Skip to main content
SpringerLink
Log in
Book cover

Comprehensive Healthcare Simulation: Anesthesiology pp 37–46Cite as

Essentials of Debriefing in Simulation-Based Education

  • Chapter
  • First Online:

Part of the book series: Comprehensive Healthcare Simulation ((CHS))

Abstract

Debriefing is a critical part of the experiential learning process in simulation. It is a well-established educational methodology with deep roots in theory and practice. It is an interaction and discussion between participants and educators to promote self-assessment and reflection and to help them abstract from the learning experience to clinical practice. The instructor must optimize the learning environment to create a space where learners can feel free to make errors and are willing to accept feedback. There are several debriefing structures and techniques. The instructor has the flexibility to use these techniques to maximize the effectiveness of learning. Debriefing should be guided by the learning objectives of the educational session as well as other factors as they present themselves in the dynamic simulation environment. Each technique and structure has its merits, with no one technique being superior to another. The skilled debriefer will optimize impact on learning as they seamlessly use a variety of strategies. Assessment tools to evaluate the effectiveness of debriefing are discussed; however, these require further study.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs: Prentice Hall; 1984.

    Google Scholar 

  2. Stocker M, Burmester M, Allen M. Optimisation of simulated team training through the application of learning theories: a debate for a conceptual framework. BMC Med Educ. 2014;14:69.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Knowles MS. Application in continuing education for the health professions: chapter five of “andragogy in action”. Mobius. 1985;5(2):80–100.

    CAS  PubMed  Google Scholar 

  4. Fanning RM, Gaba DM. The role of debriefing in simulation-based learning. Simul Healthc. 2007;2(2):115–25.

    Article  PubMed  Google Scholar 

  5. Raemer D, et al. Research regarding debriefing as part of the learning process. Simul Healthc. 2011;6 Suppl:S52–7.

    Article  Google Scholar 

  6. Zigmont JJ, Kappus LJ, Sudikoff SN. Theoretical foundations of learning through simulation. Semin Perinatol. 2011;35(2):47–51.

    Article  PubMed  Google Scholar 

  7. Rudolph JW, et al. There’s no such thing as “nonjudgmental” debriefing: a theory and method for debriefing with good judgment. Simul Healthc. 2006;1(1):49–55.

    Article  PubMed  Google Scholar 

  8. Rudolph JW, et al. Debriefing as formative assessment: closing performance gaps in medical education. Acad Emerg Med. 2008;15(11):1010–6.

    Article  PubMed  Google Scholar 

  9. Issenberg SB, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach. 2005;27(1):10–28.

    Article  PubMed  Google Scholar 

  10. Tannenbaum SI, Cerasoli CP. Do team and individual debriefs enhance performance? A meta-analysis. Hum Factors. 2013;55(1):231–45.

    Article  PubMed  Google Scholar 

  11. McGaghie WC, et al. A critical review of simulation-based medical education research: 2003–2009. Med Educ. 2010;44(1):50–63.

    Article  PubMed  Google Scholar 

  12. Darling MJ, Parry CS. From post-mortem to living practice: an in-depth study of the evolution of the after-action review. Boston: Signet Consulting Group; 2001.

    Google Scholar 

  13. Ellis S, Davidi I. After-event reviews: drawing lessons from successful and failed experience. J Appl Psychol. 2005;90(5):857–71.

    Article  PubMed  Google Scholar 

  14. van de Ridder JM, et al. What is feedback in clinical education? Med Educ. 2008;42(2):189–97.

    Article  PubMed  Google Scholar 

  15. Ende J. Feedback in clinical medical education. JAMA. 1983;250(6):777–81.

    Article  CAS  PubMed  Google Scholar 

  16. Ericsson KA. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med. 2008;15(11):988–94.

    Article  PubMed  Google Scholar 

  17. Johnson CE, et al. Identifying educator behaviours for high quality verbal feedback in health professions education: literature review and expert refinement. BMC Med Educ. 2016;16:96.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Rudolph JW, et al. Debriefing with good judgment: combining rigorous feedback with genuine inquiry. Anesthesiol Clin. 2007;25(2):361–76.

