Debriefing approach

Debriefing after a health and care simulation experience/activity

Debriefing is deemed to be the most important element of simulation-based education and the foundation of effective learning. Debriefing is the discussion following a simulation experience that allows participants to gain a clear understanding of their actions and thoughts to promote learning and enhance future clinical performance (Deickman et al 2009).    

There are many debriefing tools/methods identified in the literature each providing guidance to help the debriefer. Health Education Improvement Wales’s Simulation team have proposed a triangular approach to debriefing which includes Principles, Structure and Strategies.

Principles

The debriefer should ensure the following principles are adhered to:

Undertaking a safe and constructive discussion with all participants ensuring equality, diversity and inclusion (EDI), respect all different learner needs, guide the participants to reflect on the simulation experience, have participants share their mental models, determine that learning outcomes have been reached and aim for the highest level of facilitation possible.

Structure

Strategies

When undertaking debriefing, using the structure identified above, the following strategies should be adopted.

Psychological safety: Pre-brief: set the mood and agree ground rules, appropriate time management, include all participants in the discussion and be authentic and validate positive contributions.

Focus the discussion: Prioritise areas of discussion according to the identified Learning Outcomes and explore technical and non-technical aspects of the participants’ performances.

Facilitation techniques: Use open questions and use of silences and consider Plus / delta and/or advocacy enquiry approaches.

Closing: Allow time for questions from the participants before closing the debriefing and develop a closing (wrap up) technique.

Debrief the debriefer: Meta-debriefing after completion of the simulation session.

Reference- Dieckmann P; Molin Friis S; Lippert A and Ostergaard D (2009). The art and science of debriefing in simulation: Ideal and practice. Medical Teacher. Jul;31(7):e287-94. 

Adapted from HEIW Simulation Faculty Development Essentials course 5/2/24.