Skip to main content

Table 3 Beliefs about taboo topics in debriefing

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 %
If there were less popular topics in debriefings, maybe even taboo topics, which would that be?
  Mistakes, errors, and deviations “If someone had made a mistake, […], I only noticed this once, they pretended it had never happened, they made minimal corrections, and then they pretended it had never happened […].” 32.9
  Hierarchy “[…] Addressing problems related to working conditions and superiors, anything that could challenge hierarchy […]” 20.6
  Personal issues “[…] I find it extremely difficult to talk on a personal level. Addressing personal issues or criticizing someone […]” 19.2
  Sexual harassment “[…] Topics related to sex, harassment and other delicate issues […]” 9.6
  Emotions “Most often it is rather emotional topics that make someone feel offended or when is situation itself is a demanding.” 6.7
  Cultural differences “[…] Teamwork between nurses and physicians is always a hot topic […]” 5.5
  Nothing “The stronger the trust within the team, and in the attending physician, there are no taboo issues that can’t be talked about. In my department, I know of nothing that can’t be talked about […]” 2.7
  Ethical issues “[…] extreme situations, deciding when resuscitation efforts should be stopped or how relatives should be involved […]” 2.7
On a scale from 1 to 10, to what extent do you think people talk about unpopular topics in debriefings; 1 = only talk about popular topics, 10 = only talk about unpopular topics?
  3–4   34.4
  7–8   31.3
  5–6   25
  1–2   9.4
On a scale from 1 to 10, are these unpopular topics typically addressed at the beginning or at the end of debriefings; 1 = at the very beginning, 10 = at the very end?
  7–8   47.6
  5–6   23.8
  1–2   19.1
  3–4   9.5
In your view, who has the best ability to address unpopular issues?
  External person “I would say an external person […], people who are not involved in but still somewhat knows the process. […]. Someone standing on the side lines still knowing what is going on.” 25
  Staff members who are trained and experienced “Someone with appropriate training and experience.” 19.6
  Staff members who are open minded “[…] I guess just being open and giving anyone a voice.” 17.9
  Staff members who are popular and brave “[…] an empathic person […] who is not afraid of repercussions [...] who will not blush and backtrack [...]” 12.5
  Senior / more experienced staff members “There is a clear hierarchy. The people on the highest hierarchical level have better opportunities to address something […]” 10.7
  Involved team members “Well, I think it would be best if someone within the team would run it. In my opinion, it is easier that self-awareness arise within the conversation instead of discussing it from my point of view as a leader.” 5.4
  Physicians “Since conversations are mostly or frequently conducted by physicians, they have the greatest chance to address issues, treat them transparently and motivate the nurses.” 5.4
  Psychologists “[…] Probably psychologists, they are open for debriefings and have therefore the best requirements […]” 3.6
In your view, who has the least ability to address unpopular issues?
  Staff members without debriefings experience “Someone without appropriate training.” 27.6
  Staff members who are unpopular “The bullying head of department.” 20.7
  Staff members who cannot listen “People who cannot listen.” 13.8
  Junior staff members “[… ] lower hierarchy level would have fewer chances.” 13.8
  Physicians “Physicians because they do not wish to speak about mistakes, especially older physicians.” 6.9
  Involved team members “[… ] those who are the most affected [… ].” 6.9
  Nurses “[… ] the least requirements have nurses.” 6.9
  People taking care of patient positioning “If people taking care of patient positioning would address unpopular issues, everyone would be like ‘oh no, we do not have to listen to them’.” 3.5