    Article  PubMed  Google Scholar 

  19. Zigmont JJ, Kappus LJ, Sudikoff SN. The 3D model of debriefing: defusing, discovering, and deepening. Semin Perinatol. 2011;35(2):52–8.

    Article  PubMed  Google Scholar 

  20. Schön DA. Toward a new design for teaching and learning in the professions. In: Educating the reflective practitioner. San Francisco: Jossey-Bass; 1987.

    Google Scholar 

  21. Eppich W, Cheng A. Promoting Excellence And Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to healthcare simulation debriefing. Simul Healthc. 2015;10(2):106Y115.

    Article  Google Scholar 

  22. Orsini C, Evans P, Jerez O. How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory. J Educ Eval Health Prof. 2015;12:8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kusurkar RA, Croiset G, Ten Cate TJ. Twelve tips to stimulate intrinsic motivation in students through autonomy-supportive classroom teaching derived from self-determination theory. Med Teach. 2011;33(12):978–82.

    Article  CAS  PubMed  Google Scholar 

  24. Jawahar IM, Williams CR. Where all the children are above average: the performance appraisal purpose effect. Pers Psychol. 1997;50:905–25.

    Article  Google Scholar 

  25. Murphy KR, Cleveland JN. Understanding performance appraisal: social, organizational, and goal-based perspectives. Thousand Oaks: Sage; 1995.

    Google Scholar 

  26. Locke EA, Latham GP. A theory of goal setting and task performance. Englewood Cliffs: Prentice Hall; 1990.

    Google Scholar 

  27. Locke EA, Latham GP. Building a practically useful theory of goal setting and task motivation. A 35-year odyssey. Am Psychol. 2002;57(9):705–17.

    Article  PubMed  Google Scholar 

  28. Edelson DP, Lafond CM. Deconstructing debriefing for simulation-based education. JAMA Pediatr. 2013;167(6):586–7.

    Article  PubMed  Google Scholar 

  29. Kluger A, Denisi A. The effects of feedback interventions on performance: a historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychol Bull. 1996;119:254.

    Article  Google Scholar 

  30. Nicol DJ, MacFarlane-Dick D. Formative assessment and self regulated learning: a model and seven principles of good feedback practice. Stud High Educ. 2006;31:199–218.

    Article  Google Scholar 

  31. Barrett A, et al. A BEME (Best Evidence in Medical Education) review of the use of workplace-based assessment in identifying and remediating underperformance among postgraduate medical trainees: BEME Guide No. 43. Med Teach. 2016;38(12):1188–98.

    Article  PubMed  Google Scholar 

  32. Davis DA, et al. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2006;296(9):1094–102.

    Article  CAS  PubMed  Google Scholar 

  33. Schneider JR, et al. Patient assessment and management examination: lack of correlation between faculty assessment and resident self-assessment. Am J Surg. 2008;195(1):16–9.

    Article  PubMed  Google Scholar 

  34. Salas E, Rosen MA. Building high reliability teams: progress and some reflections on teamwork training. BMJ Qual Saf. 2013;22(5):369–73.

    Article  PubMed  Google Scholar 

  35. Parker SK, Axtell C. Seeing another viewpoint: antecedents and outcomes of employee perspective taking. Acad Manage J. 2001;44(6):1085–100.

    Google Scholar 

  36. Dismukes RK, McDonnell L, Jobe KK. Facilitating LOFT debriefings: instructor techniques and crew participation. Int J Aviat Psychol. 2000;10:35Y57.

    Article  Google Scholar 

  37. Haefner J. National Institute for Learning Outcomes Assessment. The Transparency Framework 2012 December 10, 2012. Available from: http://www.learningoutcomeassessment.org/TransparencyFramework.htm.

  38. Rudolph JW, Raemer DB, Simon R. Establishing a safe container for learning in simulation: the role of the presimulation briefing. Simul Healthc. 2014;9(6):339–49.

