Managing psychological safety in debriefings: A dynamic balancing act

BMJ Simulation and Technology Enhanced Learning

Volumn 6, Issue 3, 2020, Pages 164-171

  Kolbe, Michaela ^a,b   Eppich, Walter ^c   Rudolph, Jenny ^d,e   Meguerdichian, Michael ^f,g   Catena, Helen ^h   Cripps, Amy ^h   Grant, Vincent ^h,i   Cheng, Adam ^h,i  

^a UNIVERSITY HOSPITAL ZURICH   (Switzerland)

^b ETH ZURICH   (Switzerland)

^c NORTHWESTERN UNIVERSITY   (United States)

^d Center for Medical Simulation Cambridge   (United States)

^e MASSACHUSETTS GENERAL HOSPITAL   (United States)

^f HARLEM HOSPITAL CENTER   (United States)

^g H+H Simulation Center   (United States)

^h ALBERTA CHILDREN'S HOSPITAL   (Canada)

ⁱ UNIVERSITY OF CALGARY   (Canada)

Author keywords

communication; debriefing; faculty development; psychological safety; simulation based education

Indexed keywords

EID: 85071142108     PISSN: None     EISSN: 20566697     Source Type: Journal    
DOI: 10.1136/bmjstel-2019-000470     Document Type: Review

References (77)

