- 1Health Service and Population Research Department, Center for Implementation Science, King's College London, London, UK
- 2Institute for Education in Medical and Dental Sciences, University of Aberdeen, Aberdeen, UK
- 3Center for Primary Care, NIHR School for Primary Care Research, Manchester Academic Health Science Center, University of Manchester, Manchester, UK
- 4Miller School of Medicine, University of Miami, Miami, Florida, USA
- Correspondence to Dr Louise Hull, Center for Implementation Science, King's College London, London SE5 8AF, UK;
Introduction Debriefing is widely perceived to be the most important component of simulation-based training. This study aimed to explore the value of 360° evaluation of debriefing by examining expert debriefing evaluators, debriefers and learners’ perceptions of the quality of interdisciplinary debriefings.
Method This was a cross-sectional observational study. 41 teams, consisting of 278 learners, underwent simulation-based team training. Immediately following the postsimulation debriefing session, debriefers and learners rated the quality of debriefing using the validated Objective Structured Assessment of Debriefing (OSAD) framework. All debriefing sessions were video-recorded and subsequently rated by evaluators trained to proficiency in assessing debriefing quality.
Results Expert debriefing evaluators and debriefers’ perceptions of debriefing quality differed significantly; debriefers perceived the quality of debriefing they provided more favourably than expert debriefing evaluators (40.98% of OSAD ratings provided by debriefers were ≥+1 point greater than expert debriefing evaluators’ ratings). Further, learner perceptions of the quality of debriefing differed from both expert evaluators and debriefers’ perceptions: weak agreement between learner and expert evaluators’ perceptions was found on 2 of 8 OSAD elements (learner engagement and reflection); similarly weak agreement between learner and debriefer perceptions was found on just 1 OSAD element (application).
Conclusions Debriefers and learners’ perceptions of debriefing quality differ significantly. Both groups tend to perceive the quality of debriefing far more favourably than external evaluators. An overconfident debriefer may fail to identify elements of debriefing that require improvement. Feedback provided by learners to debriefers may be of limited value in facilitating improvements. We recommend periodic external evaluation of debriefing quality.
- simulation-based training
- interdisciplinary training
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Contributors LH made substantial contributions to the conception and design of the work, the analysis and interpretation of data, drafting the work, final approval of the version published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SR and MA made substantial contributions to the analysis and interpretation of data, revising the draft work critically for important intellectual content, final approval of the version published, and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. NS and DJB made substantial contributions to the conception and design of the work, the analysis and interpretation of data, revising the draft work critically for important intellectual content, final approval of the version published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding LH and NS's research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King's College Hospital NHS Foundation Trust. LH and NS are members of King's Improvement Science, which is part of the NIHR CLAHRC South London and comprises a specialist team of improvement scientists and senior researchers based at King's College London. Its work is funded by King's Health Partners (Guy's and St Thomas' NHS Foundation Trust, King's College Hospital NHS Foundation Trust, King's College London and South London and Maudsley NHS Foundation Trust), Guy's and St Thomas' Charity, the Maudsley Charity and the Health Foundation. MA is a NIHR Academic Clinical Fellow in Primary Care, Education Associate for the General Medical Council and a Trustee of the Clinical Human Factors Group.
Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests NS is the Director of London Safety & Training Solutions, which provides team skills training and advice on a consultancy basis in hospitals and training programmes in the UK and internationally.
Ethics approval Full Institutional Review Board approval obtained from University of Miami.
Provenance and peer review Not commissioned; externally peer reviewed.
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