References

Allen JA, Reiter-Palmon R, Crowe J, Scott C. Debriefs: teams learning from doing in context. Am Psychol.. 2018; 73:(4)504-516 https://doi.org/10.1037/amp0000246

Bisson JI, Jenkins PL, Alexander J, Bannister C. Randomised controlled trial of psychological debriefing for victims of acute burn trauma. Br J Psychiatry. 1997; 171:78-81 https://doi.org/10.1192/bjp.171.1.78

Brett-Fleegler M, Rudolph J, Eppich W Debriefing assessment for simulation in healthcare: development and psychometric properties. Simul Healthc. 2012; 7:(5)288-294 https://doi.org/10.1097/SIH.0b013e3182620228

Psychological debriefing.Leicester: BPS; 2002

Burns C, Harm NJ. Emergency nurses’ perceptions of critical incidents and stress debriefing. J Emerg Nurs. 1993; 19:(5)431-436

Dyregrov A. The process in psychological debriefings. J Trauma Stress. 1997; 10:(4)589-605 https://doi.org/10.1002/jts.2490100406

Ehlers A, Mayou RA, Bryant B. Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. J Abnorm Psychol.. 1998; 107:(3)508-519 https://doi.org/10.1037/0021-843X.107.3.508

Everly GS, Flannery RB, Eyler VA. Critical incident stress management (CISM): a statistical review of the literature. Psychiatr Q. 2002; 73:(3)171-182 https://doi.org/10.1016/S1359-1789(98)00026-3

Fanning RM, Gaba DM. The role of debriefing in simulation-based learning. Simul Healthc. 2007; 2:(2)115-125 https://doi.org/10.1097/SIH.0b013e3180315539

Flannery RB, Fulton P, Tausch J, DeLoffi AY. A program to help staff cope with psychological sequelae of assaults by patients. Hosp Community Psychiatry. 1991; 42:(9)935-938 https://doi.org/10.1176/ps.42.9.935

Gardner RM. Introduction to debriefing. Semin Perinatol.. 2013; 37:(3)166-174 https://doi.org/10.1053/j.semperi.2013.02.008

Greenberg N. A critical review of psychological debriefing: the management of psychological health after traumatic experiences. J R Nav Med Serv.. 2001; 87:(3)158-161

Halpern J, Maunder RG, Schwartz B, Gurevich M. Downtime after critical incidents in emergency medical technicians/paramedics. Biomed Res Int.. 2014; 2014 https://doi.org/10.1155/2014/483140

Hawker DM, Durkin J, Hawker DS. To debrief or not to debrief our heroes: that is the question. Clin Psychol Psychother. 2011; 18:(6)453-463 https://doi.org/10.1002/cpp.730

Health and Care Professions Council. Standards of proficiency—paramedics. 2014. https//tinyurl.com/rmj2yxn (accessed 23 December 2020)

Healy S, Tyrrell M. Importance of debriefing following critical incidents. Emerg Nurse. 2013; 20:(10)32-37 https://doi.org/10.7748/en2013.03.20.10.32.s8

Huggard J. Debriefing: a valuable component of staff support. Int J Palliat Nurs. 2013; 19:(5)212-214 https://doi.org/10.12968/ijpn.2013.19.5.212

Jackson D, Firtko A, Edenborough M. Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: a literature review. J Adv Nurs. 2007; 60:(1)1-9 https://doi.org/10.1111/j.1365-2648.2007.04412.x

Jenkins SR. Social support and debriefing efficacy among emergency medical workers after a mass shooting incident. J Soc Behav Pers.. 1996; 11:477-492

Kaufman DM. Applying educational theory in practice. BMJ. 2003; 326:(7382)213-216 https://doi.org/10.1136/bmj.326.7382.213

Kessler DO, Cheng A, Mullan PC. Debriefing in the emergency department after clinical events: a practical guide. Ann Emerg Med. 2015; 65:(6)690-698 https://doi.org/10.1016/j.annemergmed.2014.10.019

Knowles MS. Adult learning.New York (NY): McGraw Hill; 1996

Kolb DA. Experiential learning: experience as the source of learning and development.NJ: Prentice-Hall; 1984

Lederman LC. Debriefing: a critical re-examination of the post-experience analytic process and implications for effective use. Simul Games. 1984; 15:(4)415-431 https://doi.org/10.1177/0037550084154002

Lederman LC. Debriefing: towards a systematic assessment of theory and practice. Simul Games. 1992; 23:(2)145-160 https://doi.org/10.1177/1046878192232003

MacDonald CM. Evaluation of stress debriefing interventions with military populations. Mil Med. 2003; 168:(12)961-968 https://doi.org/10.1093/milmed/168.12.961

Mackinnon R, Gough S. What can we learn about debriefing from other high-risk/high-stakes industries?. Cureus. 2014; 14:(6) https://doi.org/10.7759/cureus.174

Mayou RA, Ehlers A, Hobbs M. Psychological debriefing for road traffic accident victims. Three-year follow-up of a randomised controlled trial. Br J Psychiatry. 2000; 176:589-593 https://doi.org/10.1192/bjp.176.6.589

Kolb’s learning styles and experiential learning cycle. 2017. https//www.simplypsychology.org/learning-kolb.html (accessed 23 December 2020)