1. Rudolph JW, Simon R, Rivard P, et al. Debriefing with good judgment: combining rigorous feedback with genuine inquiry. Anesthesiol Clin 2007;25:361-76.
2. Fanning RM, Gaba DM. The role of debriefing in simulation-based learning. Simul Healthc 2007;2:115-25.
3. Tannenbaum SI, Goldhaber-Fiebert S. Medical team debriefs: Simple, powerful, underutilized. In: Salas E, Frush K, eds. Improving patient safety through teamwork and team training. New York: Oxford University Press, 2013:249-56.
4. Mullan PC, Kessler DO, Cheng A. Educational opportunities with postevent debriefing. JAMA 2014;312:2333-4.
5. Salas E, Klein C, King H, et al. Debriefing medical teams: 12 evidence-based best practices and tips. Jt Comm J Qual Patient Saf 2008;34:518-27.
6. Eddy ER, Tannenbaum SI, Mathieu JE. Helping teams to help themselves: comparing two team-led debriefing methods. Pers Psychol 2013;66:975-1008.
7. Cheng A, Eppich W, Grant V, et al. Debriefing for technology-enhanced simulation: a systematic review and meta-analysis. Med Educ 2014;48:657-66.
8. Cheng A, Palaganas J, Eppich W, et al. Co-debriefing for simulation-based education: a primer for facilitators. Simul Healthc 2015;10:69-75.
9. Ahmed M, Arora S, Russ S, et al. Operation debrief: a SHARP improvement in performance feedback in the operating room. Ann Surg 2013;258:958-63.
10. Schein EH. How can organizations learn faster? The challenge of entering the green room. Sloan Management Review 1993;34:85-92.
11. Tucker AL, Edmondson AC. Why hospitals don't learn from failures: organizational and psychological dynamics that inhibit system change. Calif Manage Rev 2003;45:55-72.
12. Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q 1999;44:350-83.
13. Argyris C, Putnam R, McLain Smith D. Action science: concepts, methods, and skills for research and intervention. San Francisco: Jossey-Bass, 1985.
14. Rudolph JW, Foldy EG, Robinson T, et al. Helping without harming: the instructor's feedback dilemma in debriefing-a case study. Simul Healthc 2013;8:304-16.
15. Kihlgren P, Spanager L, Dieckmann P. Investigating novice doctors' reflections in debriefings after simulation scenarios. Med Teach 2015;37:437-43.
16. Hughes AM, Gregory ME, Joseph DL, et al. Saving lives: a meta-analysis of team training in healthcare. J Appl Psychol 2016;101:1266-304.
17. Rudolph JW, Raemer DB, Simon R. Establishing a safe container for learning in simulation: the role of the presimulation briefing. Simul Healthc 2014;9:339-49.
18. Kolbe M, Rudolph JW. What's the headline on your mind right now? How reflection guides simulation-based faculty development in a master class. BMJ Stel 2018;4:126-32.
19. Allen JA, Reiter-Palmon R, Crowe J, et al. Debriefs: teams learning from doing in context. Am Psychol 2018;73:504-16.
20. Brett-Fleegler M, Rudolph J, Eppich W, et al. Debriefing assessment for simulation in healthcare: development and psychometric properties. Simul Healthc 2012;7:288-94.
21. LeBlanc VR. The relationship between emotions and learning in simulation-based education. Simul Healthc 2019;14:137-9.
22. LeBlanc VR, McConnell MM, Monteiro SD. Predictable chaos: a review of the effects of emotions on attention, memory and decision making. Adv Health Sci Educ Theory Pract 2015;20:265-82.
23. Arora S, Ahmed M, Paige J, et al. Objective structured assessment of debriefing: bringing science to the art of debriefing in surgery. Ann Surg 2012;256:982-8.
24. Seelandt JC, Grande B, Kriech S, et al. DE-CODE: a coding scheme for assessing debriefing interactions. BMJ Stel 2018;4:51-8.
25. Edmondson AC, Lei Z. Psychological Safety: The History, Renaissance, and Future of an Interpersonal Construct. Annual Rev Org Psyc Organ Behav 2014;1:23-43.
26. Roussin CJ, MacLean T, Rudolph JW. The safety in unsafe teams: a multilevel approach to team psychological safety. Journal of Management 2014.
27. Frazier ML, Fainshmidt S, Klinger RL, et al. Psychological safety: a meta-analytic review and extension. Pers Psychol 2017;70:113-65.
28. Bateman TS, Crant JM. The proactive component of organizational behavior: a measure and correlates. J Organ Behav 1993;14:103-18.
29. Costa PT, McCrae RR. Normal personality assessment in clinical practice: the NEO personality inventory. Psychol Assess 1992;4:5-13.
30. Mindset DCS. The new psychology of success: How we can learn to fulfil our potential. New York: Ballantine, 2006.
31. Nembhard IM, Edmondson AC. Making it safe: the effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J Organ Behav 2006;27:941-66.
32. Orlander JD, Barber TW, Fincke BG. The morbidity and mortality conference: the delicate nature of learning from error. Acad Med 2002;77:1001-6.
33. Blanchette I, Richards A. Anxiety and the interpretation of ambiguous information: beyond the emotion-congruent effect. J Exp Psychol Gen 2003;132:294-309.
34. Nabi RL. Exploring the framing effects of emotion: do discrete emotions differentially influence information accessibility, information seeking, and policy preference? Commun Res 2003;30:224-47.
35. Freshwater D, Robertson C. Emotions and needs. Buckingham, UK and Philadlphia, USA: Open University Press, 2002.
36. Winnicott D. The family and individual development. London: Tavistock Publishers, 1965.
37. Rappoport A. The patient's search for safety: The organizing principle in psychotherapy. Psychotherapy: Theory, Research, Practice, Training 1997;34:250-61.
38. French RB. The teacher as container of anxiety: psychoanalysis and the role of teacher. J Manag Educ 1997;21:483-95.
39. Gilmore S, Anderson V. Anxiety and experience-based learning in a professional standards context. Manag Learn 2012;43:75-95.
