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The Art of Debriefing

Learn about the importance of debriefing in facilitating self-discovery and improving team performance. This article provides key tips and techniques for conducting successful debriefing sessions.

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The Art of Debriefing

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  1. The Art of Debriefing Angela Rodriguez Perinatal Coordinator Advocate Illinois Masonic Medical Center

  2. What is Debriefing? • Facilitated discussion among team members about events that just occurred • Facilitator’s job is to enable self-discovery among team members about • What went well and why it went well • What needs to improve and how that should be done

  3. Feedback vs. Debriefing • Debriefing is a facilitated discussion • Feedback is giving provisional information The amount of instructor feedback needed is inversely proportional to experience of the team members

  4. Debriefing is Important • The debriefing session is a necessary part of the simulation experience • A great deal of learning takes place at the debriefing session

  5. Good Facilitators are Important • They must possess both good interpersonal skills and good communication skills *Mayo Clinic Simulation Workshop-September, 2008

  6. Key points for good sessions • Facilitators should come prepared for the session. • Know your audience • Know the goals & objectives (of the simulation) • Know your co-debriefer *Mayo Clinic Simulation Workshop-September, 2008

  7. Key points for good sessions • Facilitators should brush-up on basic debriefing principals • Review debriefing sections under Tab 6 in your IDPH Obstetric Hemorrhage Education Project Instructor’s Resource Manual • Take time to read a comprehensive debriefing article for tips. I liked: • Rudolph, J.W.,Simon, R.,Rivard, P., Dufresne, R.L., Raemer, D.B. (2007) Debriefing with good judgment: combining rigorous feedback with genuine inquiry. Anesthesiology Clinics. 25(2):361-376.

  8. Key points for good sessions • Facilitators should familiarize themselves with the principals of adult learning, assuming learners are independent, self-directed individuals • Establish an effective learning climate where learners feel safe and comfortable expressing themselves • Involve learners in evaluating their own learning-this can develop their skills of critical reflection. *Knowles, MS & Associates. Andragogy in action: applying modern principals of adult learning. San Francisco: Josey-Bass 1984

  9. Key points for good sessions • Facilitators should encourage group participation • Engage all learners • Model attentiveness • Pay attention to who has spoken and who has not • Restrain yourself from conveying your viewpoint • Believe the learners can teach you • Have faith learners can work through their own problems *Mayo Clinic Simulation Workshop-September, 2008

  10. Set Ground Rules, i.e.:.. • This session will last approximately _____minutes. • This is a protected environment- what is said in this room, should stay in this room • Simulation is a safe environment. It’s ok to make mistakes and talk about them-they are learning experiences. • We will be respectful of each other

  11. Suggested statement for opening comments • State: “Everyone should help make this discussion as rich as possible by: • Contributing their ideas • Leaving time for others to do the same • Listening and learning from each other *IDPH Obstetric Hemorrhage Education Project Instructor’s Resource Manual

  12. Additional Suggestions • Progress through debriefing on some type of agenda • Chronologic review of events • “What happened when you first entered the room?” • Point-by-point according to learning objectives • “Let’s talk about objective 2 which is team work?” • Observation by observation • “Who was the team leader?”

  13. Key points for good sessions • Try to avoid a judgmental approach, one which might include harsh criticism and humiliation • Example: “Can anyone tell me Patty’s big mistake?” • People may not feel safe and might be reluctant to raise questions, interfering with the learning process. * Rudolph, J.W.,Simon, R.,Rivard, P., Dufresne, R.L., Raemer, D.B. (2007) Debriefing with good judgment: combining rigorous feedback with genuine inquiry.

  14. Key points for good sessions • But don’t be overly “nonjudgmental” either. • Example:" What do you think would have been a better idea?” • Although it allows the learner to save face, the critical message, i.e.: a mistake was made, might not be fully understood. * Rudolph, J.W.,Simon, R.,Rivard, P., Dufresne, R.L., Raemer, D.B. (2007) Debriefing with good judgment: combining rigorous feedback with genuine inquiry

  15. Key points for good sessions • Instead use the “good judgment approach”, which values the expert opinions and perspectives of both the facilitator and the learner. • Example: “I noticed you did not draw a specimen for type and cross- from my point of view it seemed problematic. I’m curious, How were you seeing the situation at that point in time?” • Helps the learner move toward learning objective * Rudolph, J.W.,Simon, R.,Rivard, P., Dufresne, R.L., Raemer, D.B. (2007) Debriefing with good judgment: combining rigorous feedback with genuine inquiry

  16. Key points for good sessions • Facilitators should practice this art of “Advocacy/Inquiry” • 1st : Putting observations/thoughts into an ADVOCACY statement • Then, following up with probing INQUIRY Another example:" It is hard to challenge a colleague even when they are wrong. Can you help me understand what might have prevented you from speaking up, when the resident ordered the wrong dose ” * Argyris, C., Putnam, R., & McLain Smith, D. (1985) Action Science:  Concepts, Methods, and Skills for Research and Intervention

  17. Questions to Dig Deeper • “Tell us more about that…” • “What would have happened if…” • “Who else observed this? What did you notice, and what were you thinking about?” • “Why was that helpful?”

  18. Videotaping • Optional • Be proficient in the use of the video, if you intend to tape the sessions • Know how to index important event • Select 1-1.5 minute long segments • Do not show a video segment unless you intend to discuss it • Pause video for comments • It can help learners see the big picture of team dynamics • But … some people may find it to be intimidating *Mayo Clinic Simulation Workshop-September, 2008

  19. Closing Remarks • Ask “What was the single most important principle you learned from this experience today?” • Thank the participants for sharing *IDPH Obstetric Hemorrhage Education Project Instructor’s Resource Manual

  20. References -Mayo Clinic Simulation Workshop-September 24th, 25th, 26th, 2008. Mayo Clinic, Rochester MN. IDPH Obstetric Hemorrhage Education Project Instructor’s Resource Manual, August 2008 -Rudolph, J.W.,Simon, R.,Rivard, P., Dufresne, R.L., Raemer, D.B. (2007) Debriefing with good judgment: combining rigorous feedback with genuine inquiry. Anesthesiology Clinics. 25(2):361-376. -Knowles, MS & Associates. Andragogy in action: applying modern principals of adult learning. San Francisco: Josey-Bass 1984 -Argyris, C., Putnam, R., & McLain Smith, D. (1985) Action Science:  Concepts, Methods, and Skills for Research and Intervention

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