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Table 4 Beliefs about facilitating 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 theme Representative quote %
If you could change the way debriefings are typically led, what would you do?
  Define who facilitates “I would have the person with the lowest rank run it, because it would turn the hierarchy upside down, symbolically and in the debriefing, and there would be more input as if an attending were running it.” 65.4
  Institutionalize debriefing “[… ] that it will be implemented from above […]” 26.9
  Apply a structure “[…] if at the end there would be another round for questions or further issues [...]” 7.7
From the perspective of the debriefing participants, what do you think a person who is running the debriefing should do to do a good job?
  Apply a structure “[… ] the important structure in this is to give participants room to say what they wish to say, not to intimidate them, and the others should not think that that’s not important.” 28
  Be curious “[… ] must not already have a solution for the problem […]” 16
  Be neutral “He/she must be neutral […]” 13.3
  Set the stage and preview “What I realize again and again is that participants need to know what to expect, a good preview, how it is run, expectations, structure, […]” 13.3
  Give space by asking questions and listening “First of all they need to listen well, make notes. […]” 10.7
  Be respectful “They need to respectfully deal with what the participants say; distribute their attention evenly [… ]” 8
  Be competent and have a standing “To do their job they need to have a certain standing, you cannot give in and be afraid. […]” 6.7
  Share point of view “[…] , I found it really bad why she beats around the bush. I had the feeling that I did not learn enough although she had noticed something […]” 4
From the perspective of the participants of a debriefing, what do you think the person who is running the debriefing should not do at all?
  Judge or take sides “What he or she must not do is take sides or judge […]” 31.5
  Be rude or humiliate learners “[…] nothing condescending […]” 18.5
  Assume to hold the truth “That person must not engage in monologues like ‘that is the debriefing and I will tell you what happened’ […]” 18.5
  Blame or abuse power “[…] no condemning or finger pointing, […]” 18.5
  Scare and get scared “The person must not be daunting, triggering reactance.” 9.3
  Laissez-faire “[…] Then it’s like a slugfest and conflict; the debriefer needs to intervene and must not let it happen. The debriefer should deescalate [...], while at the same time monitor topics that are important to him/her.[…]” 3.7
In your view, what are the three biggest barriers for the person who is running the debriefing?
  Lack of debriefing skills “[…], that you don’t know exactly what and how […]” 26
  Fear that participants might not wish to be debriefed “If somebody disapproves of debriefing, this can be a barrier; to motivate him or her might be a big barrier.” 19.2
  Being emotionally involved or not neutral “Neutrality, if somebody from anaesthesia runs a professional discussion it will be tricky to address the surgeon’s mistake.” 17.8
  Logistics “[…] the temporal aspect, when and how long will it take place and will everybody be there […]” 11
  Fear of having to be honest / exposing oneself “[…] Maybe the skill to criticize somebody […], and that you have to talk to somebody and criticize him/her” 8.2
  Fear to speak up / address certain topics “[…] The topics that you talk about, they quickly get you helpless. You are safe with the medical stuff, but with everything else it gets difficult.” 6.7
  Hierarchy “[…] That you see things too much from your own hierarchical perspective.” 4.1
  Repercussions “You don’t necessarily make yourself popular with addressing certain topics. It can put a strain on the team climate if topics such as misconduct by people get addressed [...] You can be proclaimed as someone who is just robbing you of your time which you don’t have at all after an ten hour shift […]” 4.1
  Unreasonable participants “[...] a lack of understanding from the participants – about what you are talking about or with respect to the error that had happened. […]” 2.7
On a scale from 1 to 10, how confident do you feel in running a debriefing in clinical practice; 1 = very unconfident, 10 = very confident?
  5–6   37.5
  7–8   31.3
  3–4   18.8
  1–2   6.3
  9–10   6.3
What do you need to feel even more confident?
  (Reflective) practice “Clearly the analysis of it […]” 61.1
  Training “Good training which is comprehensible, simple, easy to remember and feasible, […]” 13.9
  Support (e.g., preparation, tools) “[…] an aid, a checklist or guide […]” 13.9
  Observing others debrief “[...] It helps me to read about it and watch other debriefings.” 11.1