Debriefing

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Debriefing

• Maria Overstreet, PhD (c), RN, CCNS

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Seven Objectives for Today!

• Importance of debriefing, historical perspective.
• Educational theory supporting debriefing.
• Components of debriefing nurse educators use.
• Various methods of debriefing.
• When to use which method.
• How do you determine which method works best?
• Learn while having fun.

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History

• Term Debriefing
• What does it mean to you?
• Military
• Psychology
• Nursing

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History

• WWII
• Brigadier General Marshall
• CISD (Critical Incident Stress Debriefing)
• Mitchell
• PD (Psychological Debriefing)
• Dyregrov
• Hall
• Stress in nurses daily work life stress
  debriefing

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Theory

• Theory
• educational literature supports need to debrief
  following an experiential learning exercise
• Blooms Taxonomy?
• Domains Cognitive, Psychomotor, Affective

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Experiential Learning Reflective Practice

• Dewey (1938)
• Interaction
• Continuity
• Kolb (1984)
• Experiential learning process
• Concrete Experience, Reflective Observation,
  Abstract Conceptualization, Active
  Experimentation
• Schön (1987)
• Reflective practice

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Kolbs Experiential Learning Model Overlaid with
Nursing Clinical Simulation Debriefing (by
Overstreet 2008)
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Reflective Practice

• Schöns theory of reflective practice (1987)
• Reflection in action
• Reflection on action

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Rudolph, Simon, Dufresne, Raemer (2006)

• What is good judgment?
• Judgment, bad judgment, good judgment
• Experienced opinion delivered in a respectful
  manner
• Advocacy Inquiry
• Conversational technique
• Good judgment genuine curiosity
• Double loop learning
• Argyris Schön (1978)
• Frames Actions Results

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Medical Literature

• Gaba, et al. (2001) Anesthesia Crisis Resource
  Mgmt
• Dismukes, et al. (2006) Role of facilitator
• Bond, et al. (2004) Mistakes can cause
  reflection
• Savoldelli, et al. (2006) Value of debriefing

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Nursing Literature

• Definition
• Essential components
• Lasater
• Baldwin
• Jefferies
• Johnson-Russell
• NLN, Laerdal 3 year study
• Jefferies
• Most important design feature of simulations was
  debriefing
• Decker
• Philosophical underpinnings
• Tables to offer simplicity to novice

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Methods to Use

• Various ways to debrief
• Plus/Delta
• Facilitator
• Lecture
• Psychological
• Good Judgment
• Link to real life experiences

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Which method?

• Which method matches content of simulation
  exercise and goals?
• What pieces of the simulation do you desire to
  bring forth ethics, culture, value, moral,
  psychomotor skill, knowledge, or emotion?
• How do you expect the student will respond?
• Determine which method works best for you as the
  educatormost of all Be flexible!