9 Modalities of debriefing.
In healthcare simulation, various debriefing modalities are used to enhance learning and improve clinical practice. Here are some key modalities:
- Self-Reflection: This involves individuals reflecting on their own performance and experiences after a simulation. It encourages personal insight and self-assessment, helping learners identify their strengths and areas for improvement.
- Self-Debriefing: Similar to self-reflection, self-debriefing involves a more structured approach where individuals use guided questions or frameworks to analyse their performance. This can be done through written reflections or recorded video reviews.
- Facilitated Debriefing: This is a structured debriefing led by a facilitator, often an experienced educator or clinician. The facilitator guides the discussion, helping participants reflect on their actions, understand the rationale behind decisions, and identify learning points. Facilitated debriefing can be done in groups or one-on-one.
- Tele-Debriefing: With advancements in technology, tele-debriefing allows for remote debriefing sessions. Participants and facilitators can connect via video conferencing tools to conduct debriefings, making it accessible even when in-person sessions are not possible.
Each modality has its own benefits and can be chosen based on the specific needs and context of the simulation. Combining different modalities can also provide a comprehensive debriefing experience.
Debriefing approaches
There are many different approaches and styles to debriefing, below are the most common debriefing styles used.
Triangular approach to debriefing
Health Education Improvement Wales’s Simulation team have proposed a triangular approach to debriefing which includes Principles, Structure and Strategies.
A66 Standardizing debriefing in Wales: the Triangular Approach [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)]
Diamond Debriefing Method
Diamond debrief method is based on the debrief framework technique which is made up of: description, analysis and application. Diamond debrief also consists of aspects of the advocacy-inquiry approach and of debrief with good judgment
SHARP
SHARP contains the absolute basic principles of what to cover when conducting a debriefing. SHARP is an acronym that comprises five ‘prompts’ to guide trainers and trainees in providing/receiving a structured debrief. SHARP stands for Set learning objectives, How did it go, Address concerns, Review learning points, and Plan ahead.
Objective Structured Assessment of Debriefing
OSAD is a tool which can be used to facilitate debriefings in both real clinical and simulated settings. It identifies eight core components/categories of effective debriefing i.e. best practice guidelines. These include the approach of the trainer, establishing a learning environment, learner engagement, gauging learner reaction, descriptive reflection, analysis of performance, diagnosis of performance gaps and application to future clinical practice. Each category describes poor, average and good practices. If desirable, each category may also be rated on a scale of 1 (minimum) to 5 (maximum) regarding how well that element of the debriefing is conducted by the trainer. Descriptive anchors at the lowest point, mid-point, and highest point of the scale are used to guide ratings. The global score for OSAD, therefore, ranges from a minimum of 8 to a maximum of 40 with higher scores indicating higher quality
SHARE
The SHARE debrief tool supports health and social care teams to engage teams and staff who may be affected by the outcome (ie safety actions) of a learning response. Consists of 5 stages:
- Scene
- Hear
- Articulate
- Response
- Embed
B1465-SHARE-Debrief-v1-FINAL.pdf
TALK (NHS tool)
TALK has four steps - Target, Analysis, Learning points, Key actions and promotes guided reflection within teams as a way to improve and maintain patient safety, increase efficiency and contribute to a supportive culture of dialogue and learning in any clinical environment.
https://www.talkdebrief.org/ startingtotalk
Reflection Pod:
Is there a debriefing tool you prefer? Explain your rationale.