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Debriefing in pediatrics

  • Cho, Su Jin (Department of Pediatrics, Ewha Womans University School of Medicine)
  • Received : 2014.10.14
  • Accepted : 2014.11.14
  • Published : 2015.02.10

Abstract

Debriefing is a conversational session that revolves around the sharing and examining of information after a specific event has taken place. Debriefing may follow a simulated or actual experience and provides a forum for the learners to reflect on the experience and learn from their mistakes. Originating from the military and aviation industry, it is used on a daily basis to reflect and improve the performance in other high-risk industries. Expert debriefers may facilitate the reflection by asking open-ended questions to probe into the framework of the learners and apply lessons learned to future situations. Debriefing has been proven to improve clinical outcomes such as the return of spontaneous circulation after cardiac arrest and the teaching of teamwork and communication in pediatrics. Incorporating debriefing into clinical practice would facilitate the cultural change necessary to talk more openly about team performance and learn from near misses, errors, and successes that will improve not only clinical outcome but also patient safety.

Keywords

References

  1. Sawyer TL, Deering S. Adaptation of the US Army's After-Action Review for simulation debriefing in healthcare. Simul Healthc 2013;8:388-97. https://doi.org/10.1097/SIH.0b013e31829ac85c
  2. Fanning RM, Gaba DM. The role of debriefing in simulation-based learning. Simul Healthc 2007;2:115-25. https://doi.org/10.1097/SIH.0b013e3180315539
  3. Rudolph JW, Simon R, Raemer DB, Eppich WJ. Debriefing as formative assessment: closing performance gaps in medical education. Acad Emerg Med 2008;15:1010-6. https://doi.org/10.1111/j.1553-2712.2008.00248.x
  4. Dufrene C, Young A. Successful debriefing - best methods to achieve positive learning outcomes: a literature review. Nurse Educ Today 2014;34:372-6. https://doi.org/10.1016/j.nedt.2013.06.026
  5. Dreifuerst KT. The essentials of debriefing in simulation learning: a concept analysis. Nurs Educ Perspect 2009;30:109-14.
  6. McGreevy JM, Otten TD. Briefing and debriefing in the operating room using fighter pilot crew resource management. J Am Coll Surg 2007;205:169-76. https://doi.org/10.1016/j.jamcollsurg.2007.03.006
  7. McDonnell LK, Jobe KK, Dismukes RK. Facilitating LOS debriefings: a training manual (NASA Technical Memorandum 112192 DOT/FAA/AR-97/6). Houston, TX: NASA, 1997.
  8. National Aeronautics and Space Administration (NASA). Apollo 13 technical crew debriefing. Houston, TX: NASA, 1970:198.
  9. Mitchell AM, Sakraida TJ, Kameg K. Critical incident stress debriefing: implications for best practice. Disaster Manag Response 2003;1:46-51. https://doi.org/10.1016/S1540-2487(03)00008-7
  10. Aggarwal R, Mytton OT, Derbrew M, Hananel D, Heydenburg M, Issenberg B, et al. Training and simulation for patient safety. Qual Saf Health Care 2010;19 Suppl 2:i34-43. https://doi.org/10.1136/qshc.2009.038562
  11. Cheng A, Nadkarni V, Hunt EA, Qayumi K; EXPRESS Investigators. A multifunctional online research portal for facilitation of simulation- based research: a report from the EXPRESS pediatric simulation research collaborative. Simul Healthc 2011;6:239-43. https://doi.org/10.1097/SIH.0b013e31821d5331
  12. Andreatta P, Saxton E, Thompson M, Annich G. Simulation-based mock codes significantly correlate with improved pediatric patient cardiopulmonary arrest survival rates. Pediatr Crit Care Med 2011;12:33-8. https://doi.org/10.1097/PCC.0b013e3181e89270
  13. Halamek LP. The simulated delivery-room environment as the future modality for acquiring and maintaining skills in fetal and neonatal resuscitation. Semin Fetal Neonatal Med 2008;13:448-53. https://doi.org/10.1016/j.siny.2008.04.015
  14. Dieckmann P, Molin Friis S, Lippert A, Ostergaard D. The art and science of debriefing in simulation: Ideal and practice. Med Teach 2009;31:e287-94. https://doi.org/10.1080/01421590902866218
  15. Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education: a systematic review. Adv Health Sci Educ Theory Pract 2009;14:595-621. https://doi.org/10.1007/s10459-007-9090-2
  16. Branch WT Jr, Paranjape A. Feedback and reflection: teaching methods for clinical settings. Acad Med 2002;77(12 Pt 1):1185-8. https://doi.org/10.1097/00001888-200212000-00005
