Table 6 Description of papers included in literature review
From: Debriefing strategies for interprofessional simulation—a qualitative study
Main Author, Date | Aim(s)/Questions | Design | Terminology | Methods | Quantitative or qualitative | Summary of findings relating to debriefing |
|---|---|---|---|---|---|---|
Boet, 2013 [20] | Is ‘within team’ debriefing equal to ‘instructor led’ debriefing? | Randomised controlled repeated measures design | Interprofessional | Teams randomised to ‘within team’ or instructor led debriefing. Videos of pre and post debrief scenarios assessed by 3 blinded assessors and a score created via a framework. Pre- and post-test scores compared. | Both (mostly quantitative data) | Both ‘within team’ debriefing and instructor led debriefing are effective at improving team performance. |
Boet, 2014 [19] | 12 tips with information on developing, implementing, assessing, and evaluating an interprofessional simulation-based education session. | Narrative | Interprofessional | Description—12 tips for interprofessional simulation. One of 12 tips is a paragraph on debriefing. | Qualitative | Interprofessional debriefs are challenging. Need to ensure all learners are involved as well as psychologically safe. There is no gold standard for method of debrief—some use single debriefers, others have debriefers from all specialties. |
Boet, 2016 [21] | A narrative analysis on content of discussion during both ‘within team’ and ‘instructor led’ debriefing. | Exploratory case study | Interprofessional | Analysis of audio recordings of debriefs from debriefs—both ‘within team’ or ‘instructor led’. Data from a larger randomised controlled trial (Boet 2013 above). | Qualitative | There was no significant difference in the achievement of the learning outcomes in either group suggesting that ‘within team’ debriefing is a viable option. |
Brown, 2018 [22] | To determine the best practices in interprofessional debriefing by comparing in person with tele-debriefing and single vs interprofessional debriefers | 2 group quasi-experimental cohort comparative | Interprofessional | Questionnaires from all students after debriefing—average scores on 6 items on Likert scale found (> 4 is acceptable) | Quantitative | No significant difference between single and interprofessional debriefing (although single did have a higher score). Significantly higher score in in person debriefs compared with teledebrief. |
Cheng, 2013 [26] | To determine whether use of a script designed to facilitate debriefings by novice instructors and/or simulator physical realism affects knowledge and team performance of learners in simulated cardiopulmonary arrests. | Experimental randomised controlled trial | Interprofessional | Randomised controlled trial—each team randomised to 1 of 4 groups (with or without scripted debrief and with high or low realism). Post scenario MCQs as well as Team Leader Behaviour Performance (BAT) and Team Clinical performance (CPT) | Quantitative | Scripted debriefs caused an improvement in knowledge (MCQ) and BAT scores but no significant difference in CPT scores compared to non-scripted debriefs. |
Endacott, 2019 [27] | The main aims of this study were to identify: (1) frameworks used for debriefing interprofessional and uni-professional team-based simulations, (2) metrics that have been developed to assess the quality of debriefing and (3) evidence gaps for debrief decision | Systematic review | Interprofessional | Lit search PubMed, CINAHL, MEDLINE and Embase ‘Simulation’ AND (‘Debrief* OR Feedback’) AND ‘Evaluation’ AND (‘Quality OR Framework OR Method’) | Quantitative and qualitative | All used different debrief frameworks. Debrief framework improves debrief quality. ‘Some key aspects of debrief for team-based simulation, such as facilitator training, the inclusion of a reaction phase and the impact of learner characteristics on debrief outcomes, have no or limited evidence and provide opportunities for future research, particularly with interprofessional groups.’ |
Hull, 2017 [23] | ‘We explored the value of 360° evaluation of interdisciplinary debriefing by examining learners’, debriefers’ and expert evaluators’ perceptions of the quality of debriefing.’ | Exploratory, cross-sectional observational study | Interdisciplinary | Comparison of OSAD scores of learners, debriefers and expert debriefers of debriefs. | Quantitative | Debriefers themselves and learners tend to score the quality of debrief higher than the expert debriefers suggesting some overconfidence on the part of the debriefers which may mean that they don’t seek training opportunities. External evaluation of debriefs should be regularly completed to drive educational excellence. |
Kolbe, 2013 [31] | To find out if TeamGAINS is an effective debrief tool | Survey (to validate debrief tool) | No term—‘team’ used instead | A ‘self-assessment’ of the debrief was completed by the learners. Specifically, psychological safety and ‘leader inclusiveness’ were scored by the learners. | Quantitative | Debriefing using the TeamGAINS method was effective based on learner assessment including increasing psychological safety and leadership inclusiveness among learners. |
Meny, 2019 [33] | This study explored the difference in post-simulation reflections of multiple small groups compared to a single large group after an interprofessional simulation. | Cohort study | Interprofessional | Comparison of experiences for those in large group debrief (60 participants and those in small group debriefs (4-6)). | Quantitative and qualitative | There was no difference in the ability to identify an area for improvement or continued growth between those students participating in the large group debrief compared to the small group debrief section. |
Nystrom, 2016 [28] | To explore debriefing as a practice intended to support students’ interprofessional learning | Observational | Interprofessional | Collaborative analysis of video-recorded debriefs | ‘Two main methods of debriefing emerged ‘algorithm based’ and ‘laissez-faire’ neither ensured the main topic of interprofessional collaboration came up. Sociomaterial aspects such as time constraints, material set-up and social interaction affect as much as opportunity for reflection.’ | |