40. Edmondson A. The fearless organization. Creating psychological safety in the workplace for learning, innovation, and growth. Hoboken, New Jersey: Wiley, 2019.
41. Weiss M, Kolbe M, Grote G, et al. We can do it! Inclusive leader language promotes voice behavior in multi-professional teams. Leadersh Q 2018;29:389-402.
42. Wittenbaum GM, Stasser G, Merry CJ. Tacit coordination in anticipation of small group task completion. J Exp Soc Psychol 1996;32:129-52.
43. Kolbe M, Burtscher MJ, Manser T. Co-ACT-a framework for observing coordination behaviour in acute care teams. BMJ Qual Saf 2013;22:596-605.
44. von Schlippe A, Schweitzer J. Systemic interventions. Göttingen, Germany: Vandenhoeck & Ruprecht, 2015.
45. Roussin CJ, Larraz E, Jamieson K, et al. Psychological safety, self-efficacy, and speaking up in interprofessional health care simulation. Clin Simul Nurs 2018;17:38-46.
46. Turner S, Harder N. Psychological safe environment: a concept analysis. Clin Simul Nurs 2018;18:47-55.
47. Loo ME, Krishnasamy C, Lim WS. Considering face, rights, and goals: a critical review of rapport management in facilitator-guided simulation debriefing approaches. Simul Healthc 2018;13:52-60.
48. Newman A, Donohue R, Eva N. Psychological safety: a systematic review of the literature. Hum Resour Manag Rev 2017;27:521-35.
49. Rogers CR. The concept of the fully functioning person. Pastoral Psychol 1965;16:21-33.
50. Allen JA, Yoerger MA, Lehmann-Willenbrock N, et al. Would you please stop that!?: The relationship between counterproductive meeting behaviors, employee voice, and trust. Int J Manag Dev 2015;34:1272-87.
51. Kolbe M, Grande B, Spahn DR. Briefing and debriefing during simulation-based training and beyond: Content, structure, attitude and setting. Best Pract Res Clin Anaesthesiol 2015;29:87-96.
52. Eppich W, Cheng A. Promoting excellence and reflective learning in simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simul Healthc 2015;10:106-15.
53. Kolbe M, Weiss M, Grote G, et al. TeamGAINS: a tool for structured debriefings for simulation-based team trainings. BMJ Qual Saf 2013;22:541-53.
54. Foulk T, Woolum A, Erez A. Catching rudeness is like catching a cold: The contagion effects of low-intensity negative behaviors. J Appl Psychol 2016;101:50-67.
55. Senge P. The fifth discipline: the art and practice of the learning organization. New York: Doubleday, 1990.
56. Billow R. Relational psychotherapy: from basic concepts to passion. London: Jessica Kingsley Publishers, 2003.
57. Bowen M. Family therapy in clinical practice. Northvale, NJ: Jason Aronson, 1994.
58. Epstein R. Keeping boundaries: maintaining safety and integrity in the psychotherapeutic process. Washington, DC: American Psychiatric Press, 1994.
59. Mitchell S. Relational concepts in psychoanalysis: an integration. Cambridge, MA: Harvard University Press, 1988.
60. Sachse R, disorders P. A clarification-oriented psychotherapy treatment model. Göttingen, Germany: Hogrefe, 2019.
61. Rudolph JW, Simon R, Raemer DB, et al. Debriefing as formative assessment: closing performance gaps in medical education. Acad Emerg Med 2008;15:1010-6.
62. Rudolph JW, Taylor SS, Foldy EG. Collaborative off-line reflection: a way to develop skill in action science and action inquiry. In: Reason P, Bradbury H, eds. Handbook of action research: concise paperback edition. London: Sage, 2006.
63. Taylor S, Rudolph JW, Foldy E. Teaching reflective practice in the action science/action inquiry tradition: Key stages, concepts, and practices. In: Reason P, Bradbury H, eds. The SAGE handbook of action research, participative inquiry and practice. London: Sage, 2008.
64. Grant VJ, Robinson T, Catena H, et al. Difficult debriefing situations: a toolbox for simulation educators. Med Teach 2018:40:703-12.
65. Coan JA, Gottman JM. The Specific Affect Coding System (SPAFF). In: Coan JA, Allen JJB, eds. Handbook of emotion elicitation and assessment. Oxford: Oxford University Press, 2007:267-85.
66. McLain Smith D. The elephant in the room. How relationships make or break the success of leaders and organizations. San Francisco, CA: Jossey-Bass, 2011.
67. O'Shea CI, Schnieke-Kind C, Pugh D, et al. The Meta-Debrief Club: an effective method for debriefing your debrief. BMJ Stel 2019:bmjstel-2018-000419.
68. Stone D, Patton B, Heen S. Difficult conversations. New York: Penguin Books, 1999.
69. Porath C. Mastering civility: A manifesto for the workplace. New York: Grand Central Publishing, 2016.
70. Hicks JA, Schlegel RJ, Newman GE. Introduction to the special issue: authenticity: novel insights into a valued, yet elusive, concept. Rev Gen Psychol 2019;23:3-7.
71. Connelly CE, Turel O. Effects of team emotional authenticity on virtual team performance. Front Psychol 2016;7:1336-36.
72. Woolley AW, Chabris CF, Pentland A, et al. Evidence for a collective intelligence factor in the performance of human groups. Science 2010;330:686-8.
73. Brown B. Daring greatly: How the courage to be vulnerable transforms the way we live, love, parent, and lead. London: Penguin, 2015.
74. Krenz HL, Burtscher MJ, Kolbe M. Not only hard to make but also hard to take: Team leaders' reactions to voice. Gruppe. Interaktion. Organisation. Zeitschrift für Angewandte Organisationspsychologie 2019;50:3-13.
75. Cheng A, Morse KJ, Rudolph J, et al. Learner-Centered Debriefing for Health Care Simulation Education: Lessons for Faculty Development. Simul Healthc 2016;11:32-40.
76. Porath CL, Foulk T, Erez A. How incivility hijacks performance: it robs cognitive resources, increases dysfunctional behavior, and infects team dynamics and functioning. Organ Dyn 2015;44:258-65.
77. Prior M. MiniMax Interventions: 15 simple therapeutic interventions that have maximum impact. Carmarthen, UK: Crownhouse, 2017.