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Adaptation of the US Army’s After-Action Review for Simulation Debriefing in Healthcare

Sawyer, Taylor Lee DO, MEd; Deering, Shad MD

doi: 10.1097/SIH.0b013e31829ac85c
Special Article

Summary Statement Postsimulation debriefing is a critical component of effective learning in simulation-based health care education. Numerous formats in which to conduct the debriefing have been proposed. In this report, we describe the adaptation the US Army’s After-Action Review (AAR) debriefing format for postsimulation debriefing in health care. The Army’s AAR format is based on sound educational theory and has been used with great success in the US Army and civilian organizations for decades. Debriefing using the health care simulation AAR process requires planning, preparation, and follow-up. Conducting a postsimulation debriefing using the health care simulation AAR debriefing format includes 7 sequential steps as follows: (1) define the rules of the debriefing, (2) explain the learning objectives of the simulation, (3) benchmark performance, (4) review what was supposed to happen during the simulation, (5) identify what actually happened, (6) examine why events occurred the way they did, and (7) formalize learning by reviewing with the group what went well, what did not go well and what they would do differently if faced with a similar situation in real life. We feel that the use of the health care simulation AAR debriefing format provides a structured and supported method to conduct an effective postsimulation debriefing, with a focus on the learning objectives and reliance on preidentified performance standards.

From the School of Medicine (T.L.S.), University of Washington; Washington State Army National Guard (T.L.S.), 81st Heavy Brigade Combat Team, Seattle, WA; and Uniformed Service University of Health Sciences (S.D.), Bethesda, MD.

Reprints: Taylor Lee Sawyer, DO, MEd, University of Washington School of Medicine, Department of Pediatrics/Division of Neonatology, Box 356320, 1959 NE Pacific St, HSB, Seattle, WA 98195-6302 (e-mail:

The authors declare no conflict of interest.

The views expressed in this article are those of the author(s) and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

© 2013 by Lippincott Williams & Wilkins, Inc.