Pre and Debriefing
Danielle Hart, Director Simulation at Hennepin County on Debriefing
Hart D, McNeil MA, Griswold-Theodorson S, Bhatia K, Joing S. High fidelity case-based simulation debriefing: everything you need to know. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 19(9):E1084. 2012. PMID: 22978737
A paper on debriefing with good judgement: There’s no such thing as nonjudgemental debriefing A theory and method for debriefing with good judement
Rudolph JW, Simon R, Dufresne RL, Raemer DB. There’s no such thing as “nonjudgmental” debriefing: a theory and method for debriefing with good judgment. Simulation in healthcare : journal of the Society for Simulation in Healthcare. 1(1):49-55. 2006. PMID: 19088574
General Debriefing tips
- Focus on only 2 or 3 specific learning points per scenario. (If there are multiple educators in the room, it is probably a good idea to briefly chat about these learning points before starting the debrief.)
- Ask questions and invite the learner to share their thoughts
- Try to understand what the learner was thinking rather than just correcting specific actions
- Use silence to your advantage (eventually, someone will talk)
- Use normalization:
- “Many people have trouble with…”
- “This is a difficult case. We don’t expect you to manage it perfectly”
- Remember, you may have missed things
- ie, instead of saying “You did not do …”, say “I didn’t notice …”
- It can be helpful to have the team think out loud. “Tell me what was going through your mind when…”
- Have the learners pick one take home point they will use in future shifts
- Be flexible. If the scenario doesn’t go exactly as planned, debrief what actually happened, not what you were hoping would happen
Other good resources on debriefing
Debriefing is essential and important on mobilesim
Debriefing Techniques – the Art of Guided Reflection on emsimcases.com
It’s Good to Talk – Debrief in the Emergency Department on St Emlyn’s
Developing simulation objectives
One very important question is what kinds of teaching are appropriate for the simulation lab. The following figure from Pestroniak and Hicks considers clinical scenarios both interms of their acuity and well as how common they are or how often learners will get the opportunity to manage them. They argue that simulation is best suited for scenario that are more high acuity and that learners have less opportunity to manage outside of the sim lab.
Petrosoniak A, Hicks CM. Beyond crisis resource management: new frontiers in human factors training for acute care medicine. Current opinion in anaesthesiology. 26(6):699-706. 2013. [pubmed]
How to develop targeted simulation learning objectives – Part 1: The Theory
How to develop targeted simulation learning objectives – Part 2: The Practice
Good simulation websites