HISTORY
Debriefing originated in the military. When soldiers returned from the battlefield, the unit leaders gathered information about what happened in the field, encouraging each soldier to contribute to the conversation in order to ensure a full and accurate account of the event.
The aviation industry has also used debriefing for many years. The focus of debriefing in aviation is on safety and situational awareness; responders are almost always able to anticipate problems with enough time to change the outcome. The military and aviation are two examples of highly reliable organizations. According to the AHRQ (2019), a highly reliable organization is one that operates in a complicated environment and exists for long durations without serious accidents, catastrophes, or failures. High reliability organizations prioritize safety, seeking to create a culture where potential problems are anticipated, detected early, and responded to early enough to prevent tragedies. They focus on five virtues: dedication to resilience, fixation with failure, situational awareness, respect for frontline providers, and unwillingness to simplify explanations. Healthcare aims for high reliability because of the complexity of operations and the potential for catastrophic consequences. Medical simulation programs were the first to use debriefing as part of healthcare; debriefing continues to be an important part of medical simulation. Nursing simulation programs also use structured debriefing as a central learning tool. There is currently some evidence in the medical literature about clinical debriefing, but very limited evidence exists in the nursing literature about clinical debriefing programs. |