A Qualitative Study of Resident Experiences With Clinical Event Debriefing

Author:

Galligan Meghan M.12,Goldstein Laura1,Garcia Stephanie M.3,Kellom Katherine3,Wolfe Heather A.4,Haggerty Mary1,DeBrocco Dawn5,Barg Frances K.6,Friedlaender Eron1

Affiliation:

1. aDepartment of Pediatrics

2. bCenter for Pediatric Clinical Effectiveness

3. cPolicy Laboratory

4. dDepartment of Anesthesiology and Critical Care Medicine

5. eDepartment of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

6. fDepartment of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

Abstract

OBJECTIVES The facilitated discussion of events through clinical event debriefing (CED) can promote learning and wellbeing, but resident involvement is often limited. Although the graduate medical education field supports CED, interventions to promote resident involvement are limited by poor insight into how residents experience CED. The objective of this study was to characterize pediatric resident experiences with CED, with a specific focus on practice barriers and facilitators. METHODS We conducted this qualitative study between November and December 2020 at a large, free-standing children’s hospital. We recruited pediatric residents from postgraduate years 1 to 4 to participate in virtual focus groups. Focus groups were digitally recorded, deidentified, and transcribed. Transcripts were entered into coding software for analysis. We analyzed the data using a modified grounded theory approach to identify major themes. RESULTS We conducted 4 mixed-level focus groups with 26 residents. Our analysis identified multiple barriers and facilitators of resident involvement in CED. Several barriers were logistical in nature, but the most salient barriers were derived from unique features of the resident role. For example, residents described the transience of their role as a barrier to both participating and engaging in CED. However, they described advancing professional experience and the desire for reflective learning as facilitators. CONCLUSIONS Residents in this study highlighted many factors affecting their participation and engagement in CED, including barriers related to the unique features of their role. On the basis of resident experiences, we propose several recommendations for CED practice that graduate medical education programs and hospitals should consider for supporting resident involvement in CED.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health

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