Table 3

Observed facilitator interventions immediately before the debriefings moved into the Alternative strategies/solutions phase, number of occurrences and descriptions of the interventions

Facilitator interventionOccurrenceDescription
Dramatises8The facilitator acts out possible behaviours in a hypothetical situation often quoting something that an imagined person could have been saying and often in combination with moving around the room gesturing to imagined participants and as if they were using tools and instruments in the hypothetical situation (‘What would you do if… a father wants to know X?’, ‘Here, you can say precisely what you know: “the child’s heart is beating and we are assisting him with his breathing,” you can say that. Can you cause any harm by saying that?’). The dramatising illustrated possible behaviours and made points about how they might be experienced by others and about their possible consequences, both positive or negative ones.
Summarises and asks priority questions7The facilitator lists what the team had done. Sometimes also encouraging participants to prioritise between possible alternatives. The summaries reminded the participants of the multiple events that had taken place and related the question to a specific time and situation in the simulation and the facilitators encouraged them to make prioritisations between different activities (‘…and what is most important for the child then and there, that second?’).
Asks about possible actions5The facilitator inquires directly about how a team could or should act in a specific situation (‘…how can you ensure that a report really has been understood or not?’).
Authenticates4The facilitator relates to what could happen in a clinical setting by describing a similar case that they have experienced or might be possible in a real event.
Suggests strategies4The facilitator suggests alternate future actions to spur discussions. The facilitators sometimes asked whether the team wanted suggestions and offered recommendations about how the team could have acted (‘May I give you a suggestion?’; ‘It’s a good thing to talk about the pulse and whether it increases or not and whether the chest is rising.’).
Uses video3The video is used in a similar way as described in the Problem section. However, here the video image is used to refer to a concrete situation and to create a starting point for the discussion about alternative strategies (eg, the facilitator points at the monitor and says, ‘And if we had been back in this situation here … if you are uncertain about what you should do, how should you solve that problem?’).
Asks about own thoughts2The facilitator checks that the participants have understood the facilitator’s line of thought, for example, after attempting to explain a problematic event (‘…And what do you think my point (of saying this) is here?’).