Educational Opportunities With Postevent Debriefing

Mullan, Paul C.; Kessler, David; Cheng, Adam

doi:10.1001/jama.2014.15741

Cited by 79 publications

(67 citation statements)

References 10 publications

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“…The precise reason(s) for such findings are unclear, but do support previous research findings that debriefing is considered highly desirable19 and in addition to providing learners with the opportunity to critically reflect on their performance/simulation experience, debriefing can provide emotional and social support 20. The overall lack of variation in learners’ scores further replicates previous findings we have obtained in previous studies within a perioperative setting when learners are asked to evaluate learning 7.…”

Section: Discussionsupporting

confidence: 81%

“…The fact that debriefing is so highly regarded by trainees but occurs infrequently in clinical practice19 may explain why learners viewed their detailed debriefings so positively: to them this was a rather rare occurrence, which was very well received and personally valuable. This is one explanation, however the fact that learners perceived the quality of all OSAD elements highly may indicate a ‘halo’ effect in which good (or poor, although not in our case) performance in one area (ie, one elements of debriefing) affects the assessor's judgement in other areas (ie, other debriefing elements) and/or ‘leniency’ effect, where assessors (ie, learners), for a range of reasons, rate performance far too positively.…”

Section: Discussionmentioning

confidence: 99%

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Quality of interdisciplinary postsimulation debriefing: 360° evaluation

Hull

Russ

Ahmed

et al. 2016

BMJ Simul Technol Enhanc Learn

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IntroductionDebriefing is widely perceived to be the most important component of simulation-based training. This study aimed to explore the value of 360° evaluation of debriefing by examining expert debriefing evaluators, debriefers and learners’ perceptions of the quality of interdisciplinary debriefings.MethodThis was a cross-sectional observational study. 41 teams, consisting of 278 learners, underwent simulation-based team training. Immediately following the postsimulation debriefing session, debriefers and learners rated the quality of debriefing using the validated Objective Structured Assessment of Debriefing (OSAD) framework. All debriefing sessions were video-recorded and subsequently rated by evaluators trained to proficiency in assessing debriefing quality.ResultsExpert debriefing evaluators and debriefers’ perceptions of debriefing quality differed significantly; debriefers perceived the quality of debriefing they provided more favourably than expert debriefing evaluators (40.98% of OSAD ratings provided by debriefers were ≥+1 point greater than expert debriefing evaluators’ ratings). Further, learner perceptions of the quality of debriefing differed from both expert evaluators and debriefers’ perceptions: weak agreement between learner and expert evaluators’ perceptions was found on 2 of 8 OSAD elements (learner engagement and reflection); similarly weak agreement between learner and debriefer perceptions was found on just 1 OSAD element (application).ConclusionsDebriefers and learners’ perceptions of debriefing quality differ significantly. Both groups tend to perceive the quality of debriefing far more favourably than external evaluators. An overconfident debriefer may fail to identify elements of debriefing that require improvement. Feedback provided by learners to debriefers may be of limited value in facilitating improvements. We recommend periodic external evaluation of debriefing quality.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Quality of interdisciplinary postsimulation debriefing: 360° evaluation

Hull

Russ

Ahmed

et al. 2016

BMJ Simul Technol Enhanc Learn

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“…21,22 The fact that events centering on a communication breakdown are less likely to be debriefed highlights the value of preventing communication problems in the first place through medical education and patient-safety-based interventions such as checklists, handoffs, and simulation-based training. 7,8,[23][24][25] Crisis checklists, emergency manuals, and other cognitive aids have long been embraced as tools to improve crisis resource management and patient safety. 3,26,27 There are simulation-based training programs in existence to improve debriefing skills, encourage higher-quality conversations, and excavate reasoning, which are directly relevant to the anesthesia provider.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6] Postevent debriefing also offers opportunities for education and learning, including those that address all the core competencies from the Accreditation Council for Graduate Medical Education. 7,8 In addition, it can be beneficial for quality assurance, ensuring immediate issues are addressed before the next patient is cared for, and determining need for longer-term follow-up. 9 Despite debriefing's utility, there persists a gap between evidence-based theory and practice.…”

mentioning

confidence: 99%

Failure to Debrief after Critical Events in Anesthesia Is Associated with Failures in Communication during the Event

et al. 2019

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Background: Debriefing after an actual critical event is an established good practice in medicine, but a gap exists between principle and implementation. The authors' objective was to understand barriers to debriefing, characterize quantifiable patterns and qualitative themes, and learn potential solutions through a mixed-methods study of actual critical events experienced by anesthesia personnel.Methods: At a large academic medical center, anesthesiology residents and a small number of attending anesthesiologists were audited and/or interviewed for the occurrence and patterns of debriefing after critical events during their recent shift, including operating room crises and disruptive behavior. Patterns of the events, including event locations and event types, were quantified. A comparison was done of the proportion of cases debriefed based on whether the event contained a critical communication breakdown. Qualitative analysis, using an abductive approach, was performed on the interviews to add insight to quantitative findings.Results: During a 1-yr period, 89 critical events were identified. The overall debriefing rate was 49% (44 of 89). Nearly half of events occurred outside the operating room. Events included crisis events (e.g., cardiac arrest, difficult airway requiring an urgent surgical airway), disruptive behavior, and critical communication breakdowns. Events containing critical communication breakdowns were strongly associated with not being debriefed (64.4% [29 of 45] not debriefed in events with a communication breakdown vs. 36.4% [16 of 44] not debriefed in cases without a communication breakdown; P = 0.008). Interview responses qualitatively demonstrated that lapses in communication were associated with enduring confusion that could inhibit or shape the content of discussions between involved providers.conclusions: Despite the value of proximal debriefing to reducing provider burnout and improving wellness and learning, failure to debrief after critical events can be common among anesthesia trainees and perhaps anesthesia teams. Modifiable interpersonal factors, such as communication breakdowns, were associated with the failure to debrief. (ANESTHESIOLOGY 2019; 130:1039-48) EditoR'S PERSPEctiVE What We Already Know about This Topic• Debriefing after an actual critical event is an established good practice in medicine, but a gap exists between principle and implementation. What This Article Tells us That Is New• Failure to debrief after critical events is common among anesthesia trainees and likely anesthesia teams. Communication breakdowns are associated with a high rate of the failure to debrief. . Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology's articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.anEStHESioLoGY REFLEctionS FRoM tHE Wood LiBRaRY-MuSEuM

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“…"Educational opportunities with post-event debriefing" [15] describes how clinicians can turn events even in the busy environment of an operating theater into a learning possibility. Debriefing a post event discussion about actions that happened with the aim "to promote reflective learning to improve clinical performance".…”

Section: Trends In Anaesthesia and Critical Carementioning

confidence: 99%

Trends from the educators for anesthesia and critical care 2014/15

Greif¹

2015

Trends in Anaesthesia and Critical Care

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Educational Opportunities With Postevent Debriefing

Cited by 79 publications

References 10 publications

Quality of interdisciplinary postsimulation debriefing: 360° evaluation

Quality of interdisciplinary postsimulation debriefing: 360° evaluation

Failure to Debrief after Critical Events in Anesthesia Is Associated with Failures in Communication during the Event

Trends from the educators for anesthesia and critical care 2014/15

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