    Article  PubMed  Google Scholar 

  39. March JG. Exploration and exploitation in organizational learning. Org Sci. 1991;2(1):71Y87.

    Google Scholar 

  40. Elliot AJ, Dweck C. Handbook of competence and motivation. New York: Guilford; 2005.

    Google Scholar 

  41. Skinner EA, Belmont M. Motivation in the classroom: reciprocal effects of teacher behavior and student engagement across the school year. J Educ Psychol. 1993;85(4):572.

    Article  Google Scholar 

  42. Lefroy J, et al. Guidelines: the do’s, don’ts and don’t knows of feedback for clinical education. Perspect Med Educ. 2015;4(6):284–99.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Dieckmann P, Gaba D, Rall M. Deepening the theoretical foundations of patient simulation as social practice. Simul Healthc. 2007;2(3):183–93.

    Article  PubMed  Google Scholar 

  44. Metcalfe J. Learning from errors. Annu Rev Psychol. 2017;68:6.1–6.25.

    Article  Google Scholar 

  45. Kolbe M, et al. TeamGAINS: a tool for structured debriefings for simulation-based team trainings. BMJ Qual Saf. 2013;22(7):541–53.

    Article  PubMed  Google Scholar 

  46. Stevenson H, Stigler J. The learning gap: why our schools are failing and what we can learn from Japanese and Chinese education. New York: Simon and Schuster; 1994.

    Google Scholar 

  47. Keith N, Frese M. Effectiveness of error management training: a meta-analysis. J Appl Psychol. 2008;93(1):59–69.

    Article  PubMed  Google Scholar 

  48. Miettinen R. The concept of experiential learning and John Dewey’s theory of reflective thought and action. Int J Lifelong Educ. 2000;19(1):54–72.

    Article  Google Scholar 

  49. Baron RA. Negative effects of destructive criticism: impact on conflict, self-efficacy, and task performance. J Appl Psychol. 1988;73(2):199–207.

    Article  CAS  PubMed  Google Scholar 

  50. Sargeant J, et al. Understanding the influence of emotions and reflection upon multi-source feedback acceptance and use. Adv Health Sci Educ Theory Pract. 2008;13(3):275–88.

    Article  PubMed  Google Scholar 

  51. Loh V, et al. The moderating effect of individual differences in error-management training: who learns from mistakes? Hum Factors. 2013;55(2):435–48.

    Article  PubMed  Google Scholar 

  52. Sawyer T, et al. More than one way to debrief: a critical review of healthcare simulation debriefing methods. Simul Healthc. 2016;11(3):209–17.

    Article  PubMed  Google Scholar 

  53. Jaye P, Thomas L, Reedy G. ‘The Diamond’: a structure for simulation debrief. Clin Teach. 2015;12(3):171–5.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Phrampus P, O’Donnell J, Levine A, DeMaria S, Schwartz A, Sim A. Debriefing using a structured and supported approach. In: The comprehensive textbook of healthcare simulation. 1st ed. New York: Springer; 2013.

    Google Scholar 

  55. Sawyer T, Deering S. Adaptation of the U.S. Army’s after-action review (AAR) to simulation debriefing in healthcare. Simul Healthc. 2013;8(6):388Y397.

    Article  Google Scholar 

  56. Cheng A, et al. Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial. JAMA Pediatr. 2013;167(6):528–36.

    Article  PubMed  Google Scholar 

  57. Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simul Healthc. 2015;10(2):106–15.

    Article  PubMed  Google Scholar 

  58. Mitchell JT. When disaster strikes...the critical incident stress debriefing process. JEMS. 1983;8(1):36–9.

    CAS  PubMed  Google Scholar 

  59. Boudreau JD, Cassell E, Fuks A. Preparing medical students to become attentive listeners. Med Teach. 2009;31(1):22–9.

    Article  PubMed  Google Scholar 

  60. Cheng A, et al. Co-debriefing for simulation-based education: a primer for facilitators. Simul Healthc. 2015;10(2):69–75.

    Article  PubMed  Google Scholar 

  61. Dean M, Street RL Jr. A 3-stage model of patient-centered communication for addressing cancer patients’ emotional distress. Patient Educ Couns. 2014;94(2):143–8.

