I want to talk to you today about debriefing, and I'm not talking about what happens when
soldiers get back from assignment on homeland, but the reflection and feedback that
happens after a theatre-based simulation, that's what we call it now you know, theatrebased,
because the first time we run a scenario I have to tell you, it's as nerve wracking as
opening night on Broadway - mostly because our cast doesn't know their lines.

Anyhow, debriefing is my favourite part of being a simulation educator - I've been
debriefing for around 15 years now, back since the time that feedback consisted of a
checklist - you did AB and C, but you missed XY and Z, thanks for coming out. Now we
have fancy stuff like the Pearls framework, plus delta, directed feedback (you suck, next
time you should suck less) and advocacy/inquiry. I noticed that you sucked back there, I'm
concerned because I wouldn't have sucked as badly as you did, what's up with that?

But what I want the beginner debriefer to understand is one thing - stay curious - and I
don't mean pretend to be curious about why your participant acted the way they did, I
mean you should remain genuinely curious as to why this performance was sucky. There
may be an excellent reason why the performance sucked, and maybe it actually didn't suck
as badly as you judged it to suck.

I'll say it again, GENUINE curiosity - you need to truly believe that there is a possible
universe in which your participant is an intelligent, well-trained health care provider who
was trying to do their best, and made the choices they made for a good reason. That way,
you can get at their frame of mind, and if their frame was incorrect, you can help them
reframe - and therein lies the beauty of the debriefing.

There's a big difference between these two lines of questioning - first one: "Glenn, what's
the medication that you give to reverse magnesium sulfate overdose? calcium gluconate -
so why didn't you give calcium gluconate - I don't know, because I'm an idiot? In this
second one, this advocacy inquiry molecule gets at my frame - so Glenn, I know you're a
well-trained Ob/Gyn with 11 years of experience, so I'm curious why you didn't give calcium
gluconate to the patient with the magnesium sulfate overdose, can you tell me what you
were thinking there? Well thanks for asking, Glenn, actually, I was very concerned with
providing CPR to the patient, and I thought the team leader was going to administer the
calcium gluconate, I guess I could have shared my thought with the leader, I didn't realize
that he didn't know what the diagnosis was - BINGO, you got at my frame and you taught
me how to be a better communicator during a crisis! And that's why I love debriefing. Take
the SET course.