The 3D Model of Debriefing: Defusing, Discovering, and Deepening

doi:10.1053/j.semperi.2011.01.003

Seminars in Perinatology

Volume 35, Issue 2, April 2011, Pages 52-58

https://doi.org/10.1053/j.semperi.2011.01.003 Get rights and content

The experiential learning process involves participation in key experiences and analysis of those experiences. In health care, these experiences can occur through high-fidelity simulation or in the actual clinical setting. The most important component of this process is the postexperience analysis or debriefing. During the debriefing, individuals must reflect upon the experience, identify the mental models that led to behaviors or cognitive processes, and then build or enhance new mental models to be used in future experiences. On the basis of adult learning theory, the Kolb Experiential Learning Cycle, and the Learning Outcomes Model, we structured a framework for facilitators of debriefings entitled “the 3D Model of Debriefing: Defusing, Discovering, and Deepening.” It incorporates common phases prevalent in the debriefing literature, including description of and reactions to the experience, analysis of behaviors, and application or synthesis of new knowledge into clinical practice. It can be used to enhance learning after real or simulated events.

Section snippets

The Individual

In health care simulation, adults are the learners. According to adult learning theory, there are several key differences to consider between adults and children and how they learn: (1) Adults are self-regulated meaning that they decide what and when they want and need to learn,²⁰ (2) adult learners are intrinsically motivated, often by their self-efficacy or their belief in their ability to complete a task, their feelings of competence and their psychological safety,21, 22, 23 (3) adult

The Experience

Kolb's Experiential Learning Cycle suggests that active participation or having a “concrete experience” is an important factor in effective learning.⁹ This experience should be considered alongside one's previous experience and connections must be made to future experiences.⁷ These connections can be discussed in a postexperience debriefing. For the debriefing to be fruitful, the experience must be based on learning objectives that are practical, useful for the individual, and relevant to

Environment

Educators must consider both the learning environment and the larger clinical environment to promote effective learning. The learning environment, ie, the classroom or laboratory setting, should be a place where the adult, self-regulated, intrinsically motivated individual feels safe to practice, experiment and discuss openly and honestly.6, 20, 28, 29 In addition, educators must consider the larger clinical environment and how it affects new learning, experimentation, and sustained practice

The 3D Model

The 3D Model (Table 2) is designed to address the individual, the experience and both the micro- and macro-environments. The model has 3 distinct parts: Defusing, Discovering and Deepening and is preceded by a Pre-briefing or introduction to the process and ends with a Summary of lessons learned. The Pre-briefing outlines the ground rules for the debriefing session and sets the stage for learning in the microenvironment.6, 14, 30 Defusing is designed to help the individual voice the impact of

Setting the Learning Microenvironment

The first step in facilitating effective adult learning is creating a microenvironment that supports learning. This environment should be established at the beginning of a simulation-based course or even before the course day with a written description of goals and expectations. Adult learners must feel that the environment is safe and focused primarily on learning before they will be able to actively reflect on and share their experiences with others.6, 28 To achieve this, facilitators should

Conclusions

The individual, their experiences, and both the micro- and macroenvironments must be considered to effectively achieve life-long learning.¹⁸ Simulation and debriefing are powerful tools to assist individuals in learning from experiences. When handled skillfully, debriefing is the most important aspect of simulation-based education, as it is where the learning and processing of new information occurs.2, 3, 4, 5, 6, 14

For adults to learn from experience in the simulated environment the individual

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The 3D Model of Debriefing: Defusing, Discovering, and Deepening

Section snippets

The Individual

The Experience

Environment

The 3D Model

Setting the Learning Microenvironment

Conclusions

Anesthesiol Clin

Contemp Educ Psychol

A critical re-examination of the post-experience analytic process with implications for its effective use

Simul Games

Debriefing

Simul Games

Features and uses of high-fidelity medical simulations that lead to effective learning: A BEME systematic review

Med Teach

Promoting learning through games and simulations

Simul/Games Learn

Debriefing: Toward a systematic assessment of theory and practice

Simul Gaming

Key elements of debriefing for simulation training

Eur J Anaesthesiol

Experience and Education

Theory in Practice: Increasing Professional Effectiveness

Experiential Learning

Mental models and complex problem solving: Instructional effects

The effect of debriefing on laboratory induced helplessness: An attributional analysis

J Personal

Debriefing in experience-based learning

Simul/Games Learn

When disaster strikes… the critical incident stress debriefing process

JEMS

The role of debriefing in simulation-based learning

Simul Healthc

How to Facilitate a Debriefing

Simul Gaming