Debriefing Session: The Process of Self-Evaluation

  • Seema Yalamanchili
  • Sophie E. J. Hardy
  • Christopher AylwinEmail author
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


Major incidents can exert significant stress on existing emergency systems as they attempt to address the fallout from such events. In the aftermath, there is a window of opportunity for evaluation where lessons can be noted and carried forward to increase the resilience of the organisations and systems involved. Recent meta-analysis has shown that properly conducted debriefs can improve both individual and team performance by 20–25% (Tannenbaum and Cerasoli, Hum Factors, 55, 231–45, 2013).

Simplistically, debrief is a series of questions about a completed mission or undertaking ( However, when performed in a timely and systematic fashion, the major incident debrief permits those involved to communicate their experiences and identify potential improvements in operational performance. Major incident plans and training can then be modified to reflect these lessons.

The teaching and culture around the debrief has been developed amongst several different emergency services in different regions of the world, but learning from a major incident is often confined to the individuals or organisation directly involved. As the frequency of major incidents increases internationally, the process of recording and reporting information from them so that knowledge is shared beyond the organisations affected is a vital, though often neglected, part of the major incident debrief (Leaning and Guha-Sapir, N Engl J Med, 369, 1836–42, 2013;; Hardy, BMJ, 31, 350, 2015).


