International Journal of Healthcare Simulation

The 3 stages of debriefing skills development: the faculty development journey

Current simulation-based faculty development literature has a narrow focus, primarily on foundational skills such as debrief frameworks and conversational techniques ^[1]. It often neglects the journey debriefers undertake as they move from being novice debriefers to experts in the field.

Cheng et al ^[1] have modified Dreyfus & Dreyfus’s ^[2] model of skills development for debriefing skills in simulation-based education (SBE). They describe 3 stages:

1. The discovery stage: debriefers gain the basic, declarative knowledge of fundamental debriefing concepts such as evidence-base, frameworks, educational strategies, conversational methods and psychological safety.
2. The growth stage: debriefers work towards acquiring a growing toolbox of strategies to manage more complex debriefing interactions, including co-debriefing, tools to manage difficult discussions, balancing learner-centred debriefing with curriculum-driven intended learning outcomes, considerations about cultural influences and potentially using objective data during debriefing to assist with authenticity and standardized elements for discussion ^[3].
3. The maturity stage: debriefers learn to adapt to a variety of different debriefing contexts utilizing their comprehensive knowledge and deep understanding, solving problems intuitively and dynamically and problem-solving with innovative solutions.

Figure 1:

Faculty development strategies across 3 stages of debriefing expertise as described by Cheng et al ^[1]

Figure 2:

Faculty Advancement in Simulation Training (FAST) mapped to Cheng et al’s framework ^[1]

Figure 3:

Simulation in action (permission granted by individuals within photo)

Figure 4:

Debriefing in action (permission granted by subjects within photo)

The Faculty Advancement in Simulation Training (FAST) programme

Cheng et al’s conceptual framework ^[1] is analogous to the Scottish Clinical Skills Managed Education Network tier structure, which frames the journey of educator development from tier 1 (novice) to tier 3 (expert) ^[4]. This structure reflects the FAST programme – an introductory face-to-face practical session, an online modular programme ^[4], face-to-face workshops and formalised peer-coaching and assessment ^[5–7]. There is flexibility in which order these activities are undertaken, as developing faculty will have differing learning needs, dependent upon where they are in their individual development journey.