Helping healthcare teams to debrief effectively: associations of debriefers' actions and participants' reflections during team debriefings.

Background Debriefings help teams learn quickly and treat patients safely. However, many clinicians and educators report to struggle with leading debriefings. Little empirical knowledge on optimal debriefing processes is available. The aim of the study was to evaluate the potential of specific types...

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Published in:BMJ Quality & Safety Vol. 32; no. 3; pp. 160 - 178
Main Authors: Kolbe, Michaela, Grande, Bastian, Lehmann-Willenbrock, Nale, Seelandt, Julia Carolin
Format: research tables/charts Journal Article
Published: BMJ Publishing Group Mar2023
Online Access:View this record in EBSCOhost
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      dt: Mar2023
      vid: 32
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      pub: BMJ Publishing Group
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        10.1136/bmjqs-2021-014393
        162528338
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        atl: Helping healthcare teams to debrief effectively: associations of debriefers' actions and participants' reflections during team debriefings.
      aug:
        au:
          Kolbe, Michaela
          Grande, Bastian
          Lehmann-Willenbrock, Nale
          Seelandt, Julia Carolin
        affil: Simulation Centre, University Hospital Zurich, Zurich, Switzerland
      sug:
        subj:
          Education, Medical
          Teaching Methods, Clinical
          Communication
          Simulations
          Reflection
          Human
          Prospective Studies
          Nonexperimental Studies
          Descriptive Statistics
          Data Analysis Software
          Male
          Female
          Male
          Female
      ab: Background Debriefings help teams learn quickly and treat patients safely. However, many clinicians and educators report to struggle with leading debriefings. Little empirical knowledge on optimal debriefing processes is available. The aim of the study was to evaluate the potential of specific types of debriefer communication to trigger participants' reflection in debriefings. Methods In this prospective observational, microanalytic interaction analysis study, we observed clinicians while they participated in healthcare team debriefings following three high-risk anaesthetic scenarios during simulation-based team training. Using the video-recorded debriefings and INTERACT coding software, we applied timed, event-based coding with DE-CODE, a coding scheme for assessing debriefing interactions. We used lag sequential analysis to explore the relationship between what debriefers and participants said. We hypothesised that combining advocacy (ie, stating an observation followed by an opinion) with an open-ended question would be associated with participants' verbalisation of a mental model as a particular form of reflection. Results The 50 debriefings with overall 114 participants had a mean duration of 49.35 min (SD=8.89 min) and included 18 486 behavioural transitions. We detected significant behavioural linkages from debriefers' observation to debriefers' opinion (z=9.85, p<0.001), from opinion to debriefers' open-ended question (z=9.52, p<0.001) and from open-ended question to participants' mental model (z=7.41, p<0.001), supporting our hypothesis. Furthermore, participants shared mental models after debriefers paraphrased their statements and asked specific questions but not after debriefers appreciated their actions without asking any follow-up questions. Participants also triggered reflection among themselves, particularly by sharing personal anecdotes. Conclusion When debriefers pair their observations and opinions with open-ended questions, paraphrase participants' statements and ask specific questions, they help participants reflect during debriefings.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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