Q: I’m the director of a simulation program in a nursing program.  I occasionally find out at the last minute that I am going to have a co-debriefer. They are usually people I know and work with, and they have varying levels of debriefing skill – some have no experience or training. It often seems like we are in a power struggle to control the debriefing.  What do I do when they hijack my debriefing?

A: My best advice to you is this: an ounce of prevention is worth a pound of cure. This is a lesson I have learned the hard way! It’s very difficult (maybe impossible) to elegantly wrestle a debriefing back once a co-debriefer has hijacked it. Believe me, I’ve tried, and it has not been elegant. At all.

This is how I handle these situations now: In an ideal world, the new co-debriefer and I will have time to have a private 10–15-minute discussion about the debriefing and what our respective roles are (e.g. who will lead, who will ask questions, choose topics, and guide the talk from Reactions through Summary). What is more likely to happen is that we will have two minutes in the control room to work out those issues. In that situation, I take on more of the role of a director and explain clearly how the simulation and debriefing will run. To address debriefing, I generally say something like:

“We have not worked together before, so let’s cover how the debriefing will run. It may look like a casual conversation, but it is not. I see my role as the facilitator of the conversation, and your role as being the clinical expert. So I’ll steer the conversation, and when a clinical question comes up, I’ll invite your input. Any time you want to add something, just signal me and I’ll bring you into the conversation as soon as I can.  So I’ll start when we get into the room; I’ll move through the topics; and I’ll close out the discussion. How does that sound to you?”  

I usually find that this short “discussion” prevents most subsequent problems.

-Mary Fey, Associate Director, Applied Learning for Performance and Safety

Resources:

Cheng, A., Palaganas, J., Eppich, W., Rudolph, J., Robinson, T. and Grant, V., 2015. Co-debriefing for simulation-based education: A primer for facilitators. Simulation in Healthcare, 10(2), pp. 69-75.