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Effective Debriefing Strategies in Training

Apr 23, 2025

Debriefing with Good Judgment: Combining Rigorous Feedback with Genuine Inquiry

Authors and Affiliations

  • Jenny W. Rudolph, PhD
    • Department of Health Policy and Management, Boston University School of Public Health
  • Robert Simon, EdD
    • Harvard Medical School, Massachusetts General Hospital
  • Peter Rivard, PhD
    • Center for Organization, Leadership and Management Research, VA Boston Healthcare System
  • Ronald L. Dufresne, PhD
    • Department of Management, Haub School of Business, St. Joseph's University
  • Daniel B. Raemer, PhD
    • Center for Medical Simulation, Harvard Medical School

Key Concepts

  • Experiential Learning and Reflection

    • Reflection is critical for integrating experiences into future actions.
    • Debriefing in medical simulation is a structured way to reflect.
  • Goals of Debriefing

    • Allow trainees to explain, analyze, and synthesize information to improve future performance.
    • Process usually involves analyzing situations and forming generalizations.
  • Challenges in Debriefing

    • Creating an environment that is both challenging and safe for reflection.
    • Instructors often avoid critical judgments due to fear of confrontation.

Model of Debriefing

  • Adapted from research on improving professional effectiveness.
  • Three Components
    1. Conceptual Framework: Guides instructors to reveal mental models guiding actions.
    2. Debriefing Stance: Combines curiosity and respect with clear judgments.
    3. Communication Style: Uses advocacy and inquiry to explore trainee perspectives.

Reflective Practice

  • Scrutinizing professional practices collaboratively.
  • Helps develop crisis management and reflective skills.
  • Draws on cognitive science, social psychology, and anthropology.

Understanding Frames

  • Mental models (frames) shape actions.
  • Different frames lead to different actions and results.
  • Debriefing helps trainees analyze and revise their frames for future actions.

Debriefing Approaches

Judgmental

  • Instructor-centric truth.
  • Often leads to defensiveness and embarrassment.

Nonjudgmental

  • Avoids criticism to maintain psychological safety.
  • Can obscure important feedback.

Good Judgment

  • Combines clear insights with inquiry.
  • Encourages a mutual learning environment.

Advocacy-Inquiry Technique

  • Pairs observations with questions.
  • Encourages trainees to reflect on their frames and assumptions.
  • Promotes open discussion and deeper learning.

Application Examples

  • Dialogues demonstrating the good judgment approach.
  • Focus on understanding and revising frames, not just correcting actions.

Summary

  • The good judgment approach enhances learning by making critical insights explicit while maintaining psychological safety.
  • It aligns educational objectives with insights into trainees' frames and assumptions.
  • Effective when trainees are cooperative and open to learning.

Acknowledgments

  • Supported by various foundations and institutions for developing these ideas.

References

  • Includes literature on reflective practice, and studies on debriefing and professional development.