Summary

The debriefing is a critical component of simulation-based education, providing a structured opportunity for participants to reflect on their experience and cement new learning. As a facilitator, your role is not to teach but to guide learners in extracting insights through a collaborative analysis of the scenario experience.

Before the substantive debriefing discussion, invest significant time upfront in intentionally creating a conducive learning environment. Explicitly explain the structure, phases and expected timeframe so participants understand what to expect. Outline ground rules like maintaining confidentiality of the discussions and engaging in mutually respectful dialogue.

Most critically, work to create a psychologically safe context where learners feel able to openly share thoughts, question assumptions, admit errors and be self-critical without fear of embarrassment or retaliation. Reassure them this is not an evaluative exercise but a formative opportunity for growth. Encourage an atmosphere of candid curiosity.

The Debriefing Structure

While there are various models described in the literature, a typical healthcare debriefing follows a structured sequence with phases like:

• Reaction Phase – Allow participants to share their initial emotional reactions to the scenario to “cool down” before analytical discussion.
• Descriptive Phase – Reconstruct a shared mental model by going around and having each person describe what they experienced and the key events/decisions as they perceived them.
• Analytical Phase – The core of the debriefing. Facilitate self-reflection and analysis by exploring the reasoning behind participants’ actions/decisions. Use advocacy-inquiry, describing what you observed non-judgmentally before asking an open-ended question to understand their thought process. In this phase, if available, it is possible to use video segments to reinforce insights.
• Summarizing Phase – Consolidate and summarize the key lessons, take-aways and insights from the group discussion. Have participants articulate the most salient messages they will take back into their real practice.

Throughout, your role is to use open-ended questions, allow silences for deeper reflection, rephrase or re-ask questions as needed, and gently guide the discussion while avoiding lecturing or making judgments. Support the group’s analysis but avoid appropriating the conversation.

Addressing Gaps and Errors

Inevitably, participants’ performance during scenarios will have lapses, gaps or errors. View these not as failures but as extremely valuable learning opportunities. Use an “advocacy-inquiry” approach to raise and explore them:

• Describe the specific performance gap or error you observed as objectively as possible without judgment.
• Share your perspective on the potential consequences or impact of that action matter-of-factly.
• Then explore the participant’s reasoning and mental model through a curious, non-threatening question like “I’m interested to understand more of what was going through your mind at that point…”

This honest yet non-threatening approach promotes self-reflection and mutual understanding over defensiveness. Be sure you also reinforce positive performance by highlighting exemplary actions and having the individual(s) analyze what made it effective.

Facilitating an effective debriefing requires developing a distinct skillset of establishing a safe environment, using observation and curious questions to prompt self-critique, and adeptly managing group dynamics. With practice, you can guide participants in extracting profound insights from scenarios while fostering an environment of trust, analysis and growth.