Characteristics of Real-Time, Non-Critical Incident Debriefing Practices in the Emergency Department
Abstract
Introduction
Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing, however, data on its practice is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose. Anecdotal evidence suggests that real-time debriefings (or non-critical incident debriefings) do in fact occur in emergency departments, however, limited research has been performed on this subject. The objective of this study is to characterize real-time, non-critical incident debriefing practices in Emergency Medicine (EM).
Methods
This was a multicenter cross sectional study of EM attendings and residents conducted at 4 large, high volume, academic EM residency programs in New York City. Questionnaire design was based on a Delphi panel and pilot testing with expert panel. A convenience sample was obtained from a potential pool of approximately 300 physicians across the 4 sites with the goal of obtaining >100 responses. The survey was sent electronically to the 4 residency list-serves with a total of 6 monthly completion reminder emails. All data was collected electronically and anonymously using surveymonkey.com and was entered and analyzed Microsoft Excel.
Results
The data elucidates various characteristics of current real-time debriefing trends in EM, including its definition, perceived benefits and barriers, as well as the variety of formats of debriefings currently being conducted.
Conclusion
This survey regarding the practice of real-time, non-critical incident debriefings in four major academic emergency programs within New York City sheds light on three major, pertinent points: 1) Real-time, non-critical incident debriefing definitely occurs in clinical emergency practice; 2) In general, real-time debriefing is perceived to be of some value with respect to education, systems and performance improvement; 3) Although being practiced by clinicians, most report no formal training in actual debriefing techniques. Further study is needed to clarify actual benefits of real-time/non-critical incident debriefing as well as details on potential pitfalls of this practice and recommendations for best practices for use.