Hot debriefing can provide timely reflection on a critical clinical experience. When reflecting on simulated learning events after they have taken place, healthcare educators and providers can utilize debriefing to solidify their knowledge and improve future performance. As the debrief has been suggested as one of the most beneficial components of a healthcare simulation experience, clinical educators should consider the opportunity to utilize debriefing in the clinical environment, through the use of a “Hot Debrief”. This HealthySimulation article will explore the concepts and benefits of using “Hot Debriefing” in healthcare.
What Is Debriefing?
Debriefing is typically a structured, facilitated process that allows participants to reflect on their experience while identifying areas for future improvement. A debrief is typically conducted by an educator with training in various debriefing techniques to maximize the effectiveness of the event. Debriefing as a teaching methodology can be utilized in any learning environment that would benefit from introspection or a group discussion and is not limited to just medical simulation. Effective use of this essential tool can lead to the improvement of the learners’ clinical skills and medical knowledge while also having a positive impact on patient outcomes.
In clinical simulation, a debriefing session typically includes a review of the scenario or event, a discussion of participants’ thoughts and feelings, and an identification of key learning points from the case. These debriefings can be conducted individually or in groups and can be tailored to the needs of the participants
While there are many different ways to facilitate a debrief, each method aims to help participants reflect on their experience, learn from the encounter, and ideally be able to immediately apply that learning to future situations. Some standard debriefing methods include:
- Leader-led debrief: In this type of debrief, the debriefer (facilitator, instructor, leader, etc.) guides the group through a structured reflection on the experience. This can be done verbally, through questions, or using a pre-written guide.
- Group-led debrief: In this type of debrief, the group decides how to debrief with little or no input from the leader. This can be done through discussion, brainstorming, or any other method the group decides on.
- Individual debrief: In this type of debrief, each learner reflects on their own experience without input from others. This can be done through journaling, talking to a trusted friend or family member, or any other method that the learner finds effective.
Whichever method is chosen, the fact remains that debriefing is a vital aspect of experiential learning. By taking the time to reflect on the experience, clinical simulation faculty and learners alike can solidify their knowledge and skills that will improve performance in the future.
Hot Debriefing: What’s the Scoop?
Hot debriefing in healthcare occurs or immediately after a critical clinical event like a cardiac arrest or a code situation. By incorporating hot debriefing in emergency room settings, hospitals can better review these events and quickly create quality improvement measures.
Most emergency rooms are filled with highly stressed, increased acuity, and complex patient loads. When a critical event occurs, such as trauma and cardiac arrests, staff have little time to process before moving on to the next patient or task. Creating a process that allows staff to take a moment to debrief their experiences can allow them to absorb the recent scenario and discuss amongst themselves what interventions, if any, could have been improved.
The research study Promoting hot debriefing in an emergency department (Gilmartin 2020) performed in an Irish emergency room provided evidence to support the benefit of a hot debriefing process to improve quality and patient care. Over six months, 42% of code situations were followed by a hot debrief. Each debriefing session promoted practice and process changes to equipment, educational activities, and provider skills. Debriefing follow-ups found that all participants agreed that the hot debriefing process improved their clinical practice.
How to Host a Hot Debrief
Given that hospitals (especially emergency rooms) never close, educators in clinical environments should note that hot debriefs are often time-limited, as there will undoubtedly be other patients to care for. Luckily, a STOP format debrief guide was designed by the BC emergency medicine network, BC simulation network, and the CICSL to help facilitate quick reflections. This debriefing method allows providers and healthcare workers to meet objectives, stay on task, and remain limited in the time required.
The STOP format suggests that providers:
- Summarize the clinical event
- Things that went well (discuss & summarize)
- Opportunities to improve (discuss & summarize)
- Points of action (design a plan to implement change)
Another method of hot debriefing is a personal debrief. Each provider and healthcare worker can process individually but complete a written debrief assessment tool after clinical events. An example of what could be included may be:
- Name and role during the event
- What went well?
- What could have been done differently that may have improved the patient’s care?
- Were there any delays in care? If so, please describe.
- How could this event have been prevented or predicted?
- Did you feel prepared to care for this type of event? If not, what training would you like to receive that may help in the future?
- Did the team dynamics during the scenario help or hinder care for this patient?
For any healthcare facility wanting to enhance its quality improvement (QI) process, hot debriefs have been shown to be fruitful. Providers can process situations emotionally and psychologically while participating in an educational discussion.
Final Thoughts
The benefits of debriefing are endless and hot debriefing has specific advantages when utilized in the clinical environment. Hot debriefing is an active learning tool designed to help improve patient care in real-time. If more emergency rooms participated in hot debriefing the benefits will make their way to improved patient outcomes. The hot debrief findings from one event should improve the level of care for future patients that the team involved cares for.
