One of the most complex parts of the role of clinical simulation debriefer is the choice of what question to ask clinical simulation participants. As a debriefer with time and experience, each individual debriefer will develop their own style of questions they choose to ask and why. This article by Erin Carn-Bennett, MSN, RN, will explore some tips around considerations for the selection of a debrief question as a debriefer of clinical simulation, despite what debrief methodology is used.
Similar, But Different, Debrief Styles
Many different types of debrief methodologies can be used in healthcare simulation, all of which have different philosophies around what to ask clinical simulation participants and why. Different debriefing methods all have pros and cons unique to each style. Central to all debrief methodologies is psychological safety for clinical simulation participants and assistance to clinical simulation participants to move from unresolved emotions to a place of reflection and understanding.
As a clinical simulation debriefer, there is huge potential to significantly impact a participant’s understanding of their practice and improve care translated into improved clinical practice after a successful debrief. There is great power in dedicated time to pause and reflect on individual and team outputs in a clinical simulation scenario. To be a debriefer in clinical simulation is a huge honor and a significant responsibility to maintain psychological safety of participants.
How to Maximize Outcomes of the Reactions Phase Using Observations and Outcomes
In the reactions phase of the debrief, there is a vast amount of useful information for a clinical simulation debriefer. Use the reactions or initial phase of the clinical simulation debrief to listen deeply to what is important for the clinical simulation participants to be discussed and to consider how to frame the debrief questions of interest around this analysis of rich information.
Anyone who has written a clinical simulation scenario from scratch will know that all clinical simulation scenarios are centered around educational outcomes for participants that are woven throughout the clinical simulation scenario. As a debriefer, the experience, particularly as a junior debriefer, is to focus the debriefing questions around specific educational outcomes in carefully designed clinical simulation scenarios. As a debriefer, part of the role in the clinical simulation scenario is to make observations of behaviors from both the individual and the team collectively. However, with experience and wisdom through time in the debrief circle, there may be a deviation from the focus on the prescribed educational outcomes listed and a more central focus on the individuals and their human factors at the moment of the debrief circle.
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Get Rid of Personal Assumptions in the Debrief
A great start as a debriefer is to have an item that has been brought up in the reactions phase of the debrief, as well as an observation that may have been made by the debriefer within the clinical simulation scenario. This may also match to a prescribed educational outcome as well. However, a great debriefer will refrain from making assumptions about their participants’ performance or reaction. If an obvious hot topic is shared, be psychologically safe in the approach and frame a question around this item of interest. Do not assume to know why people have behaved in a certain manner. Ask in a psychologically safe way if this will assist in movement through emotions through a guided reflection process in the debrief style in use.
Owning Mistakes, Facilitation Over Pontification, Focus on TeamWork
Part of the role of a debriefer is, at times, not always getting the debrief question right. A question may be asked in the wrong way/tone, or the participant may need help understanding what has been asked. At times, the debriefer may have yet to see the complete picture of what occurred and may have missed some of the context on an individual or team basis. This does at times happen. As a debriefer in this situation, the best action is to own any mistake made and apologize if necessary. Part of any human experience is not to always get things right. As a clinical simulation debriefer, there is no difference. Own mistakes graciously and move on to another question. This will also help to maintain the psychological safety of the clinical simulation participants.
As a clinical simulation debriefer, there will be times of struggle to choose a debrief question. Circle back to the purpose of the debrief, which is for clinical simulation participants to move through the experience and emotions of a clinical simulation to a place of reflection and adaptations to clinical practice in the future. To make sense of what has been done, create continual reflection and improvements for the future of healthcare. Selection of a debrief question that is of most interest to the clinical simulation participants should be the priority so that this process has the best chance of success.
Despite best intentions and focus on items such as those already discussed in this article, there can still be struggles with how to focus on a debrief question. One of the biggest challenges for a junior debriefer is the panic and dread of not knowing what debrief question to ask clinical simulation participants. Common threads and educational outcomes are woven into all clinical simulation scenarios. Consider these items if you are still stuck on what to ask: communication, teamwork, and leadership.
Reflect on what the clinical simulation scenario team has achieved for the patient, what was not done, and what was exemplary practice.
This article has focused on how to choose what questions to ask participants in a clinical simulation scenario when in a debriefer role. Particularly, as a more junior debriefer, this can cause a lot of angst and nervousness. This article has discussed strategies to assist debriefers in the process of what debrief questions to choose for clinical simulation scenario participants.
These strategies have included the use of the reactions phase, observations, and outcomes, park any assumptions as a debriefer, take ownership of errors, talk about what is of interest to participants, and being a focus point of teamwork. Although often an anxious time to gain confidence in the selection of a question for a clinical simulation scenario debrief, trust in the process to go alongside the skills discussed will take the skill of debriefing to the next level.
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