DE-CODE: a coding scheme for assessing debriefing interactions

Abstract

Debriefings are crucial for learning during simulation-based training (SBT). Although the quality of debriefings is very important for SBT, few studies have examined actual debriefing conversations. Investigating debriefing conversations is important for identifying typical debriefer–learner interaction patterns, obtaining insights into associations between debriefers’ communication and learners’ reflection and comparing different debriefing approaches. We aim at contributing to the science of debriefings by developing DE-CODE, a valid and reliable coding scheme for assessing debriefers’ and learners’ communication in debriefings. It is applicable for both direct, on-site observations and video-based coding.MethodsThe coding scheme was developed both deductively and inductively from literature on team learning and debriefing and observing debriefings during SBT, respectively. Inter-rater reliability was calculated using Cohen’s kappa. DE-CODE was tested for both live and video-based coding.ResultsDE-CODE consists of 32 codes for debriefers’ communication and 15 codes for learners’ communication. For live coding, coders achieved good inter-rater reliabilities with the exception of four codes for debriefers’ communication and two codes for learners’ communication. For video-based coding, coders achieved substantial inter-rater reliabilities with the exception of five codes for debriefers’ communication and three codes for learners’ communication.ConclusionDE-CODE is designed as micro-level measurement tool for coding debriefing conversations applicable to any debriefing of SBT in any field (except for the code medical input). It is reliable for direct, on-site observations as well as for video-based coding. DE-CODE is intended to allow for obtaining insights into what works and what does not work during debriefings and contribute to the science of debriefing.

Managing psychological safety in debriefings: a dynamic balancing act

“…We also draw selected behavioural anchors and categories from existing instruments to assess debriefing performance:The Debriefing Assessment for Simulation in Healthcare (DASH) 19–21. We especially drew on element 2 of the DASH rater handbook, which addresses maintaining an engaging learning environment;The Objective Structured Assessment of Debriefing;23 DE-CODE: a coding scheme to assess debriefing interactions 24…”

“…Convey curiosity by asking open-ended questions that seek to understand the learner’s thinking, or experience (or take-aways towards end of debriefing); use elaboration and clarification-seeking questions that elicit a deeper explanation of their point of view 24 65…”

“…Appreciate when team members participate, self-reflect and discover by saying things such as ‘thanks for that’ or ‘appreciate hearing that’ 24 31 41 47 48…”

Considerations for psychological safety with system-focused debriefings

“…Video capture is not unique to SIS events13; however, it is important to be transparent about how video may be used to help drive change. For example, video capture and photography may be useful after debriefings to aid in solution prioritisation and improvement work.…”

Eye-opening facilitator behaviours: an Interaction Analysis of facilitator behaviours that advance debriefings

“…There is a lack of research about which facilitator interventions are productive in advancing and supporting participants’ analyses of their team’s performance and how they can be facilitated to develop such skills further. The details of when and how facilitators in practice should verbally interact33 or use the video recordings are rarely explicated in the literature. The aim was therefore to study which kinds of facilitator interactions contribute to advancing the participants’ analyses during video-assisted postsimulation debriefing.…”