Intended for healthcare professionals

  1. Education
  2. Team debriefings in...
  3. Team debriefings in healthcare: aligning intention and impact
Practice Practice Pointer

Team debriefings in healthcare: aligning intention and impact

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2042 (Published 13 September 2021) Cite this as: BMJ 2021;374:n2042
  1. Michaela Kolbe, director, Simulation Centre1 2,
  2. Sven Schmutz, director of cardio psychology,
  3. Julia Carolin Seelandt, head of training and faculty development1,
  4. Walter J Eppich, chair4,
  5. Jan B Schmutz, senior researcher and lecturer2
  1. 1University Hospital Zurich, Simulation Centre, Switzerland
  2. 2ETH Zurich, Switzerland
  3. 3University Hospital Bern, Inselspital, Switzerland
  4. 4RCSI University of Medicine and Health Sciences, RCSI SIM Centre for Simulation Education and Research, Ireland
  1. Correspondence to M Kolbe Michaela.Kolbe{at}usz.ch

What you need to know

  • Learning-oriented debriefings support patient care by helping teams learn and improve

  • Team debriefing with the aim of preventing post-traumatic stress disorder (PTSD) is not recommended. Do not conflate debriefing intentions to promote learning with intentions to treat acute stress disorder (ASD), PTSD, or anxiety and depressive symptoms

  • Support team members with potential symptoms of ASD, PTSD, anxiety, or depressive disorder to access specific therapeutic interventions guided by trained professionals

  • If leading a team debriefing, carefully reflect beforehand on debriefing intentions and pay close attention to signs of participant distress. If participants show signs of distress during a team debriefing switch intention from learning to managing by listening, acknowledging, and normalising reactions without pressing for details

The covid-19 pandemic has renewed focus on debriefings to improve performance among healthcare providers: debriefings help teams learn quickly and manage patients more safely.1234 However, in some circumstances, debriefings may harm more than help. In this article we introduce debriefing and its benefits, highlight the potential consequences when debriefing intentions blur, and offer guidance to navigate shifting debriefing objectives, for example during instances of clinicians’ distress related to patient care.

What are team debriefings?

Team debriefings (also known as after action reviews) are guided meetings during which members discuss, interpret, and learn from recent events.56 Debriefings will typically include both retrospective (eg, collaborative sense making in information-rich and ambiguous environments) and prospective reflection (eg, sustaining positive performance, planning treatments, anticipating problems).57 They foster reflection on clinical practice for the individual and the team. Various debriefing tools and structures are in use, such as TALK (Target, Analysis, Learning, Key Actions),8 PEARLS (Promoting Excellence and Reflective Learning in Simulation),9 and REFLECT (Review the event, Encourage team participation, Focused feedback, Listen to each other, Emphasise key points, Communicate clearly, Transform the future). …

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