Debriefing

What can I do?

Impact
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Quality
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  1. Facilitate debriefs with learners after specific events (avoid general debriefs)
  2. Allow learners to self-reflect on what happened, but also offer you expert opinion
  3. Conduct debriefs in teams of 2-5 and for longer than 20 minutes

What is this about?

Debrief practices include four elements [1]:

  1. Active self-learning - This involves engaging in forms of self-discovery, practice, or activity (as opposed to merely being a passive recipient of learning)
  2. Developmental intent - The focus of debriefing is to develop knowledge and skills, not to evaluate or appraise performance
  3. Specific events - Debriefing is characterised by reflecting on specific events (e.g., successes, failures/errors), as opposed to general feedback
  4. Multiple information sources - Debriefing is more than self-reflecting. Debriefing involved both self-reflection and feedback from at least one other person (e.g., a peer, a supervisor)

You might use these questions as a structure when conducting debriefs, [2]. After an ‘event’ (e.g., an interaction with a patient/client), ask learners:

  1. How are you feeling?
  2. What was the intended objective?
  3. What was the actual outcome?
  4. What contributed to meeting the intended outcome
  5. What detracted from meeting the intended outcome
  6. What is the intended future objective
  7. What actions will increase the likelihood of meeting the intended future objectives

What's the evidence say?

Debriefing events have a positive effect on healthcare performance ➕➕➕➕➕ [1, 2]. The effects of debriefing seem to be more effective:

  1. When debriefing sessions are facilitated by an expert who can guide learning and focus attention ➕➕➕➕➕ [1]
  2. When the task, training, and criteria are individual, compared to team or a combination of individual and team ➕➕➕➕➕ [2]
  3. When conducted in teams of 2-5 ➕➕➕➕➕ [2]
  4. When debriefing sessions are longer than 20 minutes ➕➕➕➕➕ [2]
  5. Regardless of if they’re led by learners or experts ➕➕➕➕➕ [2]

What's the underlying theory?

  1. Self-Determination Theory suggests that debriefing can enhance motivation and engagement by promoting a sense of autonomy, competence, and relatedness. Autonomy refers to the feeling of being in control of one's own life and decisions. Competence refers to the feeling of being capable and effective. Relatedness refers to the feeling of being connected to others. Debriefing can foster these feelings by providing clear goals, rules, and feedback, and by giving students a sense of choice and control over their learning experience.
  2. Social Cognitive Theory suggests that debriefing can influence learning by providing information about the standards and expectations of the learning environment and by providing opportunities for social comparison. Debriefing can also provide a sense of social support and encouragement, which can enhance motivation and learning.
  3. Self-Regulation Theory suggests that debriefing can facilitate learning by providing students with the opportunity to take responsibility for their own learning and to monitor and regulate their own progress. Debriefing can provide students with a structured and supportive environment in which to reflect on their experiences, identify areas for improvement, and develop strategies for self-regulation. This process can help students to become more self-directed and motivated learners.

Where does the evidence come from?

Two high-quality meta-analyses support this evidence summary. One meta-analysis [1] included 31 studies from across multiple settings (not just health) and reported a limited risk of publication bias. This paper included primary studies of varying quality (both randomised and non-randomised control trials) and reported a high heterogeneity score, resulting in a modest rating of overall quality ➕➕➕. The second meta-analysis [2] included 61 primary studies that employed various designs (e.g., quasi-experimental, pre-post design) from a variety of contexts, including healthcare. No analysis of heterogeniety was conducted and publication bias analyses were mixed. As such, the quality of this meta-analysis is on the lower side ➕➕.

References

  1. Tannenbaum, S. I. & Cerasoli, C. P. (2013). Do Team and Individual Debriefs Enhance Performance? A Meta-Analysis. Human Factors, 55(1), 231–245. https://doi.org/10.1177/0018720812448394‍
  2. Keiser, N.L. & Arthur, W. (2021). A meta-analysis of the effectiveness of the after-action review (or debrief) and factors that influence its effectiveness. Journal of Applied Psychology, 106(7), 1007–1032. https://doi.org/10.1037/apl0000821

Additional Resources

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