1. Kevin Floyd, RN, MS, CCRN Jennifer Mattice, RN,MS
Debriefing
Kevin Floyd, RN, MS, CCRN
Jennifer Mattice, RN,MS

2. Debriefing
Debriefing is the “heart and soul” of the simulated experience…
Rall, Manser, & Howard, 2000
Knowing how to debrief is as important as knowing how to create and initiate a simulated experience.
Jeffries, 2005
A process in which after an experience the learner is lead through a purposeful discussion related to the experience Fanning & Gaba, 2007
1. Rall, M., Manser, T., & Howard, S. K. (2000). Key elements of debriefing for simulator training. European Journal of Anaesthesiology, 17(8), doi: /j x
2. Jeffries, P. R. (2005). A frame work for designing,implementing, and evaluating simulations used as teaching strategies in nursing. Nursing Education Perspectives, 26(2), doi: / (2005)026<0096:AFWFDI>2.0.CO;2
3. Fanning, R. M., & Gaba, D. M. (2007). The role of debriefing in simulation-based learning. Simulation in Healthcare, 2(2), doi: /SIH.0b013e

3. Defining Debriefing Merriam-Webster (1945)
1 : to interrogate (as a pilot) usually upon return (as from a mission) in order to obtain useful information
2 : to carefully review upon completion <debrief the flight>
"Debrief." Merriam-Webster.com. Merriam-Webster, n.d. Web. 20 Aug <

4. Debriefing
Debriefing is the most valuable aspect of simulation experience
Equal or more time then the actually scenario
It provides immediate feedback to the participants
Self refection to assist with self identification of strengths and areas for improvement
The participants develop an emotional connection to the learning
Focus on information sharing/learning

5. Goal of Debriefing Allows for the recognition and release emotions
Reinforces the objectives of the simulation
Provides time immediately for clarification of information
Fosters critical thinking and problem solving
Encourages reflective learning
Proves a opportunity to link the simulation to the “Real World”

6. Gibbs Reflective Cycle(1988)
Gibbs G (1988) Learning by Doing: A guide to teaching and learning methods. Further Education Unit. Oxford Polytechnic: Oxford.

7. Driscoll Cycle

8. Goals of debriefing Offer a safe, educational atmosphere
Offer constructive feedback
Encourage self learning and self assessment
Promote communication and debriefing among team members
Foster culture that will improve attitudes towards “errors”
Constructively correct behavior, attitudes, and actions that hamper individual and team performance

9. Debriefing Format Video Review Positive: Challenges: Group Review
Self Identify issues more readily
Details on performance clear
Challenges:
Intimidating
Cost of AV equipment
Need review room
Group Review
Positive:
Immediate
Less time
Not need for additional room
Challenges
Difficult to break role
Harder to see behavior
Interactions

10. Factors that could distract
Lack of defined purpose and objective
Excessive instruction
Close ended questions
Too many teaching points
Allowing discussions on the limitation of simulation
Not acknowledging or underestimating the emotions

11. Factors to Consider for Debriefing Plan
Objective of the exercise
Complexity of the scenario
Experience level of the learners
Familiarity of learners
Time available for the session
Role of simulation
Individual personalities

12. Practical Aspects of Debriefing
Setting - Physical
Comfortable and private
Think about seating style
In-situ simulations
Setting – Emotional
Prebrief – set the expectations
Confidentiality, role of the facilitator, role of the participant

13. Practical Aspects - Tips
Questioning
Open ended, non-judgmental
Begin questions with what, how, or why to encourage deeper discussion
Follow-up on participant comments
Make the participant feel their contribution is important
Consider the emotional impact of the exercise

14. Practical Aspects - Tips
Include ALL participants
Bring the quiet, withdrawn participant into the discussion (they have thoughts about what is happening, but may have trouble sharing)
Reflect questions back to the participants
Use silence appropriately (10 seconds is NOT too long)
Be observant to the body language of the group or individual
Understand group dynamics

15. Facilitation
Facilitated self reflection of the participants aids in the development of critical thinking and problem solving skills
Active participation in self reflection process produces deeper analysis which may lead to longer retention and better retrieval
Participant learn and retain more when they take an active role in the self reflection and perform their own analyses

16. Process of Debriefing Introduction Personal Reactions
Discussion of Events
Summary

17. Introduction Prepare student to active analyze and evaluate
Communicate the expectations of the participants
Safe environment
Review the objective of the simulation

18. Personal reactions
Allow the students to explore and deal with their feeling that have arose during the simulation
Ensure that each participants have the opportunity to respond
Begin with open questions
How did the scenario go?
How are you feeling?
How did that go for you and the team?

19. Debriefing Focus Information sharing/learning Plus (+) Delta
Seek information
Tell me your perception of the experience
What did you do well?
What would you do differently to improve outcome?
Plus (+) Delta

20. Discussion of events
For each participant to share and discuss positive aspects of experience.
At least one positive of self and others.
*What went well?
What were you thinking at that moment?
For each participant to share and discuss less desirable aspects of experience.
At least one of the less desirable aspects of self and others.
What could have been done better?
Are there any other opportunities for improvement?

21. Discussion of Events
For each participant to share and discuss what they learned and how they will use that new knowledge in their own practice. Their own personal action plan.
How will what you learned today change your current practice?
Do you have an example of something you will do differently from now on?

22. Debriefing Non-threatening discussion
Capture and fostering “ah-ha” moments
Seek similar real-world experiences
Help apply the experience to real-world practice
Information sharing/learning

23. Summary Active listening Participant self refection Save environment
What happen is Vegas stays in Vegas
Open ended Questions
Keep the debriefing moving
Keep an open mind
Learn, Learn, Learn

24. Questions