Debriefing with Students

One of your primary responsibilities as a preceptor is facilitating lessons learned through the clinical experience. It’s one thing to witness an experience; it’s quite another to discuss, analyze and learn from the experience. Debriefing is one of the most powerful learning tools, and you, the preceptor, are the facilitator of this essential learning experience.

Why Debrief?

Debriefing is a type of retrospective analysis of critical incidents in health professions, including nursing.  Briefing as well as debriefing, enhances clinical skills, improving quality patient care.

The Debriefing Process

Debriefing is two-way communication between the student and the preceptor.  The process is not limited to feedback on performance, but also entails communication that enables students to reflect upon and enhance self-awareness for future performance.

Adults learn best when actively engaged. A daily briefing and debriefing routine can enrich the overall teaching/learning experience.

Debriefing and Kolb’s Experiential Learning Cycle

David Kolb, educational theorist and founder of Experience-Based Learning Systems, published his learning styles model in 1984, including an experiential learning cycle model that has proved to be very helpful for our preceptors as they work with students.

Kolb’s experiential learning cycle asserts that material is best absorbed and processed if the learner goes through the following four stages:

Stage One: Concrete Experience 
The student encounters a new experience or gets to experience an experience s/he has previously had.

Stage Two: Reflective Observance
The student reflects upon the experience, taking care to pay special attention to inconsistencies between what was anticipated and what happened.

Stage Three: Abstract Conceptualization
The student allows the reflection process to give way to new ideas.

Stage Four: Active Experimentation
The student takes the lessons learned from the first experience and applies this new knowledge to subsequent experiences, testing theories and starting the cycle over again.

In sum, the cycle consists of experience, reflection, conceptualization, and testing of new ideas.

For more details, view the following videos about the value of debriefing:

Effective Debriefing

Effective debriefing makes use of the principles explored in Kolb’s experiential learning cycle. Our preceptors use this learning cycle as the foundational structure for debriefing students after experiences with patients. Students are encouraged to articulate observations about the experiences they have with patients. Preceptors facilitate reflective discussion and conceptualization of clinical reasoning. Students test out plans and processes, and the cycle is repeated.

When debriefing, following these simple five steps to facilitate reflective observance and abstract conceptualization:

  • Get the student to commit to a diagnosis and treatment option.
  • Probe for supporting evidence that the diagnosis and treatment plan is viable.
  • Use this patient visit as a springboard to teach general rules that can be applied to this and other situations.
  • Reinforce what was done right.
  • Correct mistakes.

Debriefing using reflection and feedback is an essential part of clinical education. Debriefing helps students understand clinical reasoning and decision making, preparing them for the future when they will have to make similar decisions on their own.