  17. Kolbe M, Weiss M, Grote G, Knauth A, Dambach M, Spahn DR, et al. TeamGAINS: a tool for structured debriefings for simulationbased team trainings. BMJ Qual Saf 2013;22:541-53. https://doi.org/10.1136/bmjqs-2012-000917
  18. Savoldelli GL, Naik VN, Park J, Joo HS, Chow R, Hamstra SJ. Value of debriefing during simulated crisis management: oral versus video-assisted oral feedback. Anesthesiology 2006;105:279-85. https://doi.org/10.1097/00000542-200608000-00010
  19. Brett-Fleegler M, Rudolph J, Eppich W, Monuteaux M, Fleegler E, Cheng A, et al. Debriefing assessment for simulation in healthcare: development and psychometric properties. Simul Healthc 2012;7:288-94. https://doi.org/10.1097/SIH.0b013e3182620228
  20. Gardner R. Introduction to debriefing. Semin Perinatol 2013;37:166-74. https://doi.org/10.1053/j.semperi.2013.02.008
  21. Cheng A, Hunt EA, Donoghue A, Nelson K, Leflore J, Anderson J, et al. EXPRESS--Examining Pediatric Resuscitation Education Using Simulation and Scripting. The birth of an international pediatric simulation research collaborative--from concept to reality. Simul Healthc 2011;6:34-41. https://doi.org/10.1097/SIH.0b013e3181f6a887
  22. Cheng A, Hunt EA, Donoghue A, Nelson-McMillan K, Nishisaki A, Leflore J, et al. Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial. JAMA Pediatr 2013;167:528-36. https://doi.org/10.1001/jamapediatrics.2013.1389
  23. Dismukes RK, Gaba DM, Howard SK. So many roads: facilitated debriefing in healthcare. Simul Healthc 2006;1:23-5. https://doi.org/10.1097/01266021-200600110-00001
  24. American College of Obstetricians and Gynecologists Committee on Patient Safety and Quality Improvement. ACOG Committee Opinion No. 487: preparing for clinical emergencies in obstetrics and gynecology. Obstet Gynecol 2011;117:1032-4. https://doi.org/10.1097/AOG.0b013e31821922eb
  25. Goffman D, Heo H, Chazotte C, Merkatz IR, Bernstein PS. Using simulation training to improve shoulder dystocia documentation. Obstet Gynecol 2008;112:1284-7. https://doi.org/10.1097/AOG.0b013e31818c177b
  26. Soar J, Mancini ME, Bhanji F, Billi JE, Dennett J, Finn J, et al. Part 12: Education, implementation, and teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation 2010;81 Suppl 1:e288-330. https://doi.org/10.1016/j.resuscitation.2010.08.030
  27. Couper K, Perkins GD. Debriefing after resuscitation. Curr Opin Crit Care 2013;19:188-94. https://doi.org/10.1097/MCC.0b013e32835f58aa
  28. Clay AS, Que L, Petrusa ER, Sebastian M, Govert J. Debriefing in the intensive care unit: a feedback tool to facilitate bedside teaching. Crit Care Med 2007;35:738-54. https://doi.org/10.1097/01.CCM.0000257329.22025.18
  29. Tan H. Debriefing after critical incidents for anaesthetic trainees. Anaesth Intensive Care 2005;33:768-72.
  30. Cheng A, Rodgers DL, van der Jagt E, Eppich W, O'Donnell J. Evolution of the Pediatric Advanced Life Support course: enhanced learning with a new debriefing tool and Web-based module for Pediatric Advanced Life Support instructors. Pediatr Crit Care Med 2012;13:589-95. https://doi.org/10.1097/PCC.0b013e3182417709
  31. Percarpio KB, Harris FS, Hatfield BA, Dunlap B, Diekroger WE, Nichols PD, et al. Code debriefing from the Department of Veterans Affairs (VA) Medical Team Training program improves the cardiopulmonary resuscitation code process. Jt Comm J Qual Patient Saf 2010;36:424-9, 385. https://doi.org/10.1016/S1553-7250(10)36062-4
  32. Edelson DP, Litzinger B, Arora V, Walsh D, Kim S, Lauderdale DS, et al. Improving in-hospital cardiac arrest process and outcomes with performance debriefing. Arch Intern Med 2008;168:1063-9. https://doi.org/10.1001/archinte.168.10.1063
  33. Zebuhr C, Sutton RM, Morrison W, Niles D, Boyle L, Nishisaki A, et al. Evaluation of quantitative debriefing after pediatric cardiac arrest. Resuscitation 2012;83:1124-8. https://doi.org/10.1016/j.resuscitation.2012.01.021
  34. Wolfe H, Zebuhr C, Topjian AA, Nishisaki A, Niles DE, Meaney PA, et al. Interdisciplinary ICU cardiac arrest debriefing improves survival outcomes*. Crit Care Med 2014;42:1688-95. https://doi.org/10.1097/CCM.0000000000000327
  35. Mills P, Neily J, Dunn E. Teamwork and communication in surgical teams: implications for patient safety. J Am Coll Surg 2008;206:107-12. https://doi.org/10.1016/j.jamcollsurg.2007.06.281

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