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Table 2 Beliefs about debriefing topics and who gets to decide on them

From: “A debriefer must be neutral” and other debriefing myths: a systemic inquiry-based qualitative study of taken-for-granted beliefs about clinical post-event debriefing

Key themes Representative quote %
Based on your observations, what do people typically talk about during debriefings?
  Technical and medical issues “Mainly technical issues [...] I really have to make an effort not to stick to technical stuff.” 30.2
  Teamwork “[...] one of the classic issues is collaboration among the anaesthetists and the trauma team in the trauma.” 20.8
  Critical events and mistakes “Mostly about mistakes.” 18.9
  Room for improvement “Room for improvement is a major topic in our department.” 15.1
  Emotions “[…] the emotional, the mental component, how was I feeling, what issue does she have, these aren’t always just constructive, because they are exaggerated and very much dramatized.” 9.4
  Reflection “ […] they reflect about the situation, why he or she acted this way, what his or her considerations were […].” 5.7
What should be talked about in debriefings?
  Teamwork “[…] about working together, this is swept under the table.” 29.2
  Emotions and perceptions “I do believe that there should be room for feelings or good feelings in debriefings.” 18.5
  Critical events and mistakes “As unpleasant as is it, (but) we should try to talk about the things that didn’t go well [...].” 13.9
  Technical and medical issues “In the daily clinical routine, the focus is on technique, you have to show and teach your people the basic tools.” 13.9
  Room for improvement “[…] what were the reasons that something didn’t go as planned, such things, yes.” 12.3
  Reflection “[…] but also what was going on in the people’s minds, how they understood it [...].” 6.2
  Uncertainty “I believe we should talk about things that […] entail uncertainties.” 3.1
  The complete case “About the whole procedure, about all scenes, from the beginning until the end, because in the very situation so many things are happening that are running through your mind.” 3.1
Who do you think has the most influence on what is talked about in debriefings?
  Debriefer and initiator “[…] the instructor […] he or she should conduct the conversation. 31.2
  Senior / more experienced staff members “Basically, I would say that experienced staff have more influence, because they feel more confident in their roles.” 27.9
  Physicians “There are indeed attendings who determine what is talked about.” 21.3
  Personality “In principle, I believe that extroverted people say a lot more in a debriefing that those who are reserved, which you can’t change in a debriefing.” 14.7
  Everybody “I believe that everyone has influence, everyone who dares to.” 3.3
  Culture “It very much depends on the culture of the [...] groups.” 1.6
Who do you think has the least influence on what is talked about in debriefings?
  People with certain personality characteristics “Introverted staff will be rather quiet […]” 42.9
  Less powerful staff members “The least the lowest-ranking […]” 20
  Nurses “The nurses are the most reserved.” 14.3
  Those with little involvement “[…] the least the ones who are hardly involved […]” 8.6
  Residents “What I observe is that we, the attendings, do have the most influence on what is talked about because […] the residents keep listening to us automatically.” 5.7
  It depends on the respective person “I believe it depends very much on the person and on whom you’re talking to.” 5.7
  Nobody “… I don’t believe that there is someone who doesn’t have any influence.” 2.9
How do you explain that?
  Impact of hierarchy “The highest-ranking person makes the plan and the rest follows him or her blindly. 26.5
  Impact of facilitation “…the moderator conducts the discussion, but everyone should be able to have a say in it.” 26.5
  Impact of experience & expertise “[…] but they must have some idea of the topic” 20.4
  Impact of role & position “This depends entirely on the role of a participant […]” 12.2
  Impact of personality characteristics “… on the one hand with the […] power/assertiveness of the initiators.” 6.1
  Impact of logistics “This has something to do with the varying shifts and handovers, this makes it difficult […]” 8.2
In your view, who should have the most influence on what is talked about in debriefings?
  Senior / more experienced staff members “I think it is the hierarchical structures in medicine, the person at the top has most influence, and the rest just obeys.” 40
  Debriefer “The person who facilitates the conversation has most influence. They should create an atmosphere in which employees feel comfortable and free to speak up. […]” 36.7
  Everybody “[…] if anyone can initiate it as they please, then there should be no differences.” 15
  Other […] not so much related to the person […] and then not the person with the highest status or the loudest person, […] the most crucial aspects should come up for discussion. 8.3