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A discussion with Drs. McNamara and Leifer on the essentials and beyond of debriefing



Hosts:

Brian Gilberti, MD

Audrey Tse, MD





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Tags: Resuscitation ([ Ссылка ]) , Simulation ([ Ссылка ])







Show Notes



TAKE HOME POINTS




• Debriefing after a clinical case in the ED is a way to have an interprofessional, reflective conversation with a focus on improving for the next patient.  We can debrief routine cases, challenging cases, or even cases that go well.


• Follow a structure when leading a debrief.



• The prebrief sets ground rules and informs the team that the debrief is optional and will only take 3-5 minutes.


• Introduce names and roles


• Then give a one-liner about what happened in the case, followed by a plus/ delta: address  what went well and why, then how to improve


• Finally, wrap up with take home points





• Pitfalls to watch out for in clinical debriefing include:



• Avoid siloing or alienating any learners.  Learn from all your colleagues on your team- it’s less about medicine and more about interprofessional and systems issues


• Don’t pick on individual performance.  It’s not about shaming- it’s about improving patient care


• Avoid “guess what I’m thinking” questions; ask real questions


• Proceed with caution in order to dampen or avoid psychological trauma and second victim syndrome.  The learner may ask “was this my fault?”; we never want a learner to feel this way.  Ask, what systems supported or did not support you today?  Talk about what happened.  Avoid shame and blame.





• Have the right values and do it for the right reasons.




ADDITIONAL TOOLS






PEARLS Debriefing Tool ([ Ссылка ])



INFO Model:













GUESTS



Dr. Shannon McNamara ([ Ссылка ]) completed residency in Emergency Medicine at Temple University hospital and fellowship in Medical Simulation at Mount Sinai St. Lukes-Roosevelt. She now is the Director of the Simulation Division in the NYU Department of Emergency Medicine. She’s thrilled to have somehow made a career out of teaching people to talk about their feelings using big computers shaped like people.



Dr. Jessica Leifer ([ Ссылка ]) attended NYU for medical school and completed her residency training in emergency medicine at Mount Sinai St. Luke’s-Roosevelt. She completed a fellowship in medical simulation at the Mount Sinai Hospital. She is now simulation faculty in the NYU department of Emergency Medicine. Her academic interests include using simulation for patient safety, operations, and improving teamwork.






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