Debriefing Resuscitation Teams€¦ · Debriefing Resuscitation Teams Walter Eppich, MD, PhD...
Transcript of Debriefing Resuscitation Teams€¦ · Debriefing Resuscitation Teams Walter Eppich, MD, PhD...
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Debriefing Resuscitation Teams
Walter Eppich, MD, PhDAssociate Professor of Pediatrics and Medical Education
Northwestern University Feinberg School of MedicineAnn & Robert H. Lurie Children’s Hospital of Chicago/USA
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@LearnThruTalk
Objectives
After this session, you will be able to:• Identify high-yield targets for debriefing teams• Prioritize what to debrief• Outline blended approaches to debrief teams
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Ground rules
• Check your profession at the door• Everyone has a valuable contribution• Give others the chance to speak• Respect other people’s point of view• Confidentiality
Anything you would add to this list?
Our basic assumptionEveryone here is intelligent, capable, does their best, and wants to improve
Center for Medical Simulation
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• Why debrief?• Video review• How to debrief• What to debrief• Putting it together• Practice
Roadmap
YES!
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Information Reflection
Honesty
Healthcare SimulationDebriefing
Relationships & Learning culture
Process“How to debrief”
Content“What to debrief”
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Process“How to debrief”
Content“What to debrief”
Establishing a supportive learning environment
Process“How to debrief”
Content“What to debrief”
Debriefing Structure and Function:PEARLS Framework
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Eppich & Cheng 2015
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Eppich & Cheng 2015
Synthesis of educational strategies
Process“How to debrief”
Content“What to debrief”
What you say and how you say it:PEARLS Debriefing Script
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The PEARLS Debriefing Tool
https://debrief2learn.org/pearls-debriefing-tool/
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Learner self-assessment
+ Δ
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Focused facilitation:Digging deeper
using Advocacy-Inquiry (AI)
Performance gap
Actual performance
Desired performance
Rudolph et al 2008
Performance gap
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Performance gap
Actual performance
Desired performance
Rudolph et al 2008
Performance gapIntentionally
Rational
Frames of mind
Frames of
mind
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Sharing your point of view helps you dig deeper
Walter Eppich,
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Rudolph et al 2006
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Being honest but non-threatening…
First person perspective• “I saw / heard…didn’t see / hear”• “My impression is…”• “It seemed to me…”• “That made me think….”• “From my point of view…”• “My worry is/was…”• “I am concerned…”• “In my experience...• “Usually what I do”…
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Digging deeper
• “Let’s talk about about…” [topic]
• ”I saw / heard…” [data]
• “I think…” [your point of view about it]
• “What do you think? [inquiry]
After you learn the frame of mind, provide individualized teaching, or
build on it and probe further
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Process“How to debrief”
Content“What to debrief”
Debriefing Content: What to debrief• Performance domain
– Taskwork– Teamwork
• Taskwork and teamwork are interrelated entities– Use objective performance data whenever possible– Explore how teamwork achieves or prevents
attainment of taskwork
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Pre-action team reflexivity
In-action team reflexivity
Post-action team reflexivity
Situation Ad hoc briefing
Structured briefing
Concurrent reflection
Team reflexivity time-out
Ad hoc debriefing
Guided debriefing
Temporal focus &
main goal
– Future-oriented (focused on upcoming care needs); optimize upcoming patient care
– Present-oriented; optimize immediate patient care
– Past-oriented; focus on delivered care
– Future-oriented; optimize future patient care
Target of reflection
– Goals – Taskwork – Teamwork – Resources2
– Goals – Taskwork – Teamwork – Resources
– Outcome(s) – Taskwork – Teamwork – Resources
Main (team) outcome)
– SMM – Optimal preparation
– SMM – Adaptation – Learning
– Implicit or non-formal learning – Formal learning
Schmutz & Eppich, 2017
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BeforePre-action TR
“huddle, briefing”During
In-action TR“recap, summary,
inviting input
AfterPost-action TR
“debriefing”
Goal: create shared mental models, adaptation, learning
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Pre-action team reflexivity
In-action team reflexivity
Post-action team reflexivity
Situation Ad hoc briefing
Structured briefing
Concurrent reflection
Team reflexivity time-out
Ad hoc debriefing
Guided debriefing
Temporal focus &
main goal
– Future-oriented (focused on upcoming care needs); optimize upcoming patient care
– Present-oriented; optimize immediate patient care
– Past-oriented; focus on delivered care
– Future-oriented; optimize future patient care
Target of reflection
– Goals – Taskwork – Teamwork – Resources2
– Goals – Taskwork – Teamwork – Resources
– Outcome(s) – Taskwork – Teamwork – Resources
Main (team) outcome)
– SMM – Optimal preparation
– SMM – Adaptation – Learning
– Implicit or non-formal learning – Formal learning
Schmutz et al. 2018
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BeforePre-action TR
“huddle, briefing”During
In-action TR“recap, summary,
inviting input
AfterPost-action TR
“debriefing”
Key finding: In-action TR improves performance especially in larger teams
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Process“How to debrief”
Content“What to debrief”
Putting it all together
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Wrap up and take-aways
Walter Eppich, MD,