Michael Sterling, BS (Aerospace Engineering)
Technical Area Lead, Astronaut Office, Flight Director Office, Flight Operations Safety Office
Johnson Space Center, National Aeronautics and Space Administration
State the overall Goal or Outcome : The overall goal of this workshop is to heighten awareness in attendees of the major differences between healthcare debriefings and debriefings conducted in other high-risk industries. These differences include but are not limited to:
• asking “How did that feel?" vs "What happened?” at the start of each debriefing
• the belief that those being debriefed must be allowed to “decompress” before they can begin debriefing vs immediately discussing the simulated events
• the need for a trained debriefer to lead every debriefing vs the group debriefing themselves.
This workshop will begin with a discussion by panel members of their personal experiences in using debriefing in their professions (aviation, military, aerospace, risk management and healthcare). This will be followed by the presentation of a series of simulated vignettes that could occur in any high-consequence industry and solicitation from the audience of their approaches to debriefing such events. For example, a situation involving a serious failure to complete an important task during a simulated event is presented. Members of the audience will be asked to describe their approach to debriefing such a situation, including but not limited to:
• how they would initiate the debriefing
• the methods they would use to facilitate discussion
• the relative degree to which they would solicit self-assessment by the debriefees
• examples of specific questions that they would pose during the debriefing.
Panel members will then compare these responses with the strategies that they use in debriefing similar events in their industry and explain the rationale and review the evidence underlying their strategies.
Much of the healthcare literature has been devoted to the theoretical underpinnings of debriefing and describe a very similar approach consisting of three phases:
• an individual trained in debriefing who is not a member of the team leads the discussion
• the discussion typically includes reaction, description, analysis and summary phases
• patient outcome is not routinely emphasized (and may actually be avoided if felt to potentially produce negative reactions in team members).
Evidence published to date indicates that significant emotional responses are quite rare, raising serious questions about focusing on the emotional responses of those being debriefed. This generic model of debriefing in healthcare stands in contrast to how debriefing is conducted in other industries where the risk to human life is also high.
This heavy emphasis on debriefing the emotional responses of trainees to some extent results from confusion between technical performance debriefing (the type of debriefing that is typically conducted in other high-risk industries) and critical incident stress debriefing. The differences between a technical performance debriefing (used to assess human and system performance) and a critical incident stress debriefing (conducted to provide emotional/psychological support) will be explained during the course of the workshop.
This workshop will introduce methods of debriefing that are utilized in high-consequence industries such as aerospace and the military. These methods differ from approaches used in healthcare healthcare in 1) not necessarily requiring the presence of a highly trained individual to lead the debriefing and 2) focusing on learning rather than learner emotion, unless it affects performance.
Intended Audience : This workshop is appropriate for any level of healthcare professional who will be conducting technical performance debriefings or training others to do so.
Relevance to the Conference : This workshop will appeal to any conference attendee who is interested in 1) learning how debriefings in non-healthcare, high-consequence industries are conducted and 2) how the strategies used in those industries can be effectively applied in healthcare.