Debriefing with honest curiosity

The idea in one sentence: when you talk with someone after they’ve practised, say honestly what you saw and what you made of it, then ask a real question about what they were thinking. You don’t hide your view, and you don’t assume you already know why they did it.

You’ve seen this already

Picture two driving instructors after a learner misses a give-way sign.

The first says nothing, smiles, and asks, “So, how do you think that went?” The learner says, “Fine, I think.” They drive on. The learner never finds out what the instructor saw.

The second says, “I noticed we went through that junction without slowing. I was worried we hadn’t seen the sign. What was happening for you there?” The learner says, “I was watching the cyclist on the left.” Now they can talk about the real problem: where to look, and when.

The second instructor shared a view and stayed curious. That’s the whole idea.

Why it matters for your teaching

You might debrief a simulation, or talk with a student nurse after a drug round, or chat with a new healthcare assistant after their first manual handling task on the ward. In each case, people tend to slip into one of two traps:

• The vague debrief. You keep your view to yourself so nobody feels judged. But people can’t fix what they can’t see. And your view leaks out anyway, through your tone and the questions you choose.
• The verdict. “You should have called for help sooner.” It’s clear, but it shuts the conversation down. You don’t find out why they waited, so you can’t help them change it.

Debriefing with good judgement sits between them. You start from the view that the person had a reason for what they did. If you understand their thinking, you can help them change what they do next time. That’s what the whole debrief is for.

Try this

• Say what you saw, before you ask about it. “I noticed you started the obs before checking the patient’s name band.” Be specific, and describe something you could point to.
• Keep what you saw apart from what you think it means. “You seemed rushed” is a guess. “You did the history in about four minutes” is what happened. Start with what happened, then offer your guess as a guess.
• Ask a question you don’t know the answer to. “What was going through your mind at that point?” works. “Don’t you think you should have…?” doesn’t.
• End with the next time. Agree one thing they’ll do differently, and where. See feedback and feedforward.

How sure are we?

Fairly sure that debriefing matters; much less sure about which style is best. A review that pooled many simulation studies found debriefing was linked to better learning, but it could say little about which way of debriefing works best.

The good-judgement approach itself comes from a team’s long experience of teaching with simulation and from ideas about how people make sense of their actions. It is a practical method, not a tested result. It has hardly been compared head-to-head with other styles (the few comparisons are small), and it was built for simulation rooms rather than quick chats on a busy shift. It also takes practice: staying truly curious when you’re sure you know the answer is hard.

One common misreading: “non-judgemental” doesn’t mean having no view. The point here is to be honest about your view and open to being wrong.

Where it comes from

Jenny Rudolph and colleagues at the Center for Medical Simulation in Massachusetts, USA, set out the approach in two papers, in 2006 and 2007. They argued that “non-judgemental” debriefing, a popular and widely taught style, doesn’t really exist, because the person debriefing always has a view. Their answer was to pair a clear statement of that view with genuine questions about the learner’s thinking.