Navigating the Emotional Landscape of Debriefing

In the nuanced realm of simulation-based education, one critical aspect that continues to spark debate is the role of emotions in debriefing. In particular, the question of whether facilitators should actively engage and manage emotions as they arise during a debriefing is often controversial.  Emotions play a significant role in how learners reflect, process, and ultimately, improve their performance^1-3. Knowing this, what are the ideal circumstances during which debriefers should actively manage learner emotions?  This article briefly highlights some of the main perspectives and insights around this intriguing topic.

The Emotional Dichotomy in Debriefing

Emotions during debriefing can be perceived as a double-edged sword depending on the situation and how they are managed. On one hand, emotions are sometimes seen by facilitators as unnecessary distractions that could derail the focus from predefined objectives, performance metrics and important feedback. On the other hand, emotions can also be viewed as integral to the learning process, opening pathways to deeper understanding and self-reflection once the underlying drivers of the emotion response are identified.^1-2 The conversational journey taken to explore the emotion can unfreeze existing thought patterns and anchor new knowledge. Emotions, both positive and negative, undeniably influence memory, creativity, cognitive flexibility, attention, and problem-solving abilities. ^{1,2, 4-6} By acknowledging and harnessing emotions, facilitators can lead more effective and impactful debriefing sessions. It becomes tricky, however, when emotions begin to interfere with participation and the overall flow of the session. Addressing emotions isn’t just about validation; it’s about ensuring that they don’t hinder ongoing learning and reflection. Therefore, the question arises: should facilitators engage with emotions during debriefing, or should they focus solely on cognitive aspects?

The Case for Emotional Engagement

Consider situations where facilitators may be faced with confronting strong emotional reactions amongst one or more learners. For example, a learner upset with their performance might become disengaged, distracted, or upset, casting an emotional shadow over the session.⁷ If not addressed, this can potentially disrupt the tone of conversation and dynamics of the entire group. By acknowledging, normalizing and exploring these emotions, facilitators can potentially transform the emotional barrier into a rich learning opportunity for the group. Addressing emotions can also prevent this from overshadowing the entire debriefing, potentially guiding the session into a constructive dialogue rather than an emotional standoff within a psychologically unsafe learning environment.

Sometimes, the emotional display isn’t overtly negative; a learner might experience a release of stress post-simulation and burst into tears, not out of sadness, but relief. Assuming their emotion as negative could lead to mismanagement; so, facilitators must hold their assumptions loosely and keep an open mind when encountering emotions during debriefing. However, even in this circumstance, had the facilitator ignored the emotional response, they might have missed the chance to normalize the experience and clarify the emotions at play. Such examples underline the importance of discerning the type and nature of emotion before deciding on the appropriate course of action.

Emotions in debriefing are also not inherently binary. They don’t have to be managed with an all-or-nothing approach. The ideal strategy typically lies somewhere in between,

acknowledging the emotion’s presence without letting it monopolize the discussion.

Facilitators should aim to create a space where emotions are understood and addressed effectively when necessary and appropriate, while leveraging these conversations to help highlight the objectives of the session.^1,2,8-11 One crucial insight for facilitators is to remain adaptable. Emotions manifest differently across sessions, and strategies should be tailored to fit each unique situation. Simple acknowledgment and validation can often suffice for milder emotional displays, calming the room and allowing the session to progress without much interruption. In other situations, facilitators may have to use additional conversational strategies, such as normalization, paraphrasing, vulnerability and/or storytelling to help defuse the situation.^7,10

Why don’t we do clinical debriefing?

Key Considerations in Managing Emotions

When deciding whether to address emotions during debriefing, facilitators should consider the following factors. We encourage facilitators to carefully reflect on the prevalence and nature of these factors to help guide if and when emotions should be managed during a debriefing.

1. Type of Emotion: Different emotions can have various impacts on the debriefing environment, so it is not simply the type of emotion being conveyed as to whether it should be managed further.  Rather, the choice of whether to address the emotion during debriefing comes down to whether it seems deactivating or displeasing to the individual or the group.

2. Degree of Emotion: The intensity and visibility of emotions can affect their impact on the session. Highly charged overt emotions may be more disruptive and therefore demand attention as opposed to subtle emotions that might be subconscious to learners. Differentiating between a passing emotion and one that disrupts the learning environment is crucial. 

3. Impact on Debriefing: Assess whether the emotion is hindering participation or discussion. If a learner’s emotional state affects group dynamics or their ability to engage, it must be addressed. Mild emotions often require only acknowledgement, while intense emotions may necessitate a deeper exploration.

4. Prevalence Among Learners: The number of participants affected by the emotion should be considered. A phenomenon experienced by many learners is more likely to require collective acknowledgement and further discussion.

5. Facilitator Confidence and Skill: The facilitator’s comfort and skill level in handling emotion greatly influences the outcome. The ability to manage emotions effectively can depend on both experience and comfort level with navigating complex emotional situations. Specific strategies for navigating difficult debriefing conversations can be helpful in these circumstances.⁷ In situations beyond a facilitator’s comfort zone, seeking assistance from more experienced colleagues or resources can provide guidance. Facilitators might also seek out faculty development opportunities to acquire and further hone these skills.

Building Emotional Intuition in Debriefing

The emotional component in debriefing isn’t just about managing outbursts; it’s about reading the undercurrents. Facilitators must develop an intuition to perceive when emotions are veering off course and might necessitate intervention.¹ For example, when addressing technical frustrations like a malfunctioning mannequin, simple acknowledgment and validation can defuse tension quickly. Once vented and understood, the session can proceed to focus on more influential factors affecting performance. Conversely, an undercurrent of frustration in the dialogue, tone and body language amongst team members may require a conversation that goes beyond simple acknowledgement and validation.

Each situation is unique and requires a tailored approach to meet the specific needs of the learners.

What works for one group may not necessarily work for others. Continuous learning and adaptation are vital for facilitators. The facilitation of emotions in a debriefing session isn’t about having a set strategy, but rather about being present, responsive, and adaptable. By understanding and responding appropriately to emotions, facilitators not only enhance the value of the debriefing but also chart pathways to greater learning and self-awareness for their learners.

Summary

In the evolving landscape of education, understanding and managing emotions is not just an optional skill, but an indispensable one. Emotions are an intricate part of any learning process, especially during debriefing sessions following simulation training. While the debate continues over their role, this article underscores specific considerations where managing emotions becomes essential so that engaging with emotions doesn’t detract from learning, but rather enriches it.

The goal is not just to manage emotions but to harness them in a way that enhances learning outcomes.

By adopting nuanced strategies that balance emotional intelligence and intuition with educational objectives, facilitators can create a dynamic and constructive debriefing environment that caters to both the cognitive and emotional needs of learners.

Acknowledgement

This article contains original content from a ‘Coffee Talk’ lesson in the Advanced Debriefing course of the Academy Archive (www.academyarchive.com) featuring Vincent Grant and Adam Cheng. Descript (generative AI software) was used to summarize the main messages from the lesson, which was then edited by both Vincent Grant and Adam Cheng for grammar, punctuation, readability, and accuracy.

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