title: Characteristics of Real-Time, Non-Critical Incident Debriefing Practices in the Emergency Department.
abstract: BACKGROUND
  Benefits of post-simulation debriefings as an educational and feedback tool have been widely accepted for nearly a decade. Real-time, non-critical incident debriefing is similar to post-simulation debriefing; however, data on its practice in academic emergency departments (ED), is limited. Although tools such as TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) suggest debriefing after complicated medical situations, they do not teach debriefing skills suited to this purpose. Anecdotal evidence suggests that real-time debriefings (or non-critical incident debriefings) do in fact occur in academic EDs;, however, limited research has been performed on this subject. The objective of this study was to characterize real-time, non-critical incident debriefing practices in emergency medicine (EM).
  
  
  METHODS
  We conducted this multicenter cross-sectional study of EM attendings and residents at four large, high-volume, academic EM residency programs in New York City. Questionnaire design was based on a Delphi panel and pilot testing with expert panel. We sought a convenience sample from a potential pool of approximately 300 physicians across the four sites with the goal of obtaining >100 responses. The survey was sent electronically to the four residency list-serves with a total of six monthly completion reminder emails. We collected all data electronically and anonymously using SurveyMonkey.com; the data were then entered into and analyzed with Microsoft Excel.
  
  
  RESULTS
  The data elucidate various characteristics of current real-time debriefing trends in EM, including its definition, perceived benefits and barriers, as well as the variety of formats of debriefings currently being conducted.
  
  
  CONCLUSIONS
  This survey regarding the practice of real-time, non-critical incident debriefings in four major academic EM programs within New York City sheds light on three major, pertinent points: 1) real-time, non-critical incident debriefing definitely occurs in academic emergency practice; 2) in general, real-time debriefing is perceived to be of some value with respect to education, systems and performance improvement; 3) although it is practiced by clinicians, most report no formal training in actual debriefing techniques. Further study is needed to clarify actual benefits of real-time/non-critical incident debriefing as well as details on potential pitfalls of this practice and recommendations for best practices for use.
authors.affiliation: OSF St. Francis Medical Center, University of Illinois College of Medicine at Peoria, Department of Emergency Medicine, Peoria, Illinois; Kings County Hospital and SUNY Downstate Medical Center, Department of Emergency Medicine, New York, New York.
authors.forename: Nur-Ain
authors.initials: NA
authors.lastname: Nadir
authors.affiliation: Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine and Department of Medical Education, Elmhurst, New York.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bentley
authors.affiliation: Thomas Jefferson University Hospital, Department of Emergency Medicine, Philadelphia, Pennsylvania.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Papanagnou
authors.affiliation: Jacobi Medical Center, Department of Obstetrics and Gynecology, New York, New York.
authors.forename: Komal
authors.initials: K
authors.lastname: Bajaj
authors.affiliation: Kings County Hospital and SUNY Downstate Medical Center, Department of Emergency Medicine, New York, New York.
authors.forename: Stephan
authors.initials: S
authors.lastname: Rinnert
authors.affiliation: Kings County Hospital and SUNY Downstate Medical Center, Department of Emergency Medicine, New York, New York.
authors.forename: Richard
authors.initials: R
authors.lastname: Sinert
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000193:education*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005246:Feedback; D006801:Humans; D007396:Internship and Residency; D009519:New York City; D061214:Patient Safety; D012308:Risk Management / Q000379:methods*; D011795:Surveys and Questionnaires