Debrief Basics:

Debrief research for novice educators IMSH 2019, Texas

Ranjev Kainth

Colette Laws-Chapman

Gabriel Reedy

Libby Thomas

Acknowledgements to Dr Peter Jaye

Simulation & Interactive Learning Centre (SaIL), London, UK

King’s College London, London, UK

• To gain an understanding of the different approaches to

debrief research

• Describe research on debrief practice

• Describe quantitative research in relation to:

– Debrief vs non-debrief

– Scripted debrief

– Video use in debrief

• Insitu debrief

• Describe three qualitative pieces of debrief research

Workshop AimsSession Aims

Sawyer, T., et al. (2016).

More Than One Way to Debrief: A

Critical Review of Healthcare

Simulation Debriefing Methods

Simul Healthc 11(3): 209-217

Debriefing methods:

1.Facilitator guided post-event3-phase or multi-phase

2.Self-guided post-event debriefing

3.Facilitator guided within event debriefing

Research

on Debrief

Practice

How is debrief conducted?

Sawyer, T., et al. (2016).

More Than One Way to Debrief: A

Critical Review of Healthcare

Simulation Debriefing Methods

Simul Healthc 11(3): 209-217

• [Seven] Essential elements for effective debriefing:

– Psychological safety

– Basic assumption

– Debriefing rules

– Shared mental model [of scenario events]

– Address learning objectives

– Opened ended questions

– Silence

• Conversational Techniques

– Style of questioning

• Debriefing Adjuncts:

– Co-debriefing

– Use of video

– Debriefing script

Research

on Debrief

Practice

How is debrief conducted?

Debrief process elements

Tannenbaum, S. I. and C. P. Cerasoli (2013)

Do team and individual debriefs enhance

performance? A meta-analysis.

Hum Factors 55(1): 231-245.

Meta-analysis

Outcome: performance

• 25% Improved effectiveness overall

• Facilitated > non-facilitated

Debrief

Research:

Outcomes

How effective is debrief?

2013

Cheng, A., et al. (2014).

Debriefing for technology-enhanced

simulation: a systematic review and meta-

analysis.

Med Educ 48(7): 657-666.

Meta-analysis (108 studies)

“favourable and statistically significant effects for nearly all

outcomes“

Debrief

Research:

Outcomes

How effective is debrief?

2014

Cheng, A., et al. (2013)

Examining pediatric resuscitation education

using simulation and scripted debriefing: a

multicenter randomized trial.

JAMA Pediatr 167(6): 528-536.

Prospective, randomized,

factorial study design

• 14 simulation programmes

(~400 participants)

• Outcomes: MCQ, BAT, CPT

• Scripted: MCQ+BAT

• Physical realism/fidelity – no

correlation to outcomes

Debrief

Research:

Outcomes

Scripted

Physical Realism

(Savoldelli et al. 2006, Sawyer et al. 2012,

Tannenbaum et al. 2013 Cheng et al. 2014)

Equivocal:

Meta-analysis have not shown

any significant difference

between video-assisted

debriefing compared to oral

debriefing

Debrief

Research:

Outcomes

Video Vs. No Video

• Patterson (2013) identify latent errors (surfaced in the debrief)

• Bender (2011) Test new clinical environments

• Goldhaber-Fiebert (2015), Abrahamson (2006)

– Checklists such as blood transfusion, administration of drugs or

implementation of protocols may identify errors through debriefing

insitu

Debrief

evidence

Qualitative

Debrief

Research

Factors associated with Learning:• Safe Environment

• Debriefing to Explore Thoughts

• Feedback from Multiple Perspectives

• All in This Together

• Group FacilitationFey, M. K., et al. (2014).

Learning Through Debriefing: Students' Perspectives

Clinical Simulation in Nursing 10(5): e249-e256.

Ulmer et al. (2018)

Cultural prototypes and differences in

simulation debriefing. Sim Healthcare

• Examined power

distance and debrief

practice

• Interviews with debriefs

regarding debrief

practice

Ulmer et al. (2018)

Cultural prototypes and differences in

simulation debriefing. Sim Healthcare

• Low PDI

– Facilitators talked less

– Focus on and easier to discuss NTS

– Interactions initiated by participants more

– Increased perceived group interactions

Ulmer et al. (2018)

Cultural prototypes and differences in

simulation debriefing. Sim Healthcare

Summary

• Debrief follows a clear structure; questioning differs

• Evidence that debrief improves outcomes

– Scripted, facilitator-led – improved effectiveness

– Physical fidelity, video – equivocal evidence

• Debrief practice is not homogenous

– Core features which facilitate learning

– Different interaction patterns, different factors at play

Questions?

Twitter: @huMANikin

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Website: www.guysandstthomaseducation.com/project/simulation/