Okay, let's talk - short debriefings in the operating room

Introduction Debriefing is increasingly used to enhance learning and reflection in clinical practice. Nevertheless, barriers to implementing debriefings in the operating room (OR) include lack of time, the availability of trained facilitators, and difficulty gathering the full team after surgery. Spending five minutes on a debriefing during skin closure or between procedures may enhance learning and reflection on practice, generating to improve patient safety. The aim of this study was to explore characteristics, feasibility and content of short debriefings in the OR. Methods This was a mixed-method study of short debriefings, analyzing audio-recordings, field notes and relevance ratings from multi-professional teams, that conducted short debriefings in the OR at two University Hospitals in Denmark. Results A total of 135 debriefings were conducted, with a median duration of five minutes (range 1:19 min–12:05 min). A total of 477 team members participated in the debriefings. The teams’ median rating of relevance was 6 (range 1–10). The rating was higher following challenging events and in debriefings where the surgeon actively participated in the conversation. The teams discussed non-technical skills in all the debriefings and verbalized reflections on practice in 75 percent of the debriefings. Conclusion It was feasible to conduct short debriefings in a production-focused, complex work environment. In all the debriefings, the teams discussed various non-technical skills (NTS) and reflected on practice. The majority of team members rated the debriefings as relevant for their task management.publishedVersio

A feeling of flow: exploring junior scientists’ experiences with dictation of scientific articles

BACKGROUND: Science involves publishing results, but many scientists do not master this. We introduced dictation as a method of producing a manuscript draft, participating in writing teams and attending a writing retreat to junior scientists in our department. This study aimed to explore the scientists’ experiences with this process. METHODS: Four focus group interviews were conducted and comprised all participating scientists (n = 14). Each transcript was transcribed verbatim and coded independently by two interviewers. The coding structure was discussed until consensus and from this the emergent themes were identified. RESULTS: Participants were 7 PhD students, 5 scholarship students and 2 clinical research nurses. Three main themes were identified: ‘Preparing and then letting go’ indicated that dictating worked best when properly prepared. ‘The big dictation machine’ described benefits of writing teams when junior scientists got feedback on both content and structure of their papers. ‘Barriers to and drivers for participation’ described flow-like states that participants experienced during the dictation. CONCLUSIONS: Motivation and a high level of preparation were pivotal to be able to dictate a full article in one day. The descriptions of flow-like states seemed analogous to the theoretical model of flow which is interesting, as flow is usually deemed a state reserved to skilled experts. Our findings suggest that other academic groups might benefit from using the concept including dictation of manuscripts to encourage participants’ confidence in their writing skills