Debriefing using the
Advocacy-Inquiry method Phase
Purpose
Process
Example Script
Prebrief
• Prepare students for simulation • Set the tone
• Provide info on format • Provide observation guide • Review preceptor report
• “today, you will invite the SP into the conference room at 6:00. You will have 15 minutes to complete …”
Debrief: React
• Use Delta-Plus process with 2 questions • Encourage to examine what worked and areas for participation/build improvement rapport • Allow learners to clear the air and save face
Debrief: Understand • Uncover the ideas, thought processes and other factors that lead to a behaviour (student ‘frames’*) • Help the learner find ways to improve performance
Wrap-Up
• Invite reflection on the experience as a whole – solidify learning
• “What went well?” • “What would you do differently?”
Advocacy-Inquiry 1. Observe an event or result
1. You notice that the patient seemed to disengage when the team started listing their recommendations
2. Comment on the Observation Advocate for your position
2. “I noticed that Mr. Moorhouse crossed his arms and didn’t respond to a lot of the recommendations you suggested. To me, he seemed disengaged”
3. Explore the Drivers behind students’ thinking (their ‘frames’*) and actions that they think lead to the observed event or result
3. “What do you think was happening for him?” “Do you think he disengaged?” “What was happening that contributed to this result?”
4. Discover, with the students, ways to attend to issues that arose and ways to replicate positive results
4. “I agree that it’s important to be clear about what the team recommends. I wonder how your team could approach recommendations to engage Mr. Moorhouse and to ensure clarity?”
• Inquire about how students feel about the simulation as a whole and what learning they will take away
• “How are you feeling about the scenario now?” • “What’s the biggest thing that you’ll take away from the simulation?”
*Frames are in the mind of the student and facilitator. They include: assumptions, feelings, goals, knowledge base, situational awareness, and context.
Frames
Actions
Results
Figure 1. Frames, Actions, and Results
Adapted from: Lisa Guirguis and Cheryl Cox. University of Alberta PharmSim Program. Framework adapted from: Rudolph J.W., Simon R., Rivard, p., Dufresne R.L., Raemer D.B. 2007. Debriefing with good judgement: Combining rigorous feedback with genuine inquiry. Anesthesiology Clinics, 25, 361-376. doi: 10.1016/j.anclin.2007.03.007
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