Bastian Grande

Last Name

Grande

First Name

Bastian

ORCID

0000-0003-2935-1317

Organisational unit

01630 - Lehre HEST

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Publications 1 - 10 of 13

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 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.
“Asking for help is a strength”—how to promote undergraduate medical students’ teamwork through simulation training and interprofessional faculty
Kolbe, Michaela; Goldhahn, Jörg; Useini, Mirdita; et al. (2023)
Frontiers in Educational Psychology
The ability to team up and safely work in any kind of healthcare team is a critical asset and should be taught early on in medical education. Medical students should be given the chance to “walk the talk” of teamwork by training and reflecting in teams. Our goal was to design, implement and evaluate the feasibility of a simulation-based teamwork training (TeamSIM) for undergraduate medical students that puts generic teamwork skills centerstage. We designed TeamSIM to include 12 learning objectives. For this pre-post, mixed-methods feasibility study, third-year medical students, organized in teams of 11–12 students, participated and observed each other in eight simulations of different clinical situation with varying degrees of complexity (e.g., deteriorating patient in ward; trauma; resuscitation). Guided by an interprofessional clinical faculty with simulation-based instructor training, student teams reflected on their shared experience in structured team debriefings. Using published instruments, we measured (a) students’ reactions to TeamSIM and their perceptions of psychological safety via self-report, (b) their ongoing reflections via experience sampling, and (c) their teamwork skills via behavior observation. Ninety four students participated. They reported positive reactions to TeamSIM (M = 5.23, SD = 0.5). Their mean initial reported level of psychological safety was M = 3.8 (SD = 0.4) which rose to M = 4.3 (SD = 0.5) toward the end of the course [T(21) = −2.8, 95% CI −0.78 to-0.12, p = 0.011 (two-tailed)]. We obtained n = 314 headline reflections from the students and n = 95 from the faculty. For the students, the most frequent theme assigned to their headlines involved the concepts taught in the course such as “10 s for 10 min.” For the faculty, the most frequent theme assigned to their headlines were reflections on how their simulation session worked for the students. The faculty rated students’ teamwork skills higher after the last compared to the first debriefing. Undergraduate medical students can learn crucial teamwork skills in simulations supported by an experienced faculty and with a high degree of psychological safety. Both students and faculty appreciate the learning possibilities of simulation. At the same time, this learning can be challenging, intense and overwhelming. It takes a team to teach teamwork.
Exposure to incivility does not hinder speaking up: a randomised controlled high-fidelity simulation-based study
Vauk, Stefanie; Seelandt, Julia C.; Huber, Katja; et al. (2022)
British Journal of Anaesthesia
Background: Speaking up with concerns is critical for patient safety. We studied whether witnessing a civil (i.e. polite, respectful) response to speaking up would increase the occurrence of further speaking up by hospital staff members as compared with witnessing a pseudo-civil (i.e. vague and slightly dismissive) or rude response. Methods: In this RCT in a single, large academic teaching hospital, a single simulated basic life support scenario was designed to elicit standardised opportunities to speak up. Participants in teams of two or three were randomly assigned to one of three experimental conditions in which the degree of civility in reacting to speaking up was manipulated by an embedded simulated person. Speaking up behaviour was assessed by behaviour coding of the video recordings of the team interactions by applying 10 codes using The Observer XT 14.1. Data were analysed using multilevel modelling. Results: The sample included 125 interprofessional hospital staff members (82 [66%] women, 43 [34%] men). Participants were more likely to speak up when they felt psychologically safe (γ=0.47; standard error [SE]=0.19; 95% confidence interval [CI], 0.09–0.85; P=0.017). Participants were more likely to speak up in the rude condition than in the other conditions (γ=0.28; SE=0.12; 95% CI, 0.05–0.52; P=0.019). Across conditions, participants spoke up most frequently by structuring inquiry (n=289, 31.52%), proactive (n=240, 26.17%), and reactive (n=148, 16.14%) instruction statements, and gestures (n=139, 15.16%). Conclusion: Our study challenges current assumptions about the interplay of civility and speaking up behaviour in healthcare.
How to train thoracic anesthesia for residents and consultants?
Grande, Bastian; Zalunardo, Marco Piero; Kolbe, Michaela (2022)
Current Opinion in Anesthesiology
Purpose of review The training of anesthesiologists in thoracic surgery is a significant challenge. International professional societies usually provide only a case number-based or time-based training concept. There are only a few concepts of simulation trainings in thoracic anesthesia and interprofessional debriefings on a daily basis are rarely applied. In this review, we will show how professional curricula should aim for competence rather than number of cases and why simulation-based training and debriefing should be implemented. Recent findings Recent curricula recommend so-called entrustable professional activities (EPAs)as a way out of the dilemma between the number of cases vs. competence. With these EPAs, competence can be mapped and prerequisites defined. Training concepts from simulation in healthcare have so far not explicitly reached anesthesia for thoracic surgery. In addition to mere technical training, combined technical-behavioral training forms have proven to be an effective training targeting the entire team in the context of the actual working environment in the operating theatre. Summary Interdisciplinary and interprofessional learning can take place in simulation trainings and on a daily basis through postevent debriefings. When these debriefings are conducted in a structured way, an improvement in the performance of the entire team can be the result. The basis for these debriefings – as well as for other training approaches – is psychological safety, which should be established and maintained together with all professions involved.
„Die Puppe hat Luftnot“ – Simulation zum interprofessionellen Lernen im Team: aber sinnvoll!
Grande, Bastian; Breckwoldt, Jan; Kolbe, Michaela (2022)
Notfall + Rettungsmedizin
Ausbildungskonzepte, die eine Simulation von Fällen und Szenarien aller Art nutzen, haben breiten Eingang in Curricula und Praxis gefunden. Ein Vertrauen in technische Simulationsmethoden ohne qualifizierte Ausbildung in der Methode kann schaden. Deswegen sollte nach der Auswahl der korrekten Simulationsmethode großer Wert auf die Durchführung der Simulation gelegt werden. Neben einem strukturierten Design der simulierten Szenarien und der korrekten technischen Durchführung ist für den Lernerfolg vor allem das Debriefing, die Nachbesprechung, entscheidend. Prüfungen mit Simulation als Methode sind nur zu empfehlen, wenn sie von Trainings getrennt durchgeführt werden und die Bewertung nach transparenten, validierten Kriterien erfolgt.
Fostering and maintaining psychological safety-emotional regulation and learning culture in simulations, debriefings and daily clinical practice
Grande, Bastian; Kolbe, M. (2026)
Notfall + Rettungsmedizin
Simulation-based training is a core component of undergraduate, postgraduate, and continuing education in emergency and acute care medicine. It provides a protected environment in which rare events, challenging clinical situations, and new workflows or algorithms can be practiced in an interprofessional setting, while strengthening teamwork and rehearsing critical decision-making under realistic conditions. Within this context, the concept of psychological safety has gained increasing attention. From the perspective of simulation instructors, this article explores how psychological safety can be deliberately fostered, with a particular focus on neuropsychological foundations, practical implementation during training and debriefing, and the transfer of these principles into everyday clinical practice. The article highlights that psychological safety is not a static state, but a dynamic process requiring ongoing attention, reflection, and intentional design-within simulation-based education, in real-world clinical care, and among the instructor team itself.
In Response
Kolbe, Michaela; Grote, Gudela; Burtscher, Michael J.; et al. (2013)
Anesthesia & Analgesia

Publications 1 - 10 of 13

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