114 participants had a mean duration of 49.35 min (SD=8.89 min) and included 18 486 behavioural transitions. We detected significant behavioural linkages from debriefers’ observation to debriefers’ opinion (z=9.85, p<0.001), from opinion to debriefers’ open-ended question (z=9.52, p<0.001) and from open-ended question to participants’ mental model (z=7.41, p<0.001), supporting our hypothesis. Furthermore, participants shared mental models after debriefers paraphrased their statements and asked specific questions but not after debriefers appreciated their actions without asking any follow-up questions. Participants also triggered reflection among themselves, particularly by sharing personal anecdotes. Conclusion When debriefers pair their observations and opinions with open-ended questions, paraphrase participants’ statements and ask specific questions, they help participants reflect during debriefings.
Debriefing im Rettungsdienst
Grande, Bastian; Kolbe, Michaela (2024)
Notarzt
Debriefings are an important part of healthcare, especially for acute care teams. They can increase the effectiveness of teams and promote open communication. At the same time, debriefings provide an opportunity for learning within teams. Both exceptional clinical events and challenging procedures, as well as new algorithms or operations in new vehicles or with new material, can provide a reason for a debriefing. It is useful to debrief clinical events without exceptional occurrences so that team members learn how debriefing works. Effective and outstanding points should always be discussed and a focus on errors should be placed in the background. Structure and setting of specific topics play a special role in debriefings. Informal and unstructured discussions should be avoided, as should digressing into topics that are less relevant to the situation at hand. At an organizational level, debriefings should be incorporated into the structures of acute teams and encouraged. Relevance should be created through content whereas reference to the assessment of individual employees should be avoided.
Make a difference: implementation, quality and effectiveness of the WHO Surgical Safety Checklist-a narrative review
Wyss, Muriel; Kolbe, Michaela; Grande, Bastian (2023)
Journal of Thoracic Disease
Background and Objective: The positive effects of the WHO Surgery Safety Checklist (WHO SSC) have been demonstrated by a large amount of quantitative studies. With this review the focus changes to the content of qualitative studies on WHO SSC to identify possible research gaps. In this way, gaps in the content of the execution of individual checklists can be closed.Methods: The two research platforms "Ovid Medlin e" and "PubMed" formed a solid basis for the literature research. The search was conducted until 19th of September 2022. The following group terms were used: "checklist", "surgery", "implementation", "WHO Surgical Safety Checklist". Subsequently, the literature research was limited to studies between 2011 and 2021 in either English or German.Key Content and Findings: Overall, a positive effect was found in all qualitative studies on WHO SSC with respect to leadership, teamwork, timing and acceptance. Acceptance through effective implementation of the SSC deserves special mention. Several studies highlighted the lack of understanding and training, which led to variation in execution. A large number of studies agree about the WHO SSC is fostering teamwork and improving communication. However, there are also hurdles and barriers in the application that seem to have an influence on the effectiveness.Conclusions: The exact mechanisms of the advantage and application of the checklist are still poorly understood. Further research in this area is needed for a better understanding of the underlying work culture and consequently improving patient safety.
Managing psychological safety in debriefings: A dynamic balancing act
Kolbe, Michaela; Eppich, Walter J.; Rudolph, Jenny; et al. (2020)
BMJ Simulation and Technology Enhanced Learning
Measuring teamwork for training in healthcare using eye tracking and pose estimation
Weiss, Kerrin; Kolbe, Michaela; Lohmeyer, Quentin; et al. (2023)
Frontiers in Psychology
Teamwork is critical for safe patient care. Healthcare teams typically train teamwork in simulated clinical situations, which require the ability to measure teamwork via behavior observation. However, the required observations are prone to human biases and include significant cognitive load even for trained instructors. In this observational study we explored how eye tracking and pose estimation as two minimal invasive video-based technologies may measure teamwork during simulation-based teamwork training in healthcare. Mobile eye tracking, measuring where participants look, and multi-person pose estimation, measuring 3D human body and joint position, were used to record 64 third-year medical students who completed a simulated handover case in teams of four. On one hand, we processed the recorded data into the eye contact metric, based on eye tracking and relevant for situational awareness and communication patterns. On the other hand, the distance to patient metric was processed, based on multiperson pose estimation and relevant for team positioning and coordination. After successful data recording, we successfully processed the raw videos to specific teamwork metrics. The average eye contact time was 6.46 s [min 0 s – max 28.01 s], while the average distance to the patient resulted in 1.01 m [min 0.32 m – max 1.6 m]. Both metrics varied significantly between teams and simulated roles of participants (p < 0.001). With the objective, continuous, and reliable metrics we created visualizations illustrating the teams’ interactions. Future research is necessary to generalize our findings and how they may complement existing methods, support instructors, and contribute to the quality of teamwork training in healthcare.
The challenge of learning from perioperative patient harm
Wacker, Johannes; Kolbe, Michaela (2016)
Trends in Anaesthesia and Critical Care
Perioperative patient harm is frequent: Adverse events, more than half of them preventable, occur in about 30% of hospital admissions. Surgical in-hospital mortality in Europe is currently as high as 4% on average. Openly communicating as well as reporting patient harm are key to learning within institutions and improving patient outcomes, but are hindered by strong barriers in the tense working environment of perioperative healthcare. Some interventions to overcome such barriers and to improve patient outcomes are ready for adoption into routine practice. Before implementing safety interventions, specific institutional conditions should be considered to ensure local validity. Sustained improvements require local measurement and long-term monitoring of effects.

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Michaela Kolbe

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