Debriefing in Simulation and Beyond.

Debriefing, with its roots in military and aviation, is critically important to effective application of simulation education. With its widespread implementation and strong underpinnings in a variety of educational theories, debriefing is a central pillar of essentially all health care simulation centers. Even anesthesiologists who have completed training and practice outside of teaching centers will encounter debriefing when they participate in Part IV of Maintenance of Certification in Anesthesiology in endorsed simulation centers. Beyond this well-established presence, debriefing offers exciting opportunities for improvement of health care education and quality. First, debriefing practices should not be limited to the simulation setting. It is applicable to reflecting upon the crisis situations that are often faced by anesthesiologists, as well as a powerful tool for feedback on a daily basis. The improvement of feedback in both quality and quantity is considered by many educators to be a fundamental step in improving educational and training programs. The principles of debriefing, and probably more importantly the value of debriefing, are invaluable concepts for the clinical environment and amplify the impact of simulation in patient care. It can be reasonably argued that helping health care practitioners develop the habitual practice of giving and receiving feedback could become one of simulation educators' greatest contributions to patient safety. Another important role of debriefing should be in the area of IPE and practice. The challenges of IPE in simulation have been described; it is important for health care educators to be aware of these IPE experiences. These experiences have created a cadre of facilitators ready to participate in meaningful clinical debriefings across specialties and disciplines. Debriefing has played a central role in medical simulation since early implementation. This role is well founded in both history and in educational theory. Various techniques of debriefing have evolved according to learner types, personal preference, and the scenario objectives. Regardless of technique, debriefing offers the opportunity for meaningful change within participants by providing genuine reflection upon authentic experiences. These changes, when applied to clinical practice, are an important part of the claim that simulation can improve patient safety.