Briefing and debriefing during simulation-based training and beyond: Content, structure, attitude and setting.

In this article, we review the debriefing literature and point to the dilemma that although debriefings especially intend to enhance team (rather than individual) learning, it is particularly this team setting that poses risks for debriefing effectiveness (e.g., preference-consistent information sharing, lack of psychological safety inhibiting structured information sharing, ineffective debriefing models). These risks can be managed with a mindful approach with respect to content (e.g., specific learning objectives), structure (e.g., reactions phase, analysis phase, summary phase), attitude (e.g., honesty, curiosity, holding the trainee in positive regard) and setting (e.g., briefings to provide orientation and establish psychological safety). We point to the potential of integrating systemic methods such as circular questions into debriefings, discuss the empirical evidence for debriefing effectiveness and highlight the importance of faculty development.

[1]  Peter A. Bamberger,et al.  Can Surgical Teams Ever Learn? The Role of Coordination, Complexity, and Transitivity in Action Team Learning , 2013 .

[2]  R. Dismukes,et al.  What Is Facilitation and Why Use It , 2017 .

[3]  Peter E. Rivard,et al.  Debriefing with good judgment: combining rigorous feedback with genuine inquiry. , 2007, Anesthesiology clinics.

[4]  K. A. Ericsson,et al.  Deliberate practice and acquisition of expert performance: a general overview. , 2008, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[5]  J. Rudolph,et al.  Learning from experience in high-hazard organizations , 2002 .

[6]  Nick Sevdalis,et al.  Identifying best practice guidelines for debriefing in surgery: a tri-continental study. , 2012, American journal of surgery.

[7]  S. Benito,et al.  Pulmonary compliance measurement in acute respiratory failure , 1985, Critical care medicine.

[8]  Nelson P. Repenning,et al.  Capability Traps and Self-Confirming Attribution Errors in the Dynamics of Process Improvement , 2002 .

[9]  Jason J Zigmont,et al.  Theoretical foundations of learning through simulation. , 2011, Seminars in perinatology.

[10]  Tammy L. Rapp,et al.  Laying the foundation for successful team performance trajectories: The roles of team charters and performance strategies. , 2009, The Journal of applied psychology.

[11]  Shmuel Ellis,et al.  After-event reviews: drawing lessons from successful and failed experience. , 2005, The Journal of applied psychology.

[12]  J. Rudolph,et al.  Improving Faculty Feedback to Resident Trainees during a Simulated Case: A Randomized, Controlled Trial of an Educational Intervention , 2014, Anesthesiology.

[13]  S. Papaspyros,et al.  Briefing and Debriefing in the Cardiac Operating Room. Analysis of Impact on Theatre Team Attitude and Patient Safety , 2010 .

[14]  Jenny W Rudolph,et al.  Establishing a Safe Container for Learning in Simulation: The Role of the Presimulation Briefing , 2014, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[15]  A. Edmondson,et al.  Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy , 2012 .

[16]  Robert Simon,et al.  Debriefing Assessment for Simulation in Healthcare: Development and Psychometric Properties , 2012, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[17]  Peter Dieckmann,et al.  Reality and Fiction Cues in Medical Patient Simulation: An Interview Study with Anesthesiologists , 2007 .

[18]  David M Gaba,et al.  So many roads: facilitated debriefing in healthcare. , 2006, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[19]  Lori K. McDonnell,et al.  Facilitating LOS Debriefings: A Training Manual , 1997 .

[20]  David M. Gaba,et al.  The Role of Debriefing in Simulation-Based Learning , 2007, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[21]  John E. Mathieu,et al.  A Temporally Based Framework and Taxonomy of Team Processes , 2001 .

[22]  L. Boscolo,et al.  Hypothesizing--circularity--neutrality: three guidelines for the conductor of the session. , 1980, Family process.

[23]  V. Nadkarni,et al.  Research Regarding Debriefing as Part of the Learning Process , 2011, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[24]  Chris Argyris,et al.  Double-Loop Learning, Teaching, and Research , 2002 .

[25]  Jonathan Sherbino,et al.  Debriefing for technology‐enhanced simulation: a systematic review and meta‐analysis , 2014, Medical education.

