Debriefing refers to the process whereby participants re-examine a learning encounter so as to develop the appropriate competencies required for clinical practice. The value of performance debriefing is that it allows trainees to discuss their performance with a trainer so as to identify gaps and strategies for improvement. In doing so, it can improve future performance and reduce adverse events.

Although extensively employed by other safety-critical industries, empirical evidence on debriefing in surgery is surprisingly sparse. Consequently, an ad-hoc approach has evolved, mostly based on expert opinion rather than primary evidence. An inability to measure debriefing quality has also hindered the provision of formative feedback to trainers (i.e. the debriefers) on how to improve their debriefing practices.

To address this gap, we developed the Objective Structured Assessment for Debriefing tool (OSAD). OSAD is based on a systematic review of the literature as well as expert opinion of clinical debriefers across 3 continents (UK, USA, and Australia).

Based on the synthesis of the evidence base and expert opinion, OSAD includes 8 core elements of a high quality performance debrief – including Approach, Learning Environment, Learner Engagement, Reaction, Reflection, Analysis, Diagnosis, and Application.

For each element, a 5-point behaviourally anchored rating scale is provided, such that a debriefing can be evaluated across these 8 parameters and feedback can be provided to the debriefer aimed at improving the quality of the debrief.



Arora S, Ahmed M, Paige J, Nestel D, Runnacles J, Hull L, Darzi A, Sevdalis N. Objective Structured Assessment of Debriefing (OSAD): Bringing science to the art of debriefing in surgery. Annals of Surgery 2011 (in press)

Ahmed M, Sevdalis N, Paige J, Paragi-Gururaja R, Nestel D, Arora S. Identifying best practice guidelines for debriefing in surgery: A tri-continental study. American Journal of Surgery 2011 (in press)


Please contact Sonal Arora for further information.