Produced by Dr Nathan Smith, University of Manchester
Expert reviewed by Professor Scott Tannenbaum, Group for Organisational Effectiveness
Expert reviewed by Professor Andy McCann, DNA Definitive
Download the printable 1-page PDF version of this brief here.
Why is performance debriefing relevant?
During the response to the covid-19 outbreak a range of different healthcare workers will be required to interact to deliver care to critically ill patients. Ensuring that individuals and teams learn from their experiences and work efficiently together is important for sustaining high-quality care.
Although trauma-related debriefs are not encouraged (see PTSD brief here), debriefs focused on performance enhancement can be useful and are a relatively inexpensive and quick intervention for enhancing team function.
Fundamentally a debrief is a form of learning in which a team uses a process of reflection and planning to improve performance.
These are sometimes known as ‘after-action’ or ‘lessons learnt’ reviews and are commonly used in military, emergency medicine and other high-pressure settings.
Findings from a 2013 review and meta-analysis suggest that when conducted correctly, debriefs can lead to a 20-25% improvement in team performance. This is based on an average debrief length of just 18 minutes.
Essential elements of a debrief are:
Active self-learning: to be considered a debrief there must be some form of active self-learning or discovery. Simply being given feedback is not a debrief.
Developmental intent: debriefs focus on how to improve rather than evaluating or judging.
Specificity: focusing on specific activities, episodes and events rather than general performance or competency is important.
Multiple inputs: there must be multiple sources of information fed into the debrief to allow for diversity of viewpoints and perspective.
In the context of the covid-19 response, where teams will have to function under intense pressure and complexity, these types of debrief are likely to be critical for maximising what is learnt from the unique situations being encountered, and then using that learning to drive onward performance.
Not every event or situation can be debriefed but encouraging leaders to try and conduct regular debriefs is likely to be helpful for performance
Ideally, debriefs would be done as close to the event or experience as possible to allow for more accurate memory retrieval and opportunity for self-learning and reflection. However, this may be challenging when workers are tired and fatigued and/or have to redeploy to another case. The longer the time lag between the event and the debrief, the less useful it is likely to be. More general performance debriefs, with as many of the team present as possible, could collate observations from multiple discrete events. These will be harder to manage, though, and it will be more difficult to implement the 4 essential components identified above.
When leaders describe the purpose of a debrief, this should be presented as an opportunity for learning to take place rather than it being perceived as a tick-box exercise or administrative task.
Leaders should ask questions that allow the team to voice their opinions before sharing their own. This will avoid priming responses and enable a more open and honest discussion.
When questions are asked, providing enough opportunity for responses. This might mean short periods of silence to allow people to think and respond. You might also ask a team member to share their perspective.
Debriefs should discuss both teamwork (communication, cooperation and coordination) and taskwork (technical aspects of the job). They can focus on what went well (continue doing this) as well as what could be done differently in the future.
If people have opened themselves up for criticism by admitting failures or poor performances, it is imperative to avoid punitive responses. Instead, thank participants when they are being open and sharing their concerns.
Performance debriefs rely on a culture that is embedded in the desire and learn from mistakes rather than criticise.
Encouraging leaders to admit an area they would like to improve in or something they could do better is a good way of showing the team the importance of being open and continual development and will make it easier for others to speak up.
Use debriefs to reflect back on what happened and how that can shape what is done in the future. At the end of a debrief, the team should be clear about they need to continue doing, stop doing and pay attention to in the future.
Allen, J. A., Reiter-Palmon, R., Crowe, J., & Scott, C. (2018). Debriefs: Teams learning from doing in context. American Psychologist, 73(4), 504.
Lyons, R., Lazzara, E. H., Benishek, L. E., Zajac, S., Gregory, M., Sonesh, S. C., & Salas, E. (2015). Enhancing the effectiveness of team debriefings in medical simulation: More best practices. The Joint Commission Journal on Quality and Patient Safety, 41(3), 115-125.
Tannenbaum, S. I., & Cerasoli, C. P. (2013). Do Team and Individual Debriefs Enhance Performance? A Meta-Analysis. Human Factors, 55(1), 231–245. https://doi.org/10.1177/0018720812448394