[26]  Peter Dieckmann,et al.  The art and science of debriefing in simulation: Ideal and practice , 2009, Medical teacher.

[27]  J. Rudolph,et al.  Helping Without Harming: The Instructor’s Feedback Dilemma in Debriefing—A Case Study , 2013, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[28]  Ingrid M. Nembhard,et al.  Making It Safe: The Effects of Leader Inclusiveness and Professional Status on Psychological Safety and Improvement Efforts in Health Care Teams , 2006 .

[29]  KrizWilly Christian A Systemic-Constructivist Approach to the Facilitation and Debriefing of Simulations and Games , 2010 .

[30]  A. Darzi,et al.  Operation Debrief: A SHARP Improvement in Performance Feedback in the Operating Room , 2013, Annals of surgery.

[31]  R. Key Dismukes,et al.  Facilitation and Debriefing in Aviation Training and Operations , 2000 .

[32]  M. Kolbe,et al.  Snapshots of the road to reflective practice: What advanced simulation instructors think during a master class , 2013 .

[33]  William M. Kondrath How the Way We Talk Can Change the Way We Work: Seven Languages for Transformation , 2002 .

[34]  J. R. Larson,et al.  Leadership Style and the Discussion of Shared and Unshared Information in Decision-Making Groups , 1998 .

[35]  E. Tseliou,et al.  Studying circular questioning "in situ": discourse analysis of a first systemic family therapy session. , 2014, Journal of marital and family therapy.

[36]  Willy Christian Kriz,et al.  A Systemic-Constructivist Approach to the Facilitation and Debriefing of Simulations and Games , 2010 .

[37]  John E. Mathieu,et al.  Helping teams to help themselves: : comparing two team-led debriefing methods , 2013 .

[38]  D. Kolb,et al.  Learning Styles and Learning Spaces: Enhancing Experiential Learning in Higher Education , 2005 .

[39]  Chris Argyris,et al.  Making the Undiscussable and Its Undiscussability Discussable , 1980 .

[40]  David A Cook,et al.  Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. , 2011, JAMA.

[41]  Daniel B. Raemer,et al.  There's No Such Thing as “Nonjudgmental” Debriefing: A Theory and Method for Debriefing with Good Judgment , 2006, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[42]  S. Karau,et al.  Group Decision Making: The Effects of Initial Preferences and Time Pressure , 1999 .

[43]  David L. Rodgers,et al.  Evolution of the Pediatric Advanced Life Support course: Enhanced learning with a new debriefing tool and Web-based module for Pediatric Advanced Life Support instructors* , 2012, Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

[44]  S. V. Dun A training manual , 2015 .

[45]  Peter Dieckmann,et al.  Deepening the Theoretical Foundations of Patient Simulation as Social Practice , 2007, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[46]  David M Studdert,et al.  Analysis of errors reported by surgeons at three teaching hospitals. , 2003, Surgery.

[47]  Eduardo Salas,et al.  Measuring team performance in simulation-based training: adopting best practices for healthcare. , 2008, Simulation in healthcare : journal of the Society for Simulation in Healthcare.

[48]  J. Hackman,et al.  Group tasks, group interaction process, and group performance effectiveness: A review and proposed integration , 1975 .

[49]  Eduardo Salas,et al.  Developing and enhancing teamwork in organizations : evidence-based best practices and guidelines , 2013 .

[50]  Michael A. West,et al.  Effective Teamwork: Practical Lessons from Organizational Research , 2004 .

[51]  D. S. Derue,et al.  A quasi-experimental study of after-event reviews and leadership development. , 2012, The Journal of applied psychology.

[52]  Jessica Mesmer-Magnus,et al.  Information sharing and team performance: a meta-analysis , 2012 .

[53]  Eduardo Salas,et al.  Guided Team Self-Correction , 2008 .

[54]  Robert Simon,et al.  Debriefing as formative assessment: closing performance gaps in medical education. , 2008, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[55]  R. Ramanujam,et al.  The relational antecedents of voice targeted at different leaders. , 2013, The Journal of applied psychology.

[56]  K. Tomm Interventive interviewing: Part II. Reflexive questioning as a means to enable self-healing. , 1987, Family process.

[57]  P. Dieckmann,et al.  Investigating novice doctors’ reflections in debriefings after simulation scenarios , 2015, Medical teacher.

