School of Medicine and Health Sciences Poster Presentations

Title

Benefits of Debriefing after Acute Events for Medical Residents

Document Type

Poster

Abstract Category

Quality Improvement

Keywords

Quality Improvement, Resident wellness, Medical education, Debriefing

Publication Date

Spring 5-1-2019

Abstract

Background Debriefing after critical events has been increasingly utilized across industries. The process is widely accepted to have benefits ranging from psychological protection to process improvement. As the medical community has an interest in continuous improvement in patient safety, enhanced learning for trainees, and for wellness benefits of a psychologically taxing profession, the profession may stand to benefit from routine debriefs. However, standardized debriefs have yet to be widely adopted. Objectives This project sought to identify potential benefits to medical residents of debriefing after acute events as well as barriers to routinely adopting this practice. Methods Subjective data was collected first by a voluntary survey offered to all Internal Medicine residents. The survey asked respondents how frequently they had participated in debriefs, as well as the benefits and the barriers to performing a debrief. Subsequently, residents were encouraged to perform debriefs after acute events. For the purposes of this study, an acute event was a rapid response, Code Blue, or a death. Residents were asked following their debriefs to complete a brief survey to assess the benefits of the activity. Results The initial survey had 40 responses including all three years (PGY1 33%, PGY2 42%, PGY3 25%). The majority of residents (62%) indicated they only participated in 1-2 debriefs during the current academic year. Notably, 12.5% had never participated in a debrief. A large percentage of residents (48%) responded that acute events contribute to their learning more than half of the time, though one third felt this was rarely the case. They cited multiple barriers to learning during acute events, most often that no one pointed out teaching points and that they didn’t know their role (each 42%). The most common benefits of debriefing were understanding clinical reasoning and processing emotionally difficult situations. The most frequent reason for residents not engaging in a debrief was that no one senior to them initiated one (70%), with time constraints cited by only 38% of residents. After residents were encouraged to debrief, the responding residents noted benefits in both understanding clinical reasoning and processing emotionally difficult situations. Debriefs took approximately 5 minutes. Conclusions Results of these surveys suggest that medical residents could benefit from more frequent debriefs by improving clinical reasoning and contributing to resident wellness. Widespread awareness of these benefits may encourage residents at all levels, especially senior residents, to initiate debriefs with their team members.

Open Access

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Presented at Research Days 2019.

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Benefits of Debriefing after Acute Events for Medical Residents

Background Debriefing after critical events has been increasingly utilized across industries. The process is widely accepted to have benefits ranging from psychological protection to process improvement. As the medical community has an interest in continuous improvement in patient safety, enhanced learning for trainees, and for wellness benefits of a psychologically taxing profession, the profession may stand to benefit from routine debriefs. However, standardized debriefs have yet to be widely adopted. Objectives This project sought to identify potential benefits to medical residents of debriefing after acute events as well as barriers to routinely adopting this practice. Methods Subjective data was collected first by a voluntary survey offered to all Internal Medicine residents. The survey asked respondents how frequently they had participated in debriefs, as well as the benefits and the barriers to performing a debrief. Subsequently, residents were encouraged to perform debriefs after acute events. For the purposes of this study, an acute event was a rapid response, Code Blue, or a death. Residents were asked following their debriefs to complete a brief survey to assess the benefits of the activity. Results The initial survey had 40 responses including all three years (PGY1 33%, PGY2 42%, PGY3 25%). The majority of residents (62%) indicated they only participated in 1-2 debriefs during the current academic year. Notably, 12.5% had never participated in a debrief. A large percentage of residents (48%) responded that acute events contribute to their learning more than half of the time, though one third felt this was rarely the case. They cited multiple barriers to learning during acute events, most often that no one pointed out teaching points and that they didn’t know their role (each 42%). The most common benefits of debriefing were understanding clinical reasoning and processing emotionally difficult situations. The most frequent reason for residents not engaging in a debrief was that no one senior to them initiated one (70%), with time constraints cited by only 38% of residents. After residents were encouraged to debrief, the responding residents noted benefits in both understanding clinical reasoning and processing emotionally difficult situations. Debriefs took approximately 5 minutes. Conclusions Results of these surveys suggest that medical residents could benefit from more frequent debriefs by improving clinical reasoning and contributing to resident wellness. Widespread awareness of these benefits may encourage residents at all levels, especially senior residents, to initiate debriefs with their team members.