A66 Standardizing debriefing in Wales: the Triangular Approach

Background and aim:Debriefing after simulation practice offers a crucial opportunity for guided reflection and learning. However, there are many structures and models available [1].Health Education and Improvement Wales (HEIW) holds regular simulation webinars, workshops and conferences. During these events, the simulation community in Wales expressed their willingness to standardize debriefing in order to facilitate faculty sharing and to support interprofessional simulation.Activity:National debriefing experts carried out a review of the relevant literature and devised the Triangular Approach to Debriefing, incorporating agreed debriefing principles, a simple structure and recommended strategies with links to relevant key articles.This approach was shared and piloted by simulation faculty at a national workshop in September 2022. The feedback received was excellent. Comments received guided a document review. The final version was incorporated in the Essential Faculty Development Course and is currently in available in Welsh and English.Findings:The triangular approach embraces a set of collaboratively identified principles, an easy to use structure and a summary of well referenced strategies: •Principles adopted include facilitating safe and constructive discussions, with Inclusion of all participants and respect for different learner needs, aiming to guide reflective practice and sharing of mental models with the highest level of facilitation possible. •A four-step structure (see Figure 1-A66) guides the debriefer to introduce the debriefing and facilitate a chronological review with intercalated description – analysis – application (DAA) cycles. Then the learners are invited to share their new insights and the facilitator offers opportunities for questions and summarizes the discussion. The supporting cognitive aid includes examples of phrases that might be useful in each step. •Recommended strategies cover psychological safety (such as ground rules, time management, authenticity and validation of contributions), how to focus the discussion, facilitation techniques, closing and meta-debriefing. Principles adopted include facilitating safe and constructive discussions, with Inclusion of all participants and respect for different learner needs, aiming to guide reflective practice and sharing of mental models with the highest level of facilitation possible.A four-step structure (see Figure 1-A66) guides the debriefer to introduce the debriefing and facilitate a chronological review with intercalated description – analysis – application (DAA) cycles. Then the learners are invited to share their new insights and the facilitator offers opportunities for questions and summarizes the discussion. The supporting cognitive aid includes examples of phrases that might be useful in each step.Recommended strategies cover psychological safety (such as ground rules, time management, authenticity and validation of contributions), how to focus the discussion, facilitation techniques, closing and meta-debriefing.Debriefing structure in the Triangular Approach to debriefingConclusion:The Triangular Approach to debriefing has been welcomed by the simulation community in Wales. It is not expected to be the only way that facilitators debrief, but a gateway into good quality debriefing for new faculty, supporting the development of national expertise and encouraging to explore other available models as well as key debriefing literature.Ethics statement:Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.