Debriefing Frameworks
The Healthcare Simulation Standards of Best Practice™ (INACSL, 2021) state that the structure and format of any simulation needs to be informed by its purpose or objectives and supported with theory or a conceptual framework. Simulations should have a defined beginning point followed by a structured learning opportunity. They should also include engaging learning activities and end with realization and demonstration of learning outcomes. There are many different models or frameworks available to guide the debriefing process and educators will choose a model based on factors such as their teaching philosophy, time, and learner profile. The overriding principle is that a framework should be used to guide debriefing. All conceptual frameworks call for the use of a systematic approach and provide a structured, evidence-based approach to the debrief. Some examples of debriefing models, and the structure or process they employ, are summarized in Table 5.1.
Expert’s Corner: Theoretical Frameworks
Click here to download an accessible PDF version of Table 5.1.
Table 5.1: Debriefing Model Examples (Based on Pivec, 2011; Dreifuerst, 2012; Gardner, 2013; Lusk, 2013)
| Debriefing Model/Author | Structure |
|---|---|
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Plus-Delta |
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Lederman (1992) |
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GREAT |
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Fanning & Gaba (2007) |
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5-E Debriefing Model |
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3D Model of Debriefing |
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SHARP |
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Promoting Excellence and Reflective Learning in Simulation (PEARLS) |
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Trauma-informed Psychologically Safe (TiPS) debriefing framework |
NOTE: this debriefing framework attends to the emotional aspects of simulation-based experiences; particularly those that knowingly elicit emotional stress. For more information about this framework, click here to watch this video. |
Expert’s Corner: 3D-Model
One example of a commonly used debriefing model is the 3D-Model. This four-phase model includes: A) Defusing; B) Discovering; C) Deepening, and D) the Environment by Zigmont et al., 2011.
Defusing –This first phase involves facilitated discussions of how the simulation was experienced emotionally by the learner and how the activities or events in the simulation occurred. This stage permits learners to revisit the scenario and explore emotions elicited by the simulation.
Discovery- In this phase, learners actively analyze and evaluate their performance. This self-analysis assists learners to identify reasons for why they behaved as they did or why they made certain decisions during the simulation event.
Deepening – This stage focuses on examining the knowledge gained from the debrief. The learner starts to actively apply the new knowledge gained from the simulation and connects that knowledge to clinical practice.
The environment is considered both a social and physical space where the debriefing is facilitated by the educator.
