Cognitive versus Technical Debriefing after Simulation Training

Bond, William F.; Deitrick, Lynn; Eberhardt, M.; Barr, Gavin C.; Kane, Bryan G; Worrilow, Charles C.; Arnold, Darryl C.; Croskerry, Pat

doi:10.1111/j.1553-2712.2006.tb01692.x

Cited by 34 publications

(29 citation statements)

References 21 publications

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“…Debriefing can be viewed as a conversation about a medical event, where any observed clinical performance gaps are addressed 9. Learners are asked open-ended questions in order to clarify their individual thought processes and are also asked to self-critique their performance 11,13,14. By promoting constructive self-critique and self-evaluation, medical debriefing instills practices of life-long learning, considered to be important elements of “practice-based learning,” one of the six core medical education competencies required by the Accreditation Council of Graduate Medical Education.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Real-Time, Non-Critical Incident Debrie ng Practices in the Emergency Department

Nadir

Bentley

Papanagnou

et al. 2017

WestJEM

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IntroductionBenefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose. Anecdotal evidence suggests that real-time debriefings (or non-critical incident debriefings) do in fact occur in academic EDs;, however, limited research has been performed on this subject. The objective of this study was to characterize real-time, non-critical incident debriefing practices in emergency medicine (EM).MethodsWe conducted this multicenter cross-sectional study of EM attendings and residents at four large, high-volume, academic EM residency programs in New York City. Questionnaire design was based on a Delphi panel and pilot testing with expert panel. We sought a convenience sample from a potential pool of approximately 300 physicians across the four sites with the goal of obtaining >100 responses. The survey was sent electronically to the four residency list-serves with a total of six monthly completion reminder emails. We collected all data electronically and anonymously using SurveyMonkey.com; the data were then entered into and analyzed with Microsoft Excel.ResultsThe data elucidate various characteristics of current real-time debriefing trends in EM, including its definition, perceived benefits and barriers, as well as the variety of formats of debriefings currently being conducted.ConclusionThis survey regarding the practice of real-time, non-critical incident debriefings in four major academic EM programs within New York City sheds light on three major, pertinent points: 1) real-time, non-critical incident debriefing definitely occurs in academic emergency practice; 2) in general, real-time debriefing is perceived to be of some value with respect to education, systems and performance improvement; 3) although it is practiced by clinicians, most report no formal training in actual debriefing techniques. Further study is needed to clarify actual benefits of real-time/non-critical incident debriefing as well as details on potential pitfalls of this practice and recommendations for best practices for use.

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Section: Introductionmentioning

confidence: 99%

Characteristics of Real-Time, Non-Critical Incident Debrie ng Practices in the Emergency Department

Nadir

Bentley

Papanagnou

et al. 2017

WestJEM

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“…This did not reach significance 14. LeFlore and Anderson23 compared a facilitated debrief (group A) with a modified debrief (group B) in which time for questions was allowed.…”

Section: Resultsmentioning

confidence: 94%

“…Most of the studies were conducted with a trained debrief facilitator15–18 22 24 26 29 31 32 with one research team reporting use of ‘PowerPoint plus audio’ with no indication whether the ‘audio’ was prerecorded or provided by a facilitator 14. An randomised controlled trial compared two approaches to debrief: within-team debrief, with a leader from within the team providing the debrief, and instructor-led debrief 20.…”

Section: Resultsmentioning

confidence: 99%

“…Non-technical skills were addressed through the use of expert models such as crisis resource management principles or through techniques such as CDR and Advocacy Inquiry (AI) aimed at identifying mental models of participants, which lead to certain behaviours 14 26. Bond et al 14 found that technical debriefing was better received by participants than cognitive debriefing, although Dreifuerst34 reported that learners prefer debrief with reflection.…”

Section: Discussionmentioning

confidence: 99%

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Frameworks and quality measures used for debriefing in team-based simulation: a systematic review

et al. 2018

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ObjectivesThe skill of the debriefer is known to be the strongest independent predictor of the quality of simulation encounters yet educators feel underprepared for this role. The aim of this review was to identify frameworks used for debriefing team-based simulations and measures used to assess debriefing quality.MethodsWe systematically searched PubMed, CINAHL, MedLine and Embase databases for simulation studies that evaluated a debriefing framework. Two reviewers evaluated study quality and retrieved information regarding study methods, debriefing framework, outcome measures and debriefing quality.ResultsA total of 676 papers published between January 2003 and December 2017 were identified using the search protocol. Following screening of abstracts, 37 full-text articles were assessed for eligibility, 26 studies met inclusion criteria for quality appraisal and 18 achieved a sufficiently high-quality score for inclusion in the evidence synthesis. A debriefing framework was used in all studies, mostly tailored to the study. Impact of the debrief was measured using satisfaction surveys (n=11) and/or participant performance (n=18). Three themes emerged from the data synthesis: selection and training of facilitators, debrief model and debrief assessment. There was little commonality across studies in terms of participants, experience of faculty and measures used.ConclusionsA range of debriefing frameworks were used in these studies. Some key aspects of debrief for team-based simulation, such as facilitator training, the inclusion of a reaction phase and the impact of learner characteristics on debrief outcomes, have no or limited evidence and provide opportunities for future research particularly with interprofessional groups.

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“…[5][6][7][8][9][10] There are a number of studies of modalities or aids to debriefing such as the use of video, 11-13 structured 14 -17 or scripted debriefing, 6 approaches to debriefing, and whether technical or behavioral. 18,19 In addition, studies exploring underlying learning theories upon which the debriefing techniques were based were uncovered. 17,20 -23 When applying the construct of translational science (the progression from bench to bedside) to debriefing in SBE, where T1 studies measure process or outcomes in the simulated environment, T2, processes at the real-world level, and T3, outcomes of the individual patient or public health, we found that current studies of debriefing lie firmly in the T1 category.…”

Section: State Of the Sciencementioning

confidence: 99%

Research Regarding Debriefing as Part of the Learning Process

Raemer

Anderson

Cheng

et al. 2011

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare

252

132

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Cognitive versus Technical Debriefing after Simulation Training

Abstract: Survey data indicate that technical debriefing was better received than cognitive debriefing. The authors theorize that an understanding of CDRs can be facilitated through simulation training based on the analysis of interview comments.

Cited by 34 publications

References 21 publications

Characteristics of Real-Time, Non-Critical Incident Debrie ng Practices in the Emergency Department

Characteristics of Real-Time, Non-Critical Incident Debrie ng Practices in the Emergency Department

Frameworks and quality measures used for debriefing in team-based simulation: a systematic review

Research Regarding Debriefing as Part of the Learning Process

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