Debriefing is a process involving the active participation of learners, guided by a facilitator or instructor whose primary goal is to identify and close gaps in knowledge and skills. A review of existing research and a process for identifying future opportunities was undertaken.
A selective critical review of the literature on debriefing in simulation-based education was done. An iterative process of analysis, gathering input from audience participants, and consensus-based synthesis was conducted.
Research is sparse and limited in presentation for all important topic areas where debriefing is a primary variable. The importance of a format for reporting data on debriefing in a research context was realized and a “who, when, where, what, why” approach was proposed. Also, a graphical representation of the characteristics of debriefing studies was developed (Sim-PICO) to help guide simulation researchers in appropriate experimental design and reporting.
A few areas of debriefing practice where obvious gaps that deserve study were identified, such as comparing debriefing techniques, comparing trained versus untrained debriefers, and comparing the effect of different debriefing venues and times. A model for publication of research data was developed and presented which should help researchers clarify methodology in future work.
From the Center for Medical Simulation (D.R.), Cambridge, MA; Department of Anesthesia, Critical Care, and Pain Management (D.R.), Massachusetts General Hospital, Cambridge, MA; Department of Anaesthesia (D.R.), Harvard Medical School, Cambridge, MA; The University of Texas at Arlington College of Nursing (M.A.), Arlington, TX; KidSIM-Aspire Simulation Research Program (A.C.), Alberta Children's Hospital, University of Calgary, Calgary, Canada; Stanford University Medical School (R.F.), Stanford, CA; Center for Simulation, Advanced Education and Innovation (V.N.), The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA; Department of Anesthesiology (G.S.), Pharmacology and Intensive Care, Geneva University Hospitals, Geneva, Switzerland; and Unit for Development and Research in Medical Education (G.S.), University of Geneva, Geneva, Switzerland.
D.R.: Salaried instructor for simulation-based instructor courses at the Center for Medical Simulation; M.A.: Author for the online course, Debriefing and Guided Reflection, on the Simulation Innovation Resource Center site. Additionally, she teaches a continuing education course on simulation, as well as a simulation course for the Master's program at UT Arlington College of Nursing. She has done some consultation related to simulation and has received grant funding from The Laerdal Foundation for Acute Medicine, The Association of Standardized Patient Educators, and the UT System; A.C.: Instructor for simulation-based instructor courses through KidSIM at Alberta Children's Hospital and receives grant support from the Laerdal Foundation for Acute Medicine and the Heart and Stroke Foundation of Canada; R.F.: Instructor for simulation-based instructor courses at Stanford University; V.N.: Endowed Chair, Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia. He has received unrestricted research grants from the NIH (cardiac arrest and resuscitation, glycemic control) and Laerdal Foundation for Acute Care Medicine (education); G.S.: Instructor for simulation-based instructor courses through SimulHUG at the University Hospitals of Geneva, Switzerland and the University of Paris Descartes, France.
Reprints: Daniel Raemer, PhD, Center for Medical Simulation, 65 Landsdowne St., Cambridge, MA 02139 (e-mail: firstname.lastname@example.org).