Effect of a combined debriefing on team performance during an interprofessional simulation course for Crisis Resource Management: a randomized, controlled, multicenter study.

houze-cerfon charles-henri, Sylvain Boet, Michèle Saint-Jean, Jérôme Cros, Fanny Bounes-Vardon, Fouad Marhar, Sebastien Couarraze, Guillaume Der Sahakian, Laurent Mattatia, Laurent Nicolle, Frederic Balen, Sandrine Charpentier, Vincent Bounes, Thomas Geeraerts



Interprofessional simulation (IPS) has proven its effectiveness in learning crisis resource management. Debriefing modalities may affect psychological safety and team performance during IPS. This study aims to compare the effectiveness of combined debriefing with standard debriefing on team performance during crisis situations in acute care.


The interprofessional simulation session consisted in 3 successive scenarios for crisis situations performed by 3 teams. 30 sessions were randomly allocated to receive standard debriefing or combined debriefing (an individual debriefing followed by a collective debriefing) in 4 simulation centers. The first team was the only one to manage 2 scenarios, one pre-test and one post session (post-test). Blinded assessors used videotapes to evaluate the performance with the Team Emergency Assessment Measure. The quality of the debriefings was assessed by participants using the Debriefing Assessment for Simulation in Healthcare©.


Between February and October 2017, 90 interprofessional teams made of 2 to 4 participants took part in the study. There were no differences in the primary outcome between groups (p=0.64). Team performance improved similarly in both groups from pre-test to post-test (p<0.01). The improvement in leadership skill was higher in the combined debriefing than the standard debriefing group (p< 0.05) and the level of psychological safety and learning experience were significantly more effective (p<0.05).


During interprofessional simulation for crisis situation training, standard debriefing and combined debriefing improve global team performance without significant differences between both. Combined debriefing could be more effective at improving leadership skill, psychological safety and learning experience.

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