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Table 2 Examples—language to manage perception mismatches in debriefing

From: Embracing informed learner self-assessment during debriefing: the art of plus-delta

Plus-delta question Preview statement Focused facilitation
Single-barreled questions Advocacy inquiry [34, 40]
“What were some aspects of your performance that you did well?” “So, one of the things that I’m hearing is that you guys think that the communication in that scenario went very well. I can understand that, but I’ve also got a slightly different perspective that I would like to share with you.” “I noticed that there was a lot of communication amongst the team during that scenario, but it seemed to me that several of the key tasks didn’t get completed because they were not specifically given to one team member … I’m concerned that this led to a delay in those key tasks. How did you see it?”
“What would you do differently next time?” “I’m hearing that you thought that there was too much confusion about what type of shock that you were dealing with in this scenario, and that delayed your ultimate management. I can see your point of view but want to share a slightly different perspective.” “I saw there was some confusion as to what type of shock you were dealing with as you tried to work it out amongst the team. During this time the patient still got an initial bolus of intravenous fluids, which worries me as that might have been potentially harmful for a patient in cardiogenic shock. Can you share with me your thoughts as you were working through this problem?”
Double-barreled questions Circular questions [41]
“What was easy, and what was challenging for you? “I’m hearing different perceptions of what was easy and what was challenging. I think this is both normal and important for collaborating as team members.
Let’s take a moment and explore these differences further.”
“How do you explain these differences in your perception of challenges?”
“In your view, how important is it to agree on these challenges?”
“If you were saying ‘OK, I’ll take the lead and I need your help with this’, what do you imagine the other team members would do?”
“From your point of view, what did you do well, and what would you do differently next time?” “I’m hearing different perception of what went well and what could be done differently. It is very common to see things from one’s own perspective. Highlighting differences is important and why we debrief. Let’s take a moment and explore these differences further.” “How do you explain these differences in your perception of what went well and what could be improved?”
“On which aspects do you agree? What is different in these aspects? On which aspects do you not agree? What’s different here?”