Identifying best practice guidelines for debriefing in surgery: a tri-continental study

Abstract Background Changes in surgical training have decreased opportunities for experiential learning in the operating room (OR). With this decrease, a commensurate increase in debriefing-dependent simulation-based activities has occurred. Effective debriefing could optimize learning from both sim...

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Bibliographic Details
Published in:The American journal of surgery 2012-04, Vol.203 (4), p.523-529
Main Authors: Ahmed, Maria, M.P.H, Sevdalis, Nick, Ph.D, Paige, John, M.D, Paragi-Gururaja, Ram, M.D, Nestel, Debra, Ph.D, Arora, Sonal, Ph.D
Format: Article
Language:English
Subjects:
Anesthesiology - education
Australia
Best practice
Biological and medical sciences
Clinical Competence
Debriefing
Diagnosis
Embedding
Feedback
Female
General aspects
General Surgery - education
Guidelines
Health education
Humans
Interviews
Interviews as Topic
Learning
Male
Medical personnel
Medical research
Medical sciences
Miscellaneous
Nurses
Occupational medicine
Patient Care Team
Patient safety
Perioperative Nursing - education
Practice Guidelines as Topic
Problem-Based Learning
Promotion
Public health. Hygiene-occupational medicine
Qualitative
Researchers
Simulation
Skills
Studies
Surgeons
Surgery
Surgical education
Teaching
Total Quality Management
Training
United Kingdom
United States
Workplace-based learning
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Summary:Abstract Background Changes in surgical training have decreased opportunities for experiential learning in the operating room (OR). With this decrease, a commensurate increase in debriefing-dependent simulation-based activities has occurred. Effective debriefing could optimize learning from both simulated and real clinical encounters. Methods Thirty-three semistructured interviews with surgeons, anesthesiologists, and OR nurses from the United Kingdom, United States, and Australia identified the goals of debriefing, core components of an effective debrief, and solutions to its effective implementation. Interviews were audiotaped, transcribed, and coded using emergent theme analysis. Results Core components of an effective debrief include having the appropriate approach, establishing a learning environment, learner engagement, managing learner reaction, reflection, analysis, diagnosis, and application to real clinical practice. Solutions to enhance practice involve promotion of a debriefing culture within the surgical community with protected time to conduct a structured debriefing. Conclusions A need exists to enhance surgical training through regular structured debriefing. Identifying the key components of an effective debrief is a first step toward improving practice and embedding a debriefing culture within the OR.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2011.09.024