Nadir NA, Bentley S, Papanagnou D, Bajaj K, Rinnert S, Sinert R. Characteristics of real-time, non-critical incident debriefing practices in the emergency department. West J Emerg Med. 2017; 18:(1)146-151 https://doi.org/10.5811/westjem.2016.10.31467

Post-traumatic stress disorder (PTSD): the management of PTSD in adults and children in primary and secondary care.: Clinical guideline [CG26]; 2005

National Institute for Health and Care Excellence. Post-traumatic stress disorder. 2018. https//www.nice.org.uk/guidance/ng116 (accessed 23 December 2020)

Review 9. Post-traumatic stress disorder (PTSD) in ambulance staff. 2010. https//tinyurl.com/y7warfgd (accessed 23 December 2020)

Paterson HM, Whittle K, Kemp R. Detrimental effects of post-incident debriefing on memory and psychological responses. J Police Crim Psych.. 2015; 30:27-37 https://doi.org/10.1007/s11896-014-9141-6

Regehr C, Goldberg G, Hughes J. Exposure to human tragedy, empathy, and trauma in ambulance paramedics. Am J Orthopsychiatry. 2002; 72:(4)505-513 https://doi.org/10.1037/0002-9432.72.4.505

Debriefing after adverse outcomes: an opportunity to improve quality and patient safety. https//tinyurl.com/y7ld9rpz (accessed 23 December 2020)

Rose S, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev.. 2002; 2 https://doi.org/10.1002/14651858.CD000560

Rudolph JW, Taylor ST, Foldy E. Collaborative off-line reflection: a way to develop skill in action science and action inquiry.London: Sage; 2001

Salas E, Klein C, King H, Salisbury M, Augenstein JS, Birnbach DJ, Robinson DW, Upshaw C. Debriefing medical teams: 12 evidence-based best practices and tips. Jt Comm J Qual Patient Saf.. 2008; 34:(9)518-27 https://doi.org/10.1016/S1553-7250(08)34066-5

Sandhu N, Eppich W, Mikrogianakis A Postresuscitation debriefing in the pediatric emergency department: a national needs assessment. CJEM. 2014; 16:(5)383-392 https://doi.org/10.2310/8000.2013.131136

Schmidt M, Haglund K. Debrief in emergency departments to improve compassion fatigue and promote resiliency. J Trauma Nurs. 2017; 24:(5)317-322 https://doi.org/10.1097/JTN.0000000000000315

Scott C, Allen JA, Bonilla D, Baran B, Murphy D. Ambiguity and freedom of dissent in post incident discussion. J Bus Commun. 2013; 50:383-402 https://doi.org/10.1177/0021943613497054

Shore H. After compression, time for decompression: debriefing after significant clinical events. Infant. 2014; 10:(4)117-119

Sterud T, Ekeberg Ø, Hem E. Health status in the ambulance services: a systematic review. BMC Health Serv Res.. 2006; 6 https://doi.org/10.1186/1472-6963-6-82

Tannenbaum SI, Cerasoli CP. Do team and individual debriefs enhance performance? A meta-analysis. Hum Factors. 2013; 55:(1)231-245 https://doi.org/10.1177/0018720812448394

Stop 5: stop for 5 minutes — our bespoke hot debrief model. Edinburgh Emergency Medicine. Hot Debrief Poster 2, European Society for Emergency Medicine conference. 2018. https//tinyurl.com/ydgfdjby (accessed 23 December 2020)

Weathers F. Debriefing in the emergency department. Master’s Theses, Dissertations, Graduate Research and Major Papers Overview. 2017; https://doi.org/10.28971/532017WF52

Wessely S, Deahl M. Psychological debriefing is a waste of time. Br J Psychiatry. 2003; 183:12-14 https://doi.org/10.1192/bjp.183.1.12

leadership and managment

Exploring the clinical debrief: benefits and barriers

02 January 2021
Features
02 January 2021
Volume 13 · Issue 1

Abstract

Paramedics are regularly exposed to traumatic situations in the prehospital environment, which can profoundly affect their emotional resilience. A debrief is a recognised tool that is used to manage the aftermath of such events. Its aims are to unpick the components of the situation, identify any issues or achievements in clinical care, highlight learning points to improve future practice and safeguard the clinician’s emotional wellbeing. This article explores the benefits of and barriers to debriefing in clinical practice as well as the emerging debate around the potential harm or benefit of single-session debriefing.

After completing this module, the paramedic will be able to:

The first documented historical group debrief is thought to have been performed during the Second World War by Brigadier General Marshall (Gardner, 2013). It was found that when soldiers recounted events from combat, including feelings, decisions and outcomes, they gained psychological benefits. This was termed ‘spiritual purging’ as it was thought to cleanse one’s actions during combat (MacDonald, 2003). Later, the commercial aviation profession used debriefing practices to aid movement away from a hierarchy culture to improve reliability and safety in the late 1970s (Rivera-Chiauzzi and Lee, 2016).

Conducting and participating in a debrief after a critical incident is now commonplace and embedded within the professional standards of paramedic practice (Health and Care Professions Council, 2014).

By definition, a debrief is a post-experience analytic process (Lederman, 1984). It is also considered to be a discussion and analysis of an experience, where lessons learned are evaluated and integrated into one’s cognition and consciousness (Lederman, 1992).

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