Debriefing with Good Judgment: Combining Rigorous Feedback with Genuine Inquiry

Department of Health Policy and Management, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118-2526, USA.
Anesthesiology Clinics 07/2007; 25(2):361-76. DOI: 10.1016/j.anclin.2007.03.007
Source: PubMed


Drawing on theory and empirical findings from a 35-year research program in the behavioral sciences on how to improve professional effectiveness through reflective practice, we develop a model of "debriefing with good judgment." The model specifies a rigorous reflection process that helps trainees surface and resolve pressing clinical and behavioral dilemmas raised by the simulation. Based on the authors' own experience using this approach in approximately 2000 debriefings, it was found that the "debriefing with good judgment" approach often sparks self-reflection and behavior change in trainees.

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    • "Active self-learning means that the participants engage in concrete experience and self-discovery and do not just passively receive feedback from a coach. This can be achieved by actively seeking the team members' points of view with respect to a concrete action (Rudolph et al., 2007). A debriefing should focus on learning and development , not on punishing, and should rather be based on reflection on specific events and performance episodes than on general performance or competencies . "

    Full-text · Chapter · Jan 2016
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    • "Teams participated in briefing and debriefing sessions with trained facilitators using Debriefing with Good Judgment model. [13] [14] The briefing sessions focused on identifying team roles and dividing up tasks for the SP session, while the debriefing sessions included the processing of emotions related to their SP experience and team performance. The questions used by the facilitators related to the four TeamSTEPPs concepts. "

    Preview · Article · Nov 2015
    • "One reason for the disagreement about selfmodeling effectiveness among studies is that the learner may not have had a well-formed conception of the goal performance when viewing their own performance. In fact, several studies have reported that learners inaccurately assess their own skill level relative to independent raters and are surprised when they observe their own videotaped behavior (Boet, Bould, Bruppacher , Chandra, & Naik, 2010; Paul, 2010; Rudolph, Simon, Rivard, Dufresne, & Raemer, 2007). An expert model could serve as the source of information for this goal performance. "
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    ABSTRACT: It is unclear whether traditional lecture followed by simulation leads to the best learning and knowledge and skill retention over time. A 3×4 mixed design study used three modes of education-traditional lecture with self-guided learning, expert modeling/dual viewing with brief questioning, and expert plus self-modeling-at four time points to compare knowledge, time to treat, and correct steps over time. No significant differences were found in knowledge or time to treat between training methods. An expert modeling/ dual viewing group with brief questioning performed more steps correctly (p = 0.05) than did the other two groups. Expert modeling may help students remember and perform a complex series of tasks in a scenario. Further research is needed to explore expert modeling for novice learners. [J Nurs Educ. 2015;54(4):185-191.]. Copyright 2015, SLACK Incorporated.
    No preview · Article · Apr 2015
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Questions & Answers about this publication

  • Jennifer Obbard added an answer in Nursing:
    What is the best methodology for debriefing in clinical simulations?

    What is the best methodology for debriefing in clinical simulations?
    Use some background?

    Jennifer Obbard

    I haven't read through the other responses just due to my own time constraints.  I have found that having a structure helps and there are many examples of this.  However, I find what is most important in effective debriefing is the approach that the Harvard Center for Medical Simulation takes of Debriefing with Good Judgment via an Advocacy & Inquiry approach, as well as, holding a basic assumption of good will (learners are intelligent, want to learning and do their best).  It has a lot to do with the self-awareness and transparency of the facilitator.  I also find that creating a 'learning conversation' is also key and includes the need to consider 'what comes up for the facilitator as well as the students in terms of identity, feelings and what happened.  See Stone, D., Patton, B. & Heen, S. (2000). Difficult Conversations:  How to talk about what matters most. London:  Penguin Books Ltd.  These are great places to start.  There are other methodological considerations that I haven't included here.  All the best, Jennifer