Setting the Stage for Psychological Safety: Classroom Prebriefing Prior to a Blood Administration Simulation

Purpose: Blood administration is a high risk procedure completed by licensed health care personnel. Medical-surgical nursing students do not have an opportunity to administer blood products during their educational training in the clinical setting. In the simulation learning center, students are able to recognize anemia, consult with a health care provider, administer blood, and monitor the patient for a blood transfusion reaction. Prior to simulation, the prebrief ensures participants' psychological safety and sets the stage for learning outcomes to be achieved (Roh, Y., Ahn, J., Kim, E., & Kim, J., 2018). Psychological safety is an important consideration when planning any simulation learning experience. The purpose of this education intervention was to enhance students' knowledge, skills, and confidence prior to a blood administration simulation using prebriefing in the classroom setting. Methods: Over a three-year period course faculty designed and implemented an interactive prebriefing to enhance preparation for a blood administration simulation. The medical-surgical nursing course faculty collaborated with a simulation specialist to prepare third-year medical-surgical nursing students (N=253) prior to the complex transfusion reaction simulation. The prebrief began after a mini lecture on acute anemia and blood administration. Next, simulation staff transported a simulator manikin into the classroom setting for orientation to the upcoming simulation. The course faculty and a second RN demonstrated the entire procedure of blood administration while students followed along with copies of the patient ID and blood bank forms. Students then practiced the process of blood administration and discussed patient monitoring before, during, and after the procedure. Results: The first time course faculty implemented this teaching strategy students found this to be one of their most meaningful classes and simulation learning experience. Faculty recognized the interactive prebrief as a successful teaching strategy and began to integrate the prebrief across other courses with complex clinical simulations. Conclusions: Using classroom time for this learning activity improved students’ understanding of the role of the registered nurse regarding administration of blood products and preparation for the simulation learning experience. Students found the prebrief prior to simulation extremely helpful and an engaging way to learn the knowledge and skills necessary to perform this nursing function. Prebriefing may increase student engagement and comfort level with simulation learning.