DEEP DIVE - Clinical Event Debriefing with Prof Walter Eppich and A/Prof Andrew Coggins
The Critical DebriefShow Notes
(AI) What is clinical event debriefing, how does it differ from the simulation debriefing we all know, and how do you actually make it routine in a busy ED? Emergency clinicians Prof Walter Eppich and A/Prof Andrew Coggins join host Kit Rowe and the team for a deep dive. The panel works through what "clinical event debriefing" (CED) really means and how it differs from simulation debriefing: it follows a real patient event, is rarely planned, and often happens when the team is most emotionally activated. A central thread is aligning intention with impact — distinguishing debriefing to learn, to manage, and to treat, and the risks of drifting into psychological treatment without the training for it. The bigger missed opportunity, they argue, is reserving debriefing only for catastrophic events, when routine, brief, learning-oriented debriefs build the skills and psychological safety a team needs before the critical case arrives. Along the way: who should facilitate (and why it shouldn't default to the team leader), end-of-shift check-ins, "coffee and cases," M&M as after-action review, retrieval-medicine debriefing, and the support gap facing senior clinicians — "who debriefs the debriefers?" The consistent takeaway: pick a simple framework and use it, keep it short, lead with shared understanding and humility, and just start debriefing. Host: Kit Rowe | Panel: Pramod Chandru, Caroline Wilson | Guests: Prof Walter Eppich (University of Melbourne), A/Prof Andrew Coggins (Westmead) ⏱️ Episode timestamps 00:00 – Disclaimer 00:13 – Intro music 00:30 – Welcome and panel introductions 02:08 – Opening question: what is clinical event debriefing? 03:04 – CED vs simulation debriefing; the after-action review and its origins 04:36 – Key differences: a real patient, usually unplanned, compressed time 09:09 – Is CED only for "sinister" events? Reconciling experience with its potential role 11:05 – Learning vs caring for traumatised staff; aligning intention and impact 14:51 – Support at 3am without a psychologist: psychological first aid (look, listen, link) 16:59 – The learn–manage–treat spectrum; the COVID-era genesis of the BMJ paper 21:46 – Who should lead a debrief? Charge-nurse facilitation; self-led teams 27:34 – Debriefing the shift rather than the single event; translational simulation 30:16 – The STOP5 hot-debrief tool 30:47 – What to ask in a routine end-of-shift debrief 32:08 – Pramod's case (fat embolus, cardiac arrest); "who debriefs the debriefers?" 33:21 – Andrew's observational study; check-ins and building psychological safety 35:44 – Peer support and the loss of community on becoming a consultant 38:53 – Making sense of an event with a trusted colleague 41:28 – Preparing peers to debrief each other; ongoing research collaboration 43:46 – Community of practice; separating coaching/mentorship from debriefing 46:03 – Walter's case story: an overnight paediatric tragedy and an informal debrief 48:35 – Structure and frameworks: use one, keep it simple; humility as a leader 51:01 – Shared understanding and ground rules as the core of a safe debrief 52:00 – M&M as after-action review; "outcome review" and ground rules 54:11 – Debriefing in retrieval medicine; "coffee and cases" 56:02 – "Just start debriefing"; systematic review of tools; the INFO tool; the seatbelt analogy 58:56 – Wrap-up: take-home messages from the panel 59:47 – Briefing and debriefing synergy; team reflection research 1:01:14 – Sign-off 📚 References & resources (in order of discussion) Kolbe M, Schmutz S, Seelandt JC, Eppich WJ, Schmutz JB (2021). Team debriefings in healthcare: aligning intention and impact. BMJ. 2021;374:n2042. https://doi.org/10.1136/bmj.n2042 (~11:05) Keiser NL, Arthur W Jr (2021). A meta-analysis of the effectiveness of the after-action review (or debrief) and factors that influence its effectiveness. Journal of Applied Psychology. 2021;106(7):1007–1032. https://doi.org/10.1037/apl0000821 (~11:44) Keiser NL, Arthur W Jr (2022). A meta-a
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