Debriefing Challenges (Cheng et. al, 2015; Rudolf et. al, 2006)

• Lack of knowledge of learning objectives: Difficulties may arise when the facilitator is not on the same page about the learning objectives and their degree of importance for a given simulation event.
• The facilitator has a personal agenda: Facilitators with personal agenda may lead the discussion toward their particular area of interest that may not be aligned with the predefined objectives of the session.
• Facilitators are not familiar with learner level: and/or do not appreciate the understanding, skill set and potential contributions of their target students (i.e., low or high expectations). Consequently, facilitators who are unaware of learner’s level of understanding may subsequently miss opportunities to scaffold learning for the benefit of the learners.
• Facilitator dominates discussion: This often results in a predominantly didactic session with minimal reflective learning and discussion from the learners.
• “Shame and Blame approach”: the judgmental approach to debriefing: Imagine or recall the instructor whose voice, dripping with disdain, inquires of a group of students, “Can anyone tell me what went wrong here?” or “Can anyone tell me Pat’s big mistake?” The judgmental approach, whether laced with harsh criticism or more gently applied, places truth solely in the possession of the instructor, error in the hands of the learner, and presumes that there is an essential failure in the thinking or actions of the learner. A judgmental approach to debriefing, especially one that includes harsh criticism, can have serious costs: humiliation, dampened motivation, reluctance to raise questions about later areas of confusion, or exit of talented learners from the specialty or clinical practice altogether.
• Nonverbal Communication Participant: A facilitator often loses sight of the nonverbal gestures of participants and observing the body language and facial expressions of all learners during the debriefing. Experienced facilitators use deliberate eye contact and nonverbal gestures to facilitate coordinated discussion and smooth transitions.  By observing the body language of learners, facilitators can better predict the anticipated line of questioning in the debriefing and more effectively identify when and how to contribute to the conversation and guide the reflection and learning.
• Facilitator – Sharing critical judgments: Instructors often avoid giving voice to critical thoughts and feelings because they do not want to appear confrontational, and they worry that criticism might lead to hurt feelings or defensiveness on the part of the learner. Voicing critical judgment poses a dilemma for many facilitators: how to create an environment in which learners feel simultaneously challenged and psychologically safe.