title: Identifying best practice guidelines for debriefing in surgery: a tri-continental study.
abstract: BACKGROUND
  Changes in surgical training have decreased opportunities for experiential learning in the operating room (OR). With this decrease, a commensurate increase in debriefing-dependent simulation-based activities has occurred. Effective debriefing could optimize learning from both simulated and real clinical encounters.
  
  
  METHODS
  Thirty-three semistructured interviews with surgeons, anesthesiologists, and OR nurses from the United Kingdom, United States, and Australia identified the goals of debriefing, core components of an effective debrief, and solutions to its effective implementation. Interviews were audiotaped, transcribed, and coded using emergent theme analysis.
  
  
  RESULTS
  Core components of an effective debrief include having the appropriate approach, establishing a learning environment, learner engagement, managing learner reaction, reflection, analysis, diagnosis, and application to real clinical practice. Solutions to enhance practice involve promotion of a debriefing culture within the surgical community with protected time to conduct a structured debriefing.
  
  
  CONCLUSIONS
  A need exists to enhance surgical training through regular structured debriefing. Identifying the key components of an effective debrief is a first step toward improving practice and embedding a debriefing culture within the OR.
authors.affiliation: Department of Surgery and Cancer, Imperial College, St Mary's Hospital, London, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Ahmed
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
authors.forename: John
authors.initials: J
authors.lastname: Paige
authors.forename: Ram
authors.initials: R
authors.lastname: Paragi-Gururaja
authors.forename: Debra
authors.initials: D
authors.lastname: Nestel
authors.forename: Sonal
authors.initials: S
authors.lastname: Arora
mesh_terms: D000776:Anesthesiology / Q000193:education; D001315:Australia; D002983:Clinical Competence; D005260:Female; D013502:General Surgery / Q000193:education; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010348:Patient Care Team; D013527:Perioperative Nursing / Q000193:education; D017410:Practice Guidelines as Topic; D018794:Problem-Based Learning; D017749:Total Quality Management; D006113:United Kingdom; D014481:United States