Paige, 2019 [25] | Investigating whether differences exist for prebriefs (PBs) and debriefs (DBs) among faculty teams after a high-fidelity simulation-based training for interprofessional education of pre-licensure students and analysing potential causes for any differences in the quality of PBs and DBs. | Retrospective analysis of prospective collected videos of debriefs. | Interprofessional | Use of OSAD scoring to assess debrief videos after simulation—comparison of score changes over multiple debriefs/prebriefs. | Quantitative | ‘In conclusion, effective debriefing is essential for learning in HF SBT. To date, the quality of such debriefing in actual teaching practice is not well known. The scores of all 7 teams were good. Faculty teams tended to improve the quality of their DBs through time.’ |
Park, 2016 [35] | Discussion of ‘debrief from the learner’s point of view’ | Narrative column | Interprofessional | N/A | Qualitative | Using questions in the debriefing relating to team aspects and behaviour rather than individual clinical behaviour of specific team members can help focus the debrief on interprofessional interactions. |
Poore, 2019 [9] | To present an interprofessional debriefing tool, the Debriefing Interprofessionally: Recognition and Reflection (DIPRR), designed to incorporate IPE into any simulation experience. | Survey (to validate debrief tool) | Interprofessional | Survey to obtain content validity index on each question in the debrief tool. | Quantitative | ‘The ‘Debriefing Interprofessionally: Recognition and Reflection’ tool allows uni- and interprofessional simulation to be transformed into an IP learning opportunity.’ |
Richmond, 2017 [34] | This resource is an interactive, interprofessional, small-group activity designed for up to six participants per standardised patient. | Narrative | Interprofessional | Survey to participants—quantitative questions on a Likert scale and qualitative open answer questions. | Quantitative and qualitative | ‘The experience has been successful at meeting interprofessional curricular goals. Students valued the interprofessional interaction and especially the debrief discussion about their experience.’ |
Van Schaik, 2015 [36] | To explore the residents’ perceptions of simulation-based interprofessional team training. | Qualitative analysis | Interprofessional | Analysis of interviews to examine paediatric residents’ self-assessment of team leadership skills during simulated resuscitations. | Qualitative | ‘Interprofessional simulation-based team training offers an opportunity for residents to learn about, from and with other health care professionals but barriers exist that hamper its effectiveness—anxiety provoking as with colleagues that they work with normally, hesitant about providing honest feedback because of fear of offending.’ |
Schere, 2019 [30] | Description of implementing multidisciplinary team simulation from an interventional radiology point of view. | Narrative | Multidisciplinary | No method—just description of tool and why it is used. | Qualitative | ‘In conclusion, multidisciplinary team simulation training is an extremely useful tool and future research will continue to demonstrate its importance in communication, technical skills, and therefore patient care.’ |
Stockert, 2017 [24] | ‘To determine the prevalence of interprofessional simulation as an educational strategy for teaching IPE content, to identify the curricular objectives associated with interprofessional simulation experiences, and to characterize the instructional design features of interprofessional simulation experiences in entry-level PT education programs in the USA’ | Cross-sectional descriptive study | Interprofessional | A survey was sent out to each centre that has a PT programme. Responses were analysed and provided mostly quantitative data. | Quantitative | ‘In PT education programs that use immersive simulation for IPE, most programs conduct simulation experiences consistent with recognized best practice. In addition, nearly all programs that used immersive simulation for IPE included learning objectives related to the four IPEC competencies for promoting interprofessional collaborative practice.’ |
Sullivan, 2018 [29] | ‘On which non-technical skills do teams perform the strongest (e.g., decision- making, communication, leadership, cooperation or stress management) during a trauma resuscitation simulation? Are improvements in non-technical skills observed immediately following a debriefing session? Does the debriefing appear to improve some skills more than others?’ | Observational | Interprofessional | Scoring of team performance of non-technical skills via T NOTECHS score. Analysis of debrief strategies from video footage of debrief. | Quantitative and qualitative | ‘Interprofessional team simulation in trauma resuscitation scenarios followed by debriefing differently impacted individual non-technical skills domains. The debriefings were primarily focused on directive performance feedback. Additional facilitation strategies may target other non-technical skills in different ways. |
Thompson, 2018 [42] | Does the introduction of a written tool to help facilitate high-quality debriefing techniques improve the ratio of judgmental, non-judgmental, and good judgment statements from facilitators. | Quasi-experimental observational study | Interprofessional and interdisciplinary | Observation of videos of simulation debriefs before and after introduction of debrief tool | Quantitative | Debrief written tool increases number of ‘good judgement’ comments as part of debrief with a significant decrease in non-judgemental comments. |
Yang, 2019 [32] | Introduction of describe, analysis, application (DAA) based integrated interprofessional collaboration and team efficiency (IIT) simulation model. | Narrative | Interprofessional and multiprofessional | No method—just description of tool and why it is used. | Taken together, in an attempt to ensure high-quality care delivery, the integrated IPC and team-efficiency intervention is a feasible and successful strategy for training multiprofessional trainees. |