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DE-CODE: a coding scheme for assessing debriefing interactions
  1. Julia C Seelandt1,2,
  2. Bastian Grande2,3,
  3. Sarah Kriech2,
  4. Michaela Kolbe2,4
  1. 1Quality Management and Patient Safety, University Hospital Zurich, Zurich, Switzerland
  2. 2Simulation Center, University Hospital Zurich, Zurich, Switzerland
  3. 3Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland
  4. 4ETH Zurich, Zurich, Switzerland
  1. Correspondence to Dr Michaela Kolbe; mkolbe{at}


Debriefings are crucial for learning during simulation-based training (SBT). Although the quality of debriefings is very important for SBT, few studies have examined actual debriefing conversations. Investigating debriefing conversations is important for identifying typical debriefer–learner interaction patterns, obtaining insights into associations between debriefers’ communication and learners’ reflection and comparing different debriefing approaches. We aim at contributing to the science of debriefings by developing DE-CODE, a valid and reliable coding scheme for assessing debriefers’ and learners’ communication in debriefings. It is applicable for both direct, on-site observations and video-based coding.

Methods The coding scheme was developed both deductively and inductively from literature on team learning and debriefing and observing debriefings during SBT, respectively. Inter-rater reliability was calculated using Cohen’s kappa. DE-CODE was tested for both live and video-based coding.

Results DE-CODE consists of 32 codes for debriefers’ communication and 15 codes for learners’ communication. For live coding, coders achieved good inter-rater reliabilities with the exception of four codes for debriefers’ communication and two codes for learners’ communication. For video-based coding, coders achieved substantial inter-rater reliabilities with the exception of five codes for debriefers’ communication and three codes for learners’ communication.

Conclusion DE-CODE is designed as micro-level measurement tool for coding debriefing conversations applicable to any debriefing of SBT in any field (except for the code medical input). It is reliable for direct, on-site observations as well as for video-based coding. DE-CODE is intended to allow for obtaining insights into what works and what does not work during debriefings and contribute to the science of debriefing.

  • debriefings
  • simulation based-training
  • coding scheme
  • communication
  • interactions.

Statistics from


  • Contributors JCS and MK were involved in the planning, conduct and reporting of this study and developed the coding scheme. JCS and MK prepared the study proposal and created the manuscript. JCS collected data and performed the statistics. BG served as a scientific advisor, helped with data collection and revised the final manuscript. SK collected data and revised the final manuscript.

  • Funding The research was supported by a grant from the Swiss National Science Foundation (Grant No. 100014_152822).

  • Competing interests None declared.

  • Ethics approval The study was approved by the local ethics committee (Kantonale Ethikkommission Zürich (KEK-ZH-No. 2013–0592)).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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