Pause & Discuss – Are you Experienced? Recruiting for ISS Debriefing Study.

ISS recruit graphicThere is increasing use of ‘in situ’ simulation (ISS) – conducted in the actual care environment – as a healthcare simulation modality. This method supports teamwork training, process improvement and the identification of safety threats related to the environment or care systems within that real clinical environment.1,2

The shared reflective experience during simulation promotes transfer of lessons back to the workplace. Debriefing achieves improved operational performance across a range of fields, including outside healthcare.3 Most guidance on debriefing strategies4-6 comes from theoretical frameworks developed within and outside healthcare, and from educationally focused simulation. An exploration of self reported expert debriefing practice revealed that factors such as values and artistry may be as important as specific techniques.7 

Optimal debriefing strategies for ISS remain unclear, and current practice has not been reviewed systematically. Most published reports of ISS programs lack detail as to how debriefing is conducted. How expert and experienced in situ debriefers adapt their practice for this context has not been previously reported, nor have measures of effectiveness been developed or tested. This exploratory study will use survey and interview methods to identify the characteristics of debriefing currently conducted within in situ simulation programs in healthcare.

Specifically: –

What are the features of currently practiced debriefing approaches following in situ simulation (ISS) in healthcare?

  • Characteristics of the ISS
  • Characteristics of the debriefer and participants
  • Characteristics of the debriefing process
  • Characteristics of any evaluation of the debriefing

Our aim is that identification of effective debriefing strategies will have implications for design of in situ simulation programs, faculty development for simulation educators and could inform further research questions related to measures of debriefing effectiveness.

If you are someone with experience of in situ simulation debriefing (ie in the real clinical environment, rather than skills lab), we’d like to invite you to participate in a survey based study, with an option to also participate in a subsequent interview.

If you are interested, please click here to provide your details for study recruitment or write an email to

Victoria Brazil, Walter Eppich, and Margaret Bearman


  1. Guise JM, Mladenovic J. In situ simulation: identification of systems issues. Seminars in perinatology. 2013;37(3):161­5.
  1. Rosen MA, Hunt EA, Pronovost PJ, Federowicz MA, Weaver SJ. In situ simulation in continuing education for the health care professions: a systematic review. The Journal of continuing education in the health professions. 2012;32(4):243­54.
  1. Tannenbaum SI, Cerasoli CP. Do team and individual debriefs enhance performance? A meta­analysis. Human factors. 2013;55(1):231­45.
  1. Cheng A, Eppich W, Grant V, Sherbino J, Zendejas B, Cook DA. Debriefing for technology­enhanced simulation: a systematic review and meta­ analysis. Medical Education. 2014;48(7):657­66.
  1. Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simul Healthc. 2015;10(2):106­15.
  1. Sawyer T, Eppich W, Brett­Fleegler M, Grant V, Cheng A. More Than One Way to Debrief: A Critical Review of Healthcare Simulation Debriefing Methods. Simulation in Healthcare. 2016;11(3):209­17.
  1. Krogh K, Bearman M, Nestel D. “Thinking on your feet”—a qualitative study of debriefing practice. Advances in Simulation. 2016;1(1):1­11.