International Journal of Healthcare Simulation - Subject

The clinical debriefer: is experience necessary?

2026-02-05T00:00

Introduction

Clinical debriefing (CD) has been established as a powerful tool to improve clinical outcomes and staff wellbeing. Despite this, multiple barriers to widespread implementation have been identified, most notably a perceived deficiency of skilled facilitators and a lack of debriefing experience. This raises an important question: who should lead a CD?

Main body

Arguments supporting the importance of experience for clinical debriefers include the perceived necessity of training for effective debriefing, the difficulties in cultivating psychological safety and the possibility of debriefings causing harm. Arguments against this viewpoint include practical limitations in accessing experienced debriefers, the availability and utility of debriefing tools and the opportunity to learn through different forms of facilitation. There is a relative paucity of research in this area, and we draw upon evidence from the simulation literature as there are key parallels between debriefers in both contexts.

Conclusions

In this debate, we have explored a variety of relevant considerations, although evidence is mixed and it remains unclear whether experience is necessary to facilitate CDs. We believe that for the potential of CD worldwide to be realized, compromise must be reached. For particularly challenging debriefings, such as in exceptionally distressing scenarios or critical incidents, experience may be essential. Fundamentally, we hope to have enabled readers to reach their own verdicts.

The use of a pre-defined coding template in constructivist simulation-based research

2023-05-20T00:00

Introduction

Many constructivist methodologies and methods used in simulation-based research (SBR) involve coding of text, otherwise known as thematic analysis. This debate concerns whether, when thematically analysing textual data in SBR, codes should be pre-defined or derived from the data.

Pro arguments

Arguments in favour of using pre-defined codes included the grounding of a study within existing literature, building on that literature and explicitly defining the researchers’ initial knowledge and understanding. Failure to pre-define the codes may result in producing a brick to throw on the pile of SBR instead of constructively adding to existing knowledge.

Contra arguments

Arguments against the use of pre-defined codes included the risk of pre-forming conclusions at an early stage, and the potential to confine analysis, thus stifling the creation of new knowledge. SBR using pre-defined codes may create an ‘echo-chamber’ for pre-existing ideas and may result in ‘seeing only what we want to see’.

Conclusions

Factors that may determine whether to pre-define codes include the desire for transferability of results to other contexts, and uniqueness of the topic. Researchers should be aware of the arguments in favour of each of the conflicting approaches, and make explicit their reasons for choosing one approach over another.

Is interprofessional co-debriefing necessary for effective interprofessional learning within simulation-based education?

2021-09-21T00:00

Background

Interprofessional simulation-based education has become ever-more popular in recent years, in both undergraduate and postgraduate settings. Whilst the literature-base concerning debriefing interprofessional learner groups is growing, there is little research exploring interprofessional co-debriefing as a technique to facilitate effective learning in this context. This is surprising considering how pertinent the concept of interprofessional co-debriefing is in the context of interprofessional simulation-based education.

The question of whether interprofessional co-debriefing is necessary for effective interprofessional learning is relatively unexplored. In this article we examine this discussion further and provide a balanced argument highlighting both the benefits and challenges encountered when instituting interprofessional co-debriefing. We draw upon our extensive experience of interprofessional simulation-based education as well as the best available evidence to inform readers of the current understanding of best practice in this field.

Discussion

Benefits of interprofessional co-debriefing include differing perspectives and subject matter expertise, role-modelling, complementary debriefing styles, sharing of cognitive workload, and the opportunity for enhanced faculty development. However, it can also present challenges, even for experienced debriefers. For example, co-debriefers may have differing personal agendas with a focus on only one professional group, knowledge gaps concerning other professionals’ learning requirements, and both open and covert disagreements and differences in opinion that may affect the effectiveness of the debriefing. Furthermore, extra resources are required in terms of faculty numbers and training. Unfortunately, there is a lack of empirical research concerning interprofessional co-debriefing, with only one study currently reported that compares the perceived effectiveness of single debriefers versus interprofessional co-debriefers.

Conclusion

Drawing on our experiences and the best available evidence, interprofessional co-debriefing is not a necessity for effective interprofessional learning in simulation-based education. However, when utilized with skilled and trained faculty, we consider it to be an extremely powerful technique for interprofessional debriefing. This may be especially applicable for undergraduate learners who will likely have limited experience of working together with other healthcare professions. Further research is urgently needed to explore multiple aspects of interprofessional co-debriefing, including faculty and participant perceptions and expectations, and comparative studies assessing the effectiveness of debriefings led by single versus multiple debriefers.