[58]  C. Gersick MARKING TIME: PREDICTABLE TRANSITIONS IN TASK GROUPS , 1989 .

[59]  L. Ross,et al.  The “false consensus effect”: An egocentric bias in social perception and attribution processes , 1977 .

[60]  A. Edmondson,et al.  Implicit Voice Theories: Taken-for-Granted Rules of Self-Censorship at Work , 2011 .

[61]  Eduardo Salas,et al.  Debriefing medical teams: 12 evidence-based best practices and tips. , 2008, Joint Commission journal on quality and patient safety.

[62]  D. Gilbert,et al.  The correspondence bias. , 1995, Psychological bulletin.

[63]  Tobias Greitemeyer,et al.  Preference-consistent evaluation of information in the hidden profile paradigm: beyond group-level explanations for the dominance of shared information in group decisions. , 2003, Journal of personality and social psychology.

[64]  Winfred Arthur,et al.  The comparative effect of subjective and objective after-action reviews on team performance on a complex task. , 2013, The Journal of applied psychology.

[65]  A. Edmondson Speaking Up in the Operating Room: How Team Leaders Promote Learning in Interdisciplinary Action Teams , 2003 .

[66]  F. Tschan,et al.  Getting groups to develop good strategies: Effects of reflexivity interventions on team process, team performance, and shared mental models , 2007 .

[67]  Roxane Gardner,et al.  Introduction to debriefing. , 2013, Seminars in perinatology.

[68]  Edgar H. Schein,et al.  Humble Inquiry: The Gentle Art of Asking Instead of Telling , 2013 .

[69]  Johannes Wacker,et al.  Monitoring and talking to the room: autochthonous coordination patterns in team interaction and performance. , 2014, The Journal of applied psychology.

[70]  Nick Sevdalis,et al.  Objective Structured Assessment of Debriefing: Bringing Science to the Art of Debriefing in Surgery , 2012, Annals of surgery.

[71]  Peter Dieckmann,et al.  Goals, Success Factors, and Barriers for Simulation-Based Learning , 2012 .

[72]  Roger Chow,et al.  Value of Debriefing during Simulated Crisis Management: Oral versus Video-assisted Oral Feedback , 2006, Anesthesiology.

[73]  K. Tomm Interventive interviewing: Part I. Strategizing as a fourth guideline for the therapist. , 1987, Family process.

[74]  Eduardo Salas,et al.  Improving Patient Safety Through Teamwork and Team Training , 2012 .

[75]  Gudela Grote,et al.  TeamGAINS: a tool for structured debriefings for simulation-based team trainings , 2013, BMJ quality & safety.

[76]  Barbara G. Kanki,et al.  Cockpit Resource Management , 1993 .

[77]  Shmuel Ellis,et al.  The effect of filmed versus personal after-event reviews on task performance: the mediating and moderating role of self-efficacy. , 2010, The Journal of applied psychology.

[78]  Jay W. Pope,et al.  False Consensus Effect , 2013 .

[79]  P. Benneworth There's no such thing as [...] , 2014 .

[80]  N. Kodate,et al.  Simulation training for improving the quality of care for older people: an independent evaluation of an innovative programme for inter-professional education , 2012, BMJ quality & safety.

[81]  S. Minuchin,et al.  Assessing Families and Couples: From Symptom to System , 2006 .

[82]  D. M. Rosenthal,et al.  The Evolution Of Circular Questions: Training Family Therapists , 1986 .

[83]  Scott I. Tannenbaum,et al.  Do Team and Individual Debriefs Enhance Performance? A Meta-Analysis , 2013, Hum. Factors.

[84]  Roy E Butler,et al.  LOFT: FULL-MISSION SIMULATION AS CREW RESOURCE MANAGEMENT TRAINING. , 1993 .

[85]  Shmuel Ellis,et al.  The Effect of Accuracy of Performance Evaluation on Learning From Experience: The Moderating Role of After‐Event Reviews , 2009 .

[86]  Peter Dieckmann,et al.  The Relationship Between Facilitators’ Questions and the Level of Reflection in Postsimulation Debriefing , 2013, Simulation in healthcare : journal of the Society for Simulation in Healthcare.