  1. 1.
    Leaning J, Guha-Sapir D. Natural disasters, armed conflict and public health. N Engl J Med. 2013;369:1836–42.CrossRefGoogle Scholar
  2. 2.
    Global Terrorism Index 2017. Institute for Economics and Peace. 2017. Accessed 15 Feb 2018.
  3. 3.
    Blom L, Black JM. Major incidents. BMJ. 2014;28:348.Google Scholar
  4. 4.
    Mackway-Jones K. Major incident medical management: the practical approach at the scene. 3rd ed. Chichester: Blackwell-Wiley; 2012.Google Scholar
  5. 5.
    Kolb D. Experiential learning: experience as the source of learning and development. 1st ed. Englewood Cliffs: Prentice Hall; 1984.Google Scholar
  6. 6.
    Hecker A. Knowledge beyond the individual? Making sense of a notion of collective knowledge in organization theory. Organ Stud. 2012;33:423–45.CrossRefGoogle Scholar
  7. 7.
    Rajan A, Lank E, Chappel K. Good practices in knowledge creation and exchange. 1st ed. Tunbridge Wells: Create; 1998.Google Scholar
  8. 8.
    Easterby-Smith M, Araujo L. Organizational learning: current debates and opportunities. In: Easterby-Smith M, Araujo L, Burgoyne J, editors. Organizational learning and the learning organization: developments in theory and practice. London: Sage; 1999. p. 1–21.Google Scholar
  9. 9.
    Collison C, Parcell G. Learning to fly: practical knowledge management from leading and learning organisations. Chichester: Capstone Press; 2004.Google Scholar
  10. 10.
    Vashdi DR, Bamberger PA, Erez M, Weiss-Meilik A. Briefing-debriefing: using a reflexive organizational learning model from the military to enhance the performance of surgical teams. Hum Resour Manage. 2007;46:115–42.CrossRefGoogle Scholar
  11. 11.
    Wiltshire Policeforce Procedure. Debriefing procedure (critical incidents). 2017. Accessed 15 Feb 2018.
  12. 12.
    Marcellin JD. The Pilot Factor: a new look into CRM. Dayton: Plane & Simple Solutions; 2014.Google Scholar
  13. 13.
    National Health Service, England. Human factors in healthcare: a concordat from the National Quality Board. 2013. Accessed 15 Feb 2018.
  14. 14.
    Catchpole K. Spreading human factors expertise in healthcare: untangling the knots in people and systems. BMJ Qual Saf. 2013;22:793–7.CrossRefGoogle Scholar
  15. 15.
    Tannenbaum SI, Cerasoli CP. Do team and individual debriefs enhance performance? A meta-analysis. Hum Factors. 2013;55:231–45.CrossRefGoogle Scholar
  16. 16.
    Association of Anaesthetists of Great Britain and Ireland. Catastrophes in anaesthetic practice – dealing with the aftermath. 2005. Accessed 15 Feb 2018.
  17. 17.
    Shalev AY. Post traumatic stress disorder. Prim Psychiatry. 2001;8:41–6.Google Scholar
  18. 18.
    Hunt P, Greaves I. Oxford manual of major incident management. Oxford: Oxford University Press; 2017.CrossRefGoogle Scholar
  19. 19.
    Williams R, Bisson J, Ajdukovic D, Kemp V, Olff M, Alexander D, Hacker Hughtes J, Bevan P. Guidance for responding to the psychosocial and mental health needs of people affected by disasters or major incidents. 2009. . Accessed 15 Feb 2018.Google Scholar
  20. 20.
    Lederman L. Debriefing: a critical re-examination of the post-experience analytic process with implications for its effective use. Simul Games. 1984;15:415–31.CrossRefGoogle Scholar
  21. 21.
    Rose SC, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2002;(2):CD000560.
  22. 22.
    Hawker DM, Durkin J, Hawker DS. To debrief or not to debrief our heroes: that is the question. Clin Psychol Psychother. 2011;18:453–63.CrossRefGoogle Scholar
  23. 23.
    Everly G, Lating J. The Johns Hopkins guide to psychological first aid. Baltimore: John Hopkins University Press; 2017.Google Scholar
  24. 24.
    The Task Force on International Trauma Training of ISTSS. Guidelines for international training in mental health and psychosocial interventions for trauma exposed populations in clinical and community settings. Accessed 15 Feb 2018.
  25. 25.
    College of Policing. Operations: briefing and debriefing. 2013. Accessed 15 Feb 2018.
  26. 26.
    “debrief, n.1”. Oxford dictionaries online. 2018. Oxford University Press. Accessed 15 Feb 2018.
  27. 27.
    McLelland J. Organisational learning and how marginal gains can be made by debriefing and improving how they do activities next time, making best use of knowledge and management. 2015. Accessed 15 Feb 2018.
  28. 28.
    NHS England. NHS England Emergency Preparedness, Resilience and Response (EPRR) Business Continuity Management toolkit; 2016.Google Scholar
  29. 29.
    Norman S. Organisational debriefing and reporting. In: Norman S, et al., editors. Health emergency planning: a handbook for practitioners. London: TSO; 2006. p. 121–5.Google Scholar
  30. 30.
    Campbell M, Miller K, McNicholas K. Post event debriefs: a commitment to learning how to better care for patients and staff. Jt Comm J Qual Patient Saf. 2016;42(1):41–7.CrossRefGoogle Scholar
  31. 31.
    Carley S, Mackway-Jones K, Donnan S. Major incidents in Britain over the past 28 years: the case for the centralised reporting of major incidents. J Epidemiol Community Health. 1998;52:392–8.CrossRefGoogle Scholar
  32. 32.
    Smith E, Wasiak J, Sen A, Archer F, Burke F. Three decades of disaster: a review of disaster specific literature from 1977-2009. Prehosp Disaster Med. 2009;24:306–11.CrossRefGoogle Scholar
  33. 33.
    Fattah S, Rehn M, Wisborg T. Implementing a template for major incident reporting: experiences from the first year. Scand J Trauma Resusc Emerg Med. 2015;23:55.CrossRefGoogle Scholar
  34. 34.
    Bradt D, Aitken P. Disaster medicine reporting: the need for new guidelines and the CONFIDE statement. Emerg Med Australas. 2010;22:483–7.CrossRefGoogle Scholar
  35. 35.
    World Association for Disaster and Emergency Medicine & Nordic Society for Disaster Medicine. Health disaster management: guidelines for evaluation and research in the “Utstein style”. Prehosp Disaster Med. 2003;17(Suppl):1–167.Google Scholar
  36. 36.
    Hardy S, Fattah S. Trials and tribulations: how we established a major incident database. Scand J Trauma Resusc Emerg Med. 2017;5:7.CrossRefGoogle Scholar
  37. 37.
    Major Incident Reporting. Accessed 15 Feb 2018.
  38. 38.
    Hardy S. Major incidents in England. BMJ. 2015;31:350.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Seema Yalamanchili
    • 1
  • Sophie E. J. Hardy
    • 2
  • Christopher Aylwin
    • 1
    Email author
  1. 1.St Mary’s HospitalLondonUK
  2. 2.St George’s HospitalLondonUK

Personalised recommendations