Debriefing to improve interprofessional teamwork in the operating room: a systematic review

Purpose Debriefing has been pivotal in medical simulation training but its application to the real-world operating room environment has been challenging. We reviewed the literature on routine surgical debriefing with special reference to its implementation, barriers, and effectiveness. Design Descriptive systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methods Inclusion criteria were papers pertaining to debriefing in routine surgical practice. Excluded were papers reporting simulation training. We searched Google Scholar, CINAHL, Web of Science Core Collection, PsychINFO, Medline, Embase, and ProQuest Theses & Dissertations Global. The last search was performed on 14 March 2022. Quality was assessed on a 21-point checklist adapted from a standard reporting guideline. Synthesis was descriptive. Findings The search process resulted in 19 papers. Publication date ranged from 2007 – 2022. Study methods included surveys, interviews, and analysis of administrative data. Five papers involved a specific intervention. Quality scores ranged from 12 – 19 out of 21. On synthesis, we identified five topics: explanations of how debriefing had been implemented; the value of coaching and audit; the learning dimensions of debriefing, both team learning and quality improvement at the organizational level; the effect of debriefing on patient safety or the organization’s culture; and barriers to debriefing. Conclusions Debriefing is valuable for team learning, efficiency, patient safety, and psychological safety. Successful implementation programs were characterized by strong commitment from management and support by frontline workers. Integration with administrative quality and safety processes, and information feedback to frontline workers are fundamental to successful debriefing programs.