    Article  PubMed  Google Scholar 

  62. Ranjan P, Kumari A, Chakrawarty A. How can doctors improve their communication skills? J Clin Diagn Res. 2015;9(3):JE01–4.

    PubMed  PubMed Central  Google Scholar 

  63. Gerard E. The skilled helper: a problem-management approach to helping. 5th ed. Pacific Grove, California: Brooks/Cole; 1994.

    Google Scholar 

  64. Razavi D, Delvaux N. Communication skills and psychological training in oncology. Eur J Cancer. 1997;33(Suppl 6):S15–21.

    Article  PubMed  Google Scholar 

  65. Robbins JM, et al. Physician characteristics and the recognition of depression and anxiety in primary care. Med Care. 1994;32(8):795–812.

    Article  CAS  PubMed  Google Scholar 

  66. Smith-Jentsch KA, Cannon-Bowers J, Tannenbaum SI, Salas E. Guided team self-correction: impacts on team mental models, processes, and effectiveness. Small Group Resol. 2008;39(3):303Y327.

    Google Scholar 

  67. Kriz WC. A systematic-constructivist approach to the facilitation and debriefing of simulations and games. Simul Gaming. 2010;41:663Y680.

    Article  Google Scholar 

  68. Jackson VA, Back AL. Teaching communication skills using role-play: an experience-based guide for educators. J Palliat Med. 2011;14(6):775–80.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Savoldelli GL, et al. Value of debriefing during simulated crisis management: oral versus video-assisted oral feedback. Anesthesiology. 2006;105(2):279–85.

    Article  PubMed  Google Scholar 

  70. Byrne AJ, et al. Effect of videotape feedback on anaesthetists’ performance while managing simulated anaesthetic crises: a multicentre study. Anaesthesia. 2002;57(2):176–9.

    Article  CAS  PubMed  Google Scholar 

  71. Chronister C, Brown D. Comparison of simulation debriefing methods. Clin Simul Nurs. 2010;8(7):e281–8.

    Article  Google Scholar 

  72. Sawyer T, et al. The effectiveness of video-assisted debriefing versus oral debriefing alone at improving neonatal resuscitation performance: a randomized trial. Simul Healthc. 2012;7(4):213–21.

    Article  PubMed  Google Scholar 

  73. Gururaja RP, et al. Examining the effectiveness of debriefing at the point of care in simulation-based operating room team training. In: Henriksen K, et al., editors. Advances in patient safety: new directions and alternative approaches, Performance and tools, vol. 3. Rockville: Agency for Healthcare Research and Quality (US); 2008.

    Google Scholar 

  74. Reed SJ. Debriefing experience scale: development of a tool to evaluate the student learning experience in debriefing. Clin Simul Nurs. 2012;8(6):211Y217.

    Article  Google Scholar 

  75. Arora S, et al. Objective structured assessment of debriefing: bringing science to the art of debriefing in surgery. Ann Surg. 2012;256(6):982–8.

    Article  PubMed  Google Scholar 

  76. Brett-Fleegler M, et al. Debriefing assessment for simulation in healthcare: development and psychometric properties. Simul Healthc. 2012;7(5):288–94.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Vanderbilt University Medical Center, Vanderbilt University School of Medicine, Nashville, TN, USA

    Jeanette R. Bauchat

  2. Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA

    Michael Seropian

Authors
  1. Jeanette R. Bauchat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael Seropian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Seropian .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Perioperative and Pain Medicine, Mount Sinai St. Luke’s and West Hospitals, Mount Sinai St. Luke’s & Roosevelt Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Bryan Mahoney

  2. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA

    Rebecca D. Minehart

  3. Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA

    May C. M. Pian-Smith

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bauchat, J.R., Seropian, M. (2020). Essentials of Debriefing in Simulation-Based Education. In: Mahoney, B., Minehart, R., Pian-Smith, M. (eds) Comprehensive Healthcare Simulation: Anesthesiology . Comprehensive Healthcare Simulation. Springer, Cham. https://doi.org/10.1007/978-3-030-26849-7_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-26849-7_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-26848-0

  • Online ISBN: 978-3-030-26849-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation