Diversifying Description Phase Techniques During Debriefing

Diversifying Description Phase Techniques During Debriefing | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Method Article Diversifying Description Phase Techniques During Debriefing Núria Serrat-Antolí, Susana Orozco-Martínez, Aida Camps-Gómez, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8462808/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract The description phase of debriefing in simulation is an essential moment for reconstructing the sequence of events, consolidating learning, and preparing a rigorous analytical reflection. It is configured as a primarily collective process aimed at generating a shared mental model of what occurred, labeling the key elements of the experience, and facilitating their retention in long-term memory. It also enables the precise identification of turning points and critical decisions, linking actions with their clinical, relational, and organizational consequences. Building on an ecosystem of variables—type and complexity of the simulation, nature of the objectives (technical and non-technical), characteristics and experience of participants, number of agents involved, time available, and facilitator expertise—the description phase can be structured through different visual and narrative techniques. These include chronological axes by levels, by agents, or by objectives, as well as contrast, 5W, and event matrices, which allow information to be organized according to roles, sequences, resources, and macro-sequences of action. This repertoire of structures supports methodological customization of debriefing, enhances the clarity and organization of information, promotes early identification of critical aspects, and increases the precision of subsequent analysis. Such diversification of descriptive techniques raises challenges related to the need for specific training, the risk of selecting structures based on merely formal criteria, and the time constraints inherent to many simulation activities. Further research is proposed on the comparative impact of each technique in different contexts, as well as on their influence on the cognitive load of facilitators and participants. These techniques ultimately offer flexible and purposeful frameworks for aligning case reconstruction with educational objectives and with the specific needs of each group. debriefing description phase visualization techniques simulation-based education Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 1. Debriefing: Description phase in literature Debriefing is an essential component of any simulation experience. This process is defined as a key moment for consolidating learning and engaging in guided, structured reflection on the simulated practice (1–6). It represents an intrinsic component of zone 2 or 3 simulations (Roussin & Weinstock, 2017), in which, based on predefined objectives to varying degrees, the events that occurred –and the interpretations and perspectives derived from them– are analysed by both active participants and observers (8–11). The literature shows broad consensus regarding the different stages that constitute the debriefing process. Concurrently, in the reference models, the following stages are identified: emotional decompression (also referred to as “reactions”), description, analysis, and summary or transfer (12). Among these, the description phase (also called “facts,” “understanding,” or “review”– 12, 19, 20, 21) appears in nearly all models, serving as a fundamental moment that fulfils several key purposes: Confirming that participants have understood the simulated situation, thereby avoiding potential subsequent misunderstandings (13), Detailing the participants’ recollection of the simulation; and Establishing a shared mental model of what happened during the event. (14) The literature confirms that the description phase is primarily a collective process, where participants collaboratively create a shared overview of the events, identifying the most relevant moments of the scenario. During this moment, a sort of index of key events is created from the perspective of each participant (14, 15). This process establishes a common ground that facilitates the transition to the analysis, where a thorough examination and critical evaluation of the elements identified as significant is carried out. In a sense, the description provides a structured recollection while deliberately avoiding premature interpretation or evaluation. Despite its intrinsic relevance within the debriefing process, the existing literature offers limited guidance on how to implement this phase or on the different techniques that may maximize its effectiveness. One of the most notable approaches is the Timeline Debriefing Tool developed by Secheresse and Nonglaton (14), which proposes an excellent seven-step procedure. This model uses a timeline as the main tool to organize the events that occurred according to participants’ perceptions. Based on more than ten years of experience designing and conducting simulation and debriefing experiences in undergraduate and postgraduate programs, as well as in simulation programs for professional teams, we propose additional systematic approaches to conducting the description, implemented depending on a set of variables that may influence or support the selection of one strategy over another. 2. Ecosystem of Variables in Selecting the Description Technique When determining the most suitable debriefing approach for a particular group, it is imperative to consider a set of critical variables that warrant thorough analysis. These variables –diverse and complex in nature– exert a significant influence on the effectiveness of the debriefing process and, therefore, must not be underestimated or overlooked in methodological decision-making (16). In turn, these variables have a direct impact on the description phase. Several variables have been identified as relevant to the choice and implementation of debriefing approaches (17), such as the objectives, type of simulation, learners’ level, debriefing environment, equipment and facilitator expertise. From our perspective, these elements form an ecosystem of variables that should systemically influence the design of the simulation experience (from its design to the implementation of debriefing and subsequent evaluation). Consequently, this ecosystem should also be considered during the description stage of debriefing, taking into account, for example: Types of objectives and/or skills to be achieved through simulation, whether these are primarily hard skills or power skills, or a combination of both. The description may require different approaches, depending on the objectives that are being developed. Nature of the participant group and time of development : group of students with the same or different profile, natural team, unidisciplinary group, etc. It is also relevant to determine whether participants are new in their roles, experienced professionals or if updating, consolidation, or review of existing knowledge is required, etc. Degree of knowledge of the simulation methodology . In groups with prior simulation experience, the description technique may evolve, as well as stimulate their direct involvement in the process. Degree of maturity, openness and knowledge of team members. Although the description stage is arguably the most neutral part of debriefing, describing what occurred is not always perceived positively, as factors such as seniority, hierarchy, and prior experience may intervene. The number o f participants involved in the scenario may condition the type of descriptive visualization that is required. For instance, whether the simulation involves a single actor or multiple participants may lead to the selection of a particular schema during the description. The complexity of the situation to be simulated will require using more or less comprehensive description techniques and highlighting varying degrees of detail. Complexity will influence both the level of detail that is intended to be reached during the description and the debriefer's ability to record what happened (even when supported by video recording). Linearity of action , that is, whether the simulation follows “the” correct way to act (e.g. a protocol) or allows for multiple valid approaches, each with its own consequences. Available time for debriefing. Since time constraints often limit debriefing, it is necessary to choose among description options, and some of them require more dedication than others (and more if we combine them with other variables in this list). Roles of the group and facilitator. Although we understand that both the group and facilitator can intervene more or less directly in the description phase, it is true that the combination with other variables can affect their degree of direct participation. For instance, a complex simulation may require greater facilitator input to clarify participants’ actions, whereas a group with limited experience in simulation methodology may need closer guidance by the debriefer to identify key moments of the scenario. Undoubtedly, the facilitator’s expertise in simulation methodology will significantly influence both the effectiveness of this stage and the overall quality of the debriefing process. Considering these different variables, there is no doubt that the visual materialization of the description phase and its role during debriefing contribute to: First, labelling what has occurred in the recent past–a mental process necessary to ensure the review, cataloguing and incorporation into memory of key events to be remembered (18). Second, generating a shared narrative by selecting specific terms that may be linked either to particular theoretical frameworks (depending on the disciplinary content) or to experiences, sensations and other elements that emerge from the shared experience and become a collective, real-time account. Third, to a subsequent review of events about which uncertainty may exist (e.g., whether something occurred or not, its chronological order within the sequence, or who carried it out, etc.). Fourth, serving as a reference point for both the debriefer and the group, allowing them to return to it to ensure that no analytical point is overlooked (if deemed relevant). Finally, enabling more precise feedback, when necessary (16), by referring to elements that the group itself has previously identified as relevant. In light of these considerations, we propose a series of techniques for visualizing and structuring the description phase that aim to maximize its potential and guide participants toward a more detailed and contextually meaningful review of events. Several of them can be applied with the general procedural framework established by Secheresse and Nonglaton (14), while incorporating specific steps and processes according to the variables and implementation context. 3. Techniques for Implementing the Description Phase From this conceptual framework and the described ecosystem of variables, a range of techniques is presented below for operationalizing the description stage of debriefing, with the aim of cognitively, visually, and narratively structuring the events of the scenario in a manner aligned with the characteristics of the group and the educational objectives. 3.1. Chronological Axis by Levels This type of axis can be particularly useful when the goal is to explore certain details of the action and to distinguish between different types of events. Using the Timeline Debriefing Tool , the chronological axis is visually divided into two levels: an upper and a lower one. Each level displays pre-agreed aspects between the debriefer and the group. For example, the upper level may represent actions implemented (e.g., in an anaphylactic shock), while the lower level indicates the medications administered at each point. This dual-level axis is intuitive for groups with less experience in simulation methodology and can be made as complex as the group’s and debriefer’s require (e.g., by adding another level to incorporate further meaning, such as key phrases). It presents challenges in scenarios with numerous and diverse actions or many participants, and it does not always allow objectives to be clearly broken down. Image 1. Chronological Axis by Levels. 3.2. Chronological Axis by Agents This type of chronological axis is suitable when different agents participate in the simulation, ideally two. Its purpose is to visualize, in sequence, what occurred in the scenario while distinguishing the roles involved. The Timeline Debriefing Tool is used, but with two distinct colours (one for each agent or role), or by using initials that refer to the person’s name or role (e.g., P – paediatrician; N – nurse for critical patients). After the elaboration of the chronological axis, the interventions of each of the agents are quickly observed. Although they can be used with more agents/roles, from 3 onwards we recommend using other techniques, for example, the contrast matrix. Our experience suggests that this approach is most appropriate for low-complexity simulations involving two roles and for groups with limited familiarity with simulation methodology. Image 2. Chronological Axis by Agents. 3.3. Chronological Axis by Objectives This type of axis is suitable when multiple objectives of different natures exist (e.g., one technical and one non-technical). The Timeline Debriefing Tool is employed, placing on the left-hand column the different objectives to be achieved (these can already be written on the board). The description then focuses on how each objective unfolds over the course of the time sequence. This technique can be combined with the previous one by adding colors or initials next to each action, or by writing each action in a predetermined color (associated with a specific role). Ideally, two roles are manageable (especially for the debriefer), although experienced groups can help complete the distribution of actions along the axis. A challenge arises when there are two distinct types of objectives (particularly when one is technical and the other attitudinal) since the level of descriptive detail often differs between them (usually to the detriment of the latter). It is therefore essential that both the debriefer and the group maintain a high level of awareness regarding the actions carried out in relation to both types of objectives. Image 3. Chronological Axis by Objectives. 3.4. Contrast Matrix This matrix is especially suitable when participants with diverse professional profiles take part in a simulation (for example, multidisciplinary teams, whether in initial training or continuing education). Its purpose is to compare the actions carried out by each participant across time and to visualize the contribution of each member to the overall activity. On the horizontal axis, the key moments of the simulation are represented –that is, the main actions that shaped the scenario (e.g., a protocol or a critical interprofessional situation, etc.). On the vertical axis, the roles or professional profiles involved in each action are listed (e.g., physicians, nurses, assistants, etc.). A third horizontal line at the bottom can indicate the passage of time during the event. There are at least two ways to apply it: The description begins by identifying the main moments as large blocks on the horizontal line, and, in the vertical line, the individuals participating in each key moment (marking an X or a circle in the corresponding profile) are identified; or, The description begins by identifying the main moments as large blocks, and, subsequently, the concrete action of each of the participants at each moment is specified. The specific action can be described with one or two key words. The first version is recommended for groups with limited experience in interdisciplinary simulations or those experiencing their first simulations, while the second version enables greater situational awareness regarding each participant’s contribution. If a layer related to objectives is desired, a color code (one color per objective) or a symbolic code (one symbol per objective) can be added in each cell. In some cases (ideally), the matrix can be maintained throughout the session, allowing objectives to be identified at the end by placing the code of each objective in each cell, as appropriate. This technique fosters a broader, integrative view of the scenario and promotes early awareness –right from the start of the debriefing– of each member’s contribution to the collective performance. Image 4. Contrast Matrix. 3.5. 5W Matrix It is particularly suitable when an objective and direct description is desired, without delving excessively into the underlying reasons for the events. The description is structured through four columns, each corresponding to a question: when, what, who and with what (a fifth column for where may be added, if applicable). Then, according to the time, in the following column the different actions carried out are written (from top to bottom). In the third column is recorded who has carried out each action and in the last, what resources have been used (human, material, temporary, etc.). Participants can collaboratively construct this matrix, resulting in a clear and concise overview of the situation through the identification of four key elements: time, action, participants and resources employed. More experienced groups can add complexity by incorporating additional columns (for instance, initial assessment, which can facilitate transition toward the analysis stage). It can be especially useful when multiple agents or roles are involved and when the simulation has a technical focus; however, its complexity increases in simulations that pursue diverse types of objectives. Image 5. 5W Matrix. 3.6. Event Matrix The event matrix is a particularly effective for describing scenarios structured into macro-sequences of action without requiring a strict chronological order. The group and the debriefer collaboratively identify, label, and organize the main action units –the core building blocks of the simulation– placing them along the upper horizontal axis of the matrix. Beneath each block, the specific actions carried out during the simulation are recorded as sub-blocks. This matrix is especially useful for complex simulations in which the order of execution is not essential, but all blocks must be completed to achieve the objectives. What occurs within each block is understood as a “possible option” among several valid alternatives grounded in theory and practice. In an Event Matrix, it is less relevant to specify who performed each action. Rather, the focus lies on identifying what occurred according to the different possibilities. In experienced groups, the macro-sequences can be jointly identified, whereas with novice groups, the debriefer may need to pre-write them on the board, with the participants subsequently identifying the specific actions within each block. If it becomes necessary to indicate the agents or roles involved, color codes previously described can be employed. Image 6. Event Matrix. 4. Discussion and Conclusions Undoubtedly, the description phase constitutes a key moment within the process of reflection that occurs during debriefing. By reconstructing the sequence of events, participants not only recall what happened but also re-experience–safely and outside the scenario–the decisions and challenges they faced. Through the discussion of the clinic (22), the clinical context is anchored chronologically. In this process, the most relevant events are recovered, labelling them in the past (18) in a more rational manner and by means of a specific language somewhat distanced from the original experience. This prompt and precise recollection process may help ensure that the details of the experience are retained for longer within the memory structures participants are constructing (23). From another perspective, the detailed review of events also supports the identification of turning points and critical moments in which specific decisions correspond with particular impacts or consequences –both in participants’ experience and in the outcomes achieved. Describing events with precision through contextually appropriate techniques enables deeper examination of the causes and consequences of actions during the analysis. To make this possible, and as a best practice, when devising a simulation experience, the simulation design team considers the ecosystem of variables inherent to each simulation. Accordingly, based on these variables, the debriefer selects the description strategy most appropriate to the ecosystem, achieving greater methodological customization and fostering more focused reflection during the analysis phase. Each of the techniques described above helps participants and the debriefer highlight nuances linked to the combination of specific variables within their scenario. For instance, in certain simulations, a description option may be required that captures subtle distinctions dependent on the objective, participants’ roles, or the timing of an action. As debriefers, we thus select one that enables the group to achieve the most precise and meaningful reconstruction of what occurred. Consequently, beyond identifying topics that will be likely to be addressed in the debriefing, the different description options allow to center and polish the focus of attention from the beginning. It is no longer a brief account of the events in temporal or sequential terms, but each simulation (depending on its variables) affects one aspect or another; each technique collects this particularity for subsequent analysis. The collaborative narrative that has allowed the creation of the shared mental model is enriched by the particular focus to which attention is directed, which will remain central throughout the debriefing. In a sense, description strategies are also a way of adapting to the needs of participants. Even in simulations where objectives were not fully met or performance differed from expectations, the debriefer can select a technique that allows a greater adjustment to capture what happened based on the particularities of the participants. In a way, there is a sort of customization and adaptation in real time. Each technique applicable within the description stage contributes to creating structure during the debriefing process and supports guides observation during the simulation itself. If the technique is selected in advance based on the constituent variables of the simulation, it becomes possible to take notes using its items or structure. This, in turn, helps minimize the cognitive load associated with debriefing (24) and with the participants themselves. It must be acknowledged, however, that while this range of techniques allows for more precise methodological alignment, it also presents potential challenges for both debriefers and participants. Knowing in detail the objectives of the simulation, detecting the needs or degree of professional development of the group, awareness of the scenario’s progression, etc., will ensure that the description stage serves as a vital bridge between the simulated experience and subsequent reflective analysis. 5. Limitations and Future Directions There is no doubt that the multiplicity of available techniques is not always perceived as an advantage by debriefers. Repetition of the same structure allows debriefers remain within their comfort zone, although this may limit the use of alternative structures and their respective benefits, for both facilitator and participants. While this variety of techniques indeed allows for more tailored selection, it can also pose distinct challenges for debriefers and participants. Training in these new “structures” is necessary, particularly to understand the reason behind their selection and how they interact with the ecosystem of variables. A significant limitation arises when such selection becomes merely a technical or visual matter, thereby losing the potential that each structure brings to the simulation experience. As Secheresse and Nonglaton (14) point out, training in these techniques is necessary. As with the timeline tool, it is not simply a matter of drawing an axis or a matrix and filling in the facts. The decision to employ one option or another must be justified in terms of supporting participants’ learning (while also considering the potential cognitive load it may impose on the debriefer). Moreover, another possible limitation are time constraints. Despite the pressure many groups and teams face, learning does not occur due to “time pressure.” Some forms of learning are inherently demanding (for instance, certain threshold concepts that are often challenged during simulation) and require effort that is not always compatible with a lack of time. Some of the techniques described require a certain amount of time, although we have also observed that this time is later “recovered” through greater precision and efficiency during the analysis phase. We acknowledge the lack of scientific evidence regarding the impact of each of these options within the field of simulation. Although they have been tested in other contexts, further research is needed to determine their specific applicability to simulation-based education. The positive feedback received (from both final participants and instructors/facilitators) has focused on aspects such as: the clarity of the information displayed; the order that it implies for both the debriefer and the participants; the focus of the description allows greater precision in the analysis; the early identification of critical aspects that will be key during the analysis; the ability to compare performance across different moments and agents; and the customization of the description according to the different roles. Consequently, giving the forgoing, several questions emerge for future research: To what extent are the description able to capture the key events of the simulation? Are they consistent in different contexts and with different facilitators? How effective is each one in eliciting event recall among different participant profiles? How does each strategy influence the cognitive load of the debriefer? These are promising questions and considerations that call for further practice and research. At the same time, we must not forget that debriefing combines both technique and art, structure and flexibility. Declarations Authors’ contributions NS made a substantial contribution to the conception and design and was involved in drafting the manuscript and critical revisions. SN was involved in the critical revision of the manuscript. NS, SO, AC and AG applied the different techniques with professional participants and undergraduate students in medicine, nursing, and social education. AG contributed to the acquisition of data and assisted in drafting specific sections of the manuscript. Funding This project has received funding from REDICE-22-3386 and REDICE24-3669 from the University of Barcelona. Ethics approval and consent to participate Not applicable. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. References Dufrene, C., & Young, A. (2014). Successful debriefing. Best methods to achieve positive learning outcomes: a literature review. Nurse Education Today , 34 (3)372-376. Shinnick, M. A., Woo, M., Horwich, T. B., & Steadman, R. (2011). Debriefing: The most important component in simulation? Clinical Simulation in Nursing , 7 (3), e105-e111. Dismukes, R. K., Gaba, D. M., & Howard, S. K. (2006). So many roads: Facilitated debriefing in healthcare. Simulation in Healthcare , 1 (1), 23-25. Dreifuerst, K. (2009). The essentials of debriefing in simulation learning: A concept analysis. Nursing Education Perspectives , 30 (2), 109-114. Fanning, R., & Gaba, D. (2007). The role of debriefing in simulation-based learning. Society for Simulation in Healthcare , 2 (2), 115-125. Oriot, D., & Alinier, G. (2017). Pocket book for simulation debriefing in healthcare. Springer. Roussin, C. J., & Weinstock, P. (2017). SimZones: An Organizational Innovation for Simulation Programs and Centers. Academic Medicine , 92 (8), 1114-1120. Dieckmann, P., Molin Friis, S., Lippert, A., & Ostergaard, D. (2009). The art and science of debriefing in simulation: ideal and practice. Medical Teacher, 31 (7): e287–94. Rudolph, J.W., Simon, R., Dufrene, R.L., & Raemer, D.B. (2006). There’s no such thing as “nonjudgmental” debriefing: a theory and method for debriefing with good judgment. Simulation in Healthcare , 1 (1):49–55. Eppich, W., & Cheng, A. (2015) Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simulation in Healthcare, 10 (2):106–15. Steinwachs, B. (1992). How to facilitate a debriefing. Simulation&Gaming , 23 (2): 186-195. Oriot, D., & Alinier, D. (2018). Pocket book for Simulation Debriefing in Healthcare . Springer. Oriot, D., & Alinier, D. (2019). La simulation en santé. Le débriefing clés en mains . Elsevier Masson. Secheresse, T., & Nonglaton, S. (2019). The “Timeline Debriefing Tool”: a tool for structuring the debriefing description phase. Advances in Simulation , 4 (29), 1-6. Dieckmann, P., Sharara-Chami, R., & Langli, H. (2023). Debriefing Practices in Simulation-Based Education. In: Clinical Education for the Health Professions: Theory and Practice (pp. 699-715). Springer Nature. Teschner, R. (2018). Debrief to win. How America’s Top Guns Practice Accountable Leadership… and How you can, too! VMax Group-RTI Press. Rockstraw, L. (2023). Essentials of Debriefing and Feedback. In: Kutzin, J.M., Waxman, K., López, C.M., & Kiegaldie, D. (eds). Comprehensive Healthcare Simulation: Nursing (pp. 19-23). Springer International Publisher. Budson, A., & Kensinger, E. (2024). Por qué olvidamos y cómo recordar mejor. La ciencia que estudia la memoria . Pinolia. Thiagarajan, S. (1992). Using games for debriefing. Simulation&Gaming , 23 (2), 161-173. Schwägele, S., Zürn, B., Lukosch, H., & Freese, M. (2021). Design of an Impulse-Debriefing-Spiral for Simulation Game Facilitation. Simulation & Gaming , 52 (3): 364-372. Kriz, W. (2010). A Systemic-Constructivist Approach to the Facilitation and Debriefing of Simulations and Games. Simulation & Gaming , 41 (5) 663–680. Kolbe, M., Schmutz, S., Seelandt, J.C., Eppich, W.J., & Schmutz, J.B. (2021). Team debriefings in healthcare: aligning intention and impact. BMJ Quality & Safety , 13 , 374: n2042. Dunsmoor, J., Murty, V., Davachi, L., & Phelps, E. (2015). Emotional learning selectively and retroactively strengthens episodic memories for related events”. Nature , 520(7547), 345-348. Meguerdichian, M., Bajaj, K., Ivanhoe, R. Lin, Y., Sloma, A., de Roche, A., Altonen, B., Bentley, S., Cheng, A., & Walker, K. (2002). Impact of the PEARLS Healthcare Debriefing cognitive aid on facilitator cognitive load, workload, and debriefing quality: a pilot study. Advances in Simulation , 7 (40), 1-9. Additional Declarations No competing interests reported. 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10:10:22","extension":"html","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":65458,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8462808/v1/5046df6ed6449835aae12f59.html"},{"id":100574447,"identity":"b6c79799-7d38-48e5-a718-29e71a18103a","added_by":"auto","created_at":"2026-01-19 10:10:22","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":122576,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eChronological Axis by Levels.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8462808/v1/f6735939ea549c95d76d73c5.png"},{"id":100574449,"identity":"c0be4570-5570-430c-b568-52aec79a478f","added_by":"auto","created_at":"2026-01-19 10:10:22","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":156460,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eChronological Axis by Agents.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8462808/v1/5187b43a4e063cbbd04c4673.png"},{"id":100595124,"identity":"58ebafdb-d8f2-448d-ba45-8ac364a34366","added_by":"auto","created_at":"2026-01-19 13:47:31","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":187282,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eChronological Axis by Objectives.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8462808/v1/27511cf5b88b2f6576fd59ff.png"},{"id":100595558,"identity":"8b01eab8-49b6-4616-b011-29801591b03d","added_by":"auto","created_at":"2026-01-19 13:48:47","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":284951,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eContrast Matrix.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-8462808/v1/4b66520710800317d54666b9.png"},{"id":100574454,"identity":"891fb8e2-7aed-42fe-9626-4d680524bedc","added_by":"auto","created_at":"2026-01-19 10:10:22","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":134951,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e5W Matrix.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-8462808/v1/9c5cd6a4edd89ab3d9039842.png"},{"id":100574458,"identity":"dddad17d-a7e8-4adf-b0bc-83aeb335a73a","added_by":"auto","created_at":"2026-01-19 10:10:22","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":212611,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eEvent Matrix.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-8462808/v1/a9c0586800081f7d185c8be5.png"},{"id":100803994,"identity":"b527cb5d-43f8-4440-a742-1a0d0d03f7c9","added_by":"auto","created_at":"2026-01-21 14:33:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1234846,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8462808/v1/de647ae4-0a2f-42f0-9e4a-57c238b6de9b.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Diversifying Description Phase Techniques During Debriefing ","fulltext":[{"header":"1. Debriefing: Description phase in literature","content":"\u003cp\u003eDebriefing is an essential component of any simulation experience. This process is defined as a key moment for consolidating learning and engaging in guided, structured reflection on the simulated practice (1\u0026ndash;6). It represents an intrinsic component of zone 2 or 3 simulations (Roussin \u0026amp; Weinstock, 2017), in which, based on predefined objectives to varying degrees, the events that occurred \u0026ndash;and the interpretations and perspectives derived from them\u0026ndash; are analysed by both active participants and observers (8\u0026ndash;11).\u003c/p\u003e \u003cp\u003eThe literature shows broad consensus regarding the different stages that constitute the debriefing process. Concurrently, in the reference models, the following stages are identified: emotional decompression (also referred to as \u0026ldquo;reactions\u0026rdquo;), description, analysis, and summary or transfer (12). Among these, the description phase (also called \u0026ldquo;facts,\u0026rdquo; \u0026ldquo;understanding,\u0026rdquo; or \u0026ldquo;review\u0026rdquo;\u0026ndash; 12, 19, 20, 21) appears in nearly all models, serving as a fundamental moment that fulfils several key purposes:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eConfirming that participants have understood the simulated situation, thereby avoiding potential subsequent misunderstandings (13),\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eDetailing the participants\u0026rsquo; recollection of the simulation; and\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eEstablishing a shared mental model of what happened during the event. (14)\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe literature confirms that the description phase is primarily a collective process, where participants collaboratively create a shared overview of the events, identifying the most relevant moments of the scenario. During this moment, a sort of index of key events is created from the perspective of each participant (14, 15). This process establishes a common ground that facilitates the transition to the analysis, where a thorough examination and critical evaluation of the elements identified as significant is carried out. In a sense, the description provides a structured recollection while deliberately avoiding premature interpretation or evaluation.\u003c/p\u003e \u003cp\u003eDespite its intrinsic relevance within the debriefing process, the existing literature offers limited guidance on how to implement this phase or on the different techniques that may maximize its effectiveness. One of the most notable approaches is the \u003cem\u003eTimeline Debriefing Tool\u003c/em\u003e developed by Secheresse and Nonglaton (14), which proposes an excellent seven-step procedure. This model uses a timeline as the main tool to organize the events that occurred according to participants\u0026rsquo; perceptions.\u003c/p\u003e \u003cp\u003eBased on more than ten years of experience designing and conducting simulation and debriefing experiences in undergraduate and postgraduate programs, as well as in simulation programs for professional teams, we propose additional systematic approaches to conducting the description, implemented depending on a set of variables that may influence or support the selection of one strategy over another.\u003c/p\u003e"},{"header":"2. Ecosystem of Variables in Selecting the Description Technique","content":"\u003cp\u003eWhen determining the most suitable debriefing approach for a particular group, it is imperative to consider a set of critical variables that warrant thorough analysis. These variables \u0026ndash;diverse and complex in nature\u0026ndash; exert a significant influence on the effectiveness of the debriefing process and, therefore, must not be underestimated or overlooked in methodological decision-making (16). In turn, these variables have a direct impact on the description phase.\u003c/p\u003e \u003cp\u003eSeveral variables have been identified as relevant to the choice and implementation of debriefing approaches (17), such as the objectives, type of simulation, learners\u0026rsquo; level, debriefing environment, equipment and facilitator expertise. From our perspective, these elements form an \u003cem\u003eecosystem of variables\u003c/em\u003e that should systemically influence the design of the simulation experience (from its design to the implementation of debriefing and subsequent evaluation). Consequently, this ecosystem should also be considered during the description stage of debriefing, taking into account, for example:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eTypes of objectives and/or skills\u003c/em\u003e to be achieved through simulation, whether these are primarily hard skills or power skills, or a combination of both.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe description may require different approaches, depending on the objectives that are being developed.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eNature of the participant group and time of development\u003c/em\u003e: group of students with the same or different profile, natural team, unidisciplinary group, etc. It is also relevant to determine whether participants are new in their roles, experienced professionals or if updating, consolidation, or review of existing knowledge is required, etc.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eDegree of knowledge of the simulation methodology\u003c/em\u003e. In groups with prior simulation experience, the description technique may evolve, as well as stimulate their direct involvement in the process.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eDegree of maturity, openness and knowledge of team members.\u003c/em\u003e Although the description stage is arguably the most neutral part of debriefing, describing what occurred is not always perceived positively, as factors such as seniority, hierarchy, and prior experience may intervene.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe number o\u003cem\u003ef participants involved in the scenario\u003c/em\u003e may condition the type of descriptive visualization that is required. For instance, whether the simulation involves a single actor or multiple participants may lead to the selection of a particular schema during the description.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eThe complexity of the situation to be simulated\u003c/em\u003e will require using more or less comprehensive description techniques and highlighting varying degrees of detail. Complexity will influence both the level of detail that is intended to be reached during the description and the debriefer's ability to record what happened (even when supported by video recording).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eLinearity of action\u003c/em\u003e, that is, whether the simulation follows \u0026ldquo;the\u0026rdquo; correct way to act (e.g. a protocol) or allows for multiple valid approaches, each with its own consequences.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eAvailable time\u003c/em\u003e for debriefing. Since time constraints often limit debriefing, it is necessary to choose among description options, and some of them require more dedication than others (and more if we combine them with other variables in this list).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eRoles of the group and facilitator.\u003c/em\u003e Although we understand that both the group and facilitator can intervene more or less directly in the description phase, it is true that the combination with other variables can affect their degree of direct participation. For instance, a complex simulation may require greater facilitator input to clarify participants\u0026rsquo; actions, whereas a group with limited experience in simulation methodology may need closer guidance by the debriefer to identify key moments of the scenario. Undoubtedly, the facilitator\u0026rsquo;s expertise in simulation methodology will significantly influence both the effectiveness of this stage and the overall quality of the debriefing process.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eConsidering these different variables, there is no doubt that the visual materialization of the description phase and its role during debriefing contribute to:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eFirst, labelling what has occurred in the recent past\u0026ndash;a mental process necessary to ensure the review, cataloguing and incorporation into memory of key events to be remembered (18).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSecond, generating a shared narrative by selecting specific terms that may be linked either to particular theoretical frameworks (depending on the disciplinary content) or to experiences, sensations and other elements that emerge from the shared experience and become a collective, real-time account.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eThird, to a subsequent review of events about which uncertainty may exist (e.g., whether something occurred or not, its chronological order within the sequence, or who carried it out, etc.).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eFourth, serving as a reference point for both the debriefer and the group, allowing them to return to it to ensure that no analytical point is overlooked (if deemed relevant).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eFinally, enabling more precise feedback, when necessary (16), by referring to elements that the group itself has previously identified as relevant.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eIn light of these considerations, we propose a series of techniques for visualizing and structuring the description phase that aim to maximize its potential and guide participants toward a more detailed and contextually meaningful review of events. Several of them can be applied with the general procedural framework established by Secheresse and Nonglaton (14), while incorporating specific steps and processes according to the variables and implementation context.\u003c/p\u003e"},{"header":"3. Techniques for Implementing the Description Phase","content":"\u003cp\u003eFrom this conceptual framework and the described ecosystem of variables, a range of techniques is presented below for operationalizing the description stage of debriefing, with the aim of cognitively, visually, and narratively structuring the events of the scenario in a manner aligned with the characteristics of the group and the educational objectives.\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Chronological Axis by Levels\u003c/h2\u003e \u003cp\u003eThis type of axis can be particularly useful when the goal is to explore certain details of the action and to distinguish between different types of events. Using the \u003cem\u003eTimeline Debriefing Tool\u003c/em\u003e, the chronological axis is visually divided into two levels: an upper and a lower one. Each level displays pre-agreed aspects between the debriefer and the group. For example, the upper level may represent actions implemented (e.g., in an anaphylactic shock), while the lower level indicates the medications administered at each point.\u003c/p\u003e \u003cp\u003eThis dual-level axis is intuitive for groups with less experience in simulation methodology and can be made as complex as the group\u0026rsquo;s and debriefer\u0026rsquo;s require (e.g., by adding another level to incorporate further meaning, such as key phrases). It presents challenges in scenarios with numerous and diverse actions or many participants, and it does not always allow objectives to be clearly broken down.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eImage 1. Chronological Axis by Levels.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Chronological Axis by Agents\u003c/h2\u003e \u003cp\u003eThis type of chronological axis is suitable when different agents participate in the simulation, ideally two. Its purpose is to visualize, in sequence, what occurred in the scenario while distinguishing the roles involved. The \u003cem\u003eTimeline Debriefing Tool\u003c/em\u003e is used, but with two distinct colours (one for each agent or role), or by using initials that refer to the person\u0026rsquo;s name or role (e.g., P \u0026ndash; paediatrician; N \u0026ndash; nurse for critical patients).\u003c/p\u003e \u003cp\u003eAfter the elaboration of the chronological axis, the interventions of each of the agents are quickly observed. Although they can be used with more agents/roles, from 3 onwards we recommend using other techniques, for example, the contrast matrix. Our experience suggests that this approach is most appropriate for low-complexity simulations involving two roles and for groups with limited familiarity with simulation methodology.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eImage 2. Chronological Axis by Agents.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e3.3. Chronological Axis by Objectives\u003c/h2\u003e \u003cp\u003eThis type of axis is suitable when multiple objectives of different natures exist (e.g., one technical and one non-technical). The \u003cem\u003eTimeline Debriefing Tool\u003c/em\u003e is employed, placing on the left-hand column the different objectives to be achieved (these can already be written on the board). The description then focuses on how each objective unfolds over the course of the time sequence.\u003c/p\u003e \u003cp\u003eThis technique can be combined with the previous one by adding colors or initials next to each action, or by writing each action in a predetermined color (associated with a specific role). Ideally, two roles are manageable (especially for the debriefer), although experienced groups can help complete the distribution of actions along the axis.\u003c/p\u003e \u003cp\u003eA challenge arises when there are two distinct types of objectives (particularly when one is technical and the other attitudinal) since the level of descriptive detail often differs between them (usually to the detriment of the latter). It is therefore essential that both the debriefer and the group maintain a high level of awareness regarding the actions carried out in relation to both types of objectives.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eImage 3. Chronological Axis by Objectives.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.4. Contrast Matrix\u003c/h2\u003e \u003cp\u003eThis matrix is especially suitable when participants with diverse professional profiles take part in a simulation (for example, multidisciplinary teams, whether in initial training or continuing education). Its purpose is to compare the actions carried out by each participant across time and to visualize the contribution of each member to the overall activity.\u003c/p\u003e \u003cp\u003eOn the horizontal axis, the key moments of the simulation are represented \u0026ndash;that is, the main actions that shaped the scenario (e.g., a protocol or a critical interprofessional situation, etc.). On the vertical axis, the roles or professional profiles involved in each action are listed (e.g., physicians, nurses, assistants, etc.). A third horizontal line at the bottom can indicate the passage of time during the event.\u003c/p\u003e \u003cp\u003eThere are at least two ways to apply it:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe description begins by identifying the main moments as large blocks on the horizontal line, and, in the vertical line, the individuals participating in each key moment (marking an X or a circle in the corresponding profile) are identified; or,\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe description begins by identifying the main moments as large blocks, and, subsequently, the concrete action of each of the participants at each moment is specified. The specific action can be described with one or two key words.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eThe first version is recommended for groups with limited experience in interdisciplinary simulations or those experiencing their first simulations, while the second version enables greater situational awareness regarding each participant\u0026rsquo;s contribution. If a layer related to objectives is desired, a color code (one color per objective) or a symbolic code (one symbol per objective) can be added in each cell. In some cases (ideally), the matrix can be maintained throughout the session, allowing objectives to be identified at the end by placing the code of each objective in each cell, as appropriate.\u003c/p\u003e \u003cp\u003eThis technique fosters a broader, integrative view of the scenario and promotes early awareness \u0026ndash;right from the start of the debriefing\u0026ndash; of each member\u0026rsquo;s contribution to the collective performance.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eImage 4. Contrast Matrix.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.5. 5W Matrix\u003c/h2\u003e \u003cp\u003eIt is particularly suitable when an objective and direct description is desired, without delving excessively into the underlying reasons for the events. The description is structured through four columns, each corresponding to a question: when, what, who and with what (a fifth column for where may be added, if applicable). Then, according to the time, in the following column the different actions carried out are written (from top to bottom). In the third column is recorded who has carried out each action and in the last, what resources have been used (human, material, temporary, etc.).\u003c/p\u003e \u003cp\u003eParticipants can collaboratively construct this matrix, resulting in a clear and concise overview of the situation through the identification of four key elements: time, action, participants and resources employed. More experienced groups can add complexity by incorporating additional columns (for instance, initial assessment, which can facilitate transition toward the analysis stage).\u003c/p\u003e \u003cp\u003eIt can be especially useful when multiple agents or roles are involved and when the simulation has a technical focus; however, its complexity increases in simulations that pursue diverse types of objectives.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eImage 5. 5W Matrix.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.6. Event Matrix\u003c/h2\u003e \u003cp\u003eThe event matrix is a particularly effective for describing scenarios structured into macro-sequences of action without requiring a strict chronological order. The group and the debriefer collaboratively identify, label, and organize the main action units \u0026ndash;the core building blocks of the simulation\u0026ndash; placing them along the upper horizontal axis of the matrix. Beneath each block, the specific actions carried out during the simulation are recorded as sub-blocks.\u003c/p\u003e \u003cp\u003eThis matrix is especially useful for complex simulations in which the order of execution is not essential, but all blocks must be completed to achieve the objectives. What occurs within each block is understood as a \u0026ldquo;possible option\u0026rdquo; among several valid alternatives grounded in theory and practice.\u003c/p\u003e \u003cp\u003eIn an Event Matrix, it is less relevant to specify who performed each action. Rather, the focus lies on identifying what occurred according to the different possibilities. In experienced groups, the macro-sequences can be jointly identified, whereas with novice groups, the debriefer may need to pre-write them on the board, with the participants subsequently identifying the specific actions within each block. If it becomes necessary to indicate the agents or roles involved, color codes previously described can be employed.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eImage 6. Event Matrix.\u003c/em\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion and Conclusions","content":"\u003cp\u003eUndoubtedly, the description phase constitutes a key moment within the process of reflection that occurs during debriefing. By reconstructing the sequence of events, participants not only recall what happened but also re-experience\u0026ndash;safely and outside the scenario\u0026ndash;the decisions and challenges they faced. Through the discussion of the clinic (22), the clinical context is anchored chronologically. In this process, the most relevant events are recovered, labelling them in the past (18) in a more rational manner and by means of a specific language somewhat distanced from the original experience. This prompt and precise recollection process may help ensure that the details of the experience are retained for longer within the memory structures participants are constructing (23). From another perspective, the detailed review of events also supports the identification of turning points and critical moments in which specific decisions correspond with particular impacts or consequences \u0026ndash;both in participants\u0026rsquo; experience and in the outcomes achieved. Describing events with precision through contextually appropriate techniques enables deeper examination of the causes and consequences of actions during the analysis.\u003c/p\u003e \u003cp\u003eTo make this possible, and as a best practice, when devising a simulation experience, the simulation design team considers the ecosystem of variables inherent to each simulation. Accordingly, based on these variables, the debriefer selects the description strategy most appropriate to the ecosystem, achieving greater methodological customization and fostering more focused reflection during the analysis phase.\u003c/p\u003e \u003cp\u003eEach of the techniques described above helps participants and the debriefer highlight nuances linked to the combination of specific variables within their scenario. For instance, in certain simulations, a description option may be required that captures subtle distinctions dependent on the objective, participants\u0026rsquo; roles, or the timing of an action. As debriefers, we thus select one that enables the group to achieve the most precise and meaningful reconstruction of what occurred.\u003c/p\u003e \u003cp\u003eConsequently, beyond identifying topics that will be likely to be addressed in the debriefing, the different description options allow to center and polish the focus of attention from the beginning. It is no longer a brief account of the events in temporal or sequential terms, but each simulation (depending on its variables) affects one aspect or another; each technique collects this particularity for subsequent analysis. The collaborative narrative that has allowed the creation of the shared mental model is enriched by the particular focus to which attention is directed, which will remain central throughout the debriefing.\u003c/p\u003e \u003cp\u003eIn a sense, description strategies are also a way of adapting to the needs of participants. Even in simulations where objectives were not fully met or performance differed from expectations, the debriefer can select a technique that allows a greater adjustment to capture what happened based on the particularities of the participants. In a way, there is a sort of customization and adaptation in real time.\u003c/p\u003e \u003cp\u003eEach technique applicable within the description stage contributes to creating structure during the debriefing process and supports guides observation during the simulation itself. If the technique is selected in advance based on the constituent variables of the simulation, it becomes possible to take notes using its items or structure. This, in turn, helps minimize the cognitive load associated with debriefing (24) and with the participants themselves.\u003c/p\u003e \u003cp\u003eIt must be acknowledged, however, that while this range of techniques allows for more precise methodological alignment, it also presents potential challenges for both debriefers and participants. Knowing in detail the objectives of the simulation, detecting the needs or degree of professional development of the group, awareness of the scenario\u0026rsquo;s progression, etc., will ensure that the description stage serves as a vital bridge between the simulated experience and subsequent reflective analysis.\u003c/p\u003e"},{"header":"5. Limitations and Future Directions","content":"\u003cp\u003eThere is no doubt that the multiplicity of available techniques is not always perceived as an advantage by debriefers. Repetition of the same structure allows debriefers remain within their comfort zone, although this may limit the use of alternative structures and their respective benefits, for both facilitator and participants. While this variety of techniques indeed allows for more tailored selection, it can also pose distinct challenges for debriefers and participants.\u003c/p\u003e \u003cp\u003eTraining in these new \u0026ldquo;structures\u0026rdquo; is necessary, particularly to understand the reason behind their selection and how they interact with the ecosystem of variables. A significant limitation arises when such selection becomes merely a technical or visual matter, thereby losing the potential that each structure brings to the simulation experience. As Secheresse and Nonglaton (14) point out, training in these techniques is necessary. As with the timeline tool, it is not simply a matter of drawing an axis or a matrix and filling in the facts. The decision to employ one option or another must be justified in terms of supporting participants\u0026rsquo; learning (while also considering the potential cognitive load it may impose on the debriefer).\u003c/p\u003e \u003cp\u003eMoreover, another possible limitation are time constraints. Despite the pressure many groups and teams face, learning does not occur due to \u0026ldquo;time pressure.\u0026rdquo; Some forms of learning are inherently demanding (for instance, certain threshold concepts that are often challenged during simulation) and require effort that is not always compatible with a lack of time. Some of the techniques described require a certain amount of time, although we have also observed that this time is later \u0026ldquo;recovered\u0026rdquo; through greater precision and efficiency during the analysis phase.\u003c/p\u003e \u003cp\u003eWe acknowledge the lack of scientific evidence regarding the impact of each of these options within the field of simulation. Although they have been tested in other contexts, further research is needed to determine their specific applicability to simulation-based education. The positive feedback received (from both final participants and instructors/facilitators) has focused on aspects such as:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ethe clarity of the information displayed;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ethe order that it implies for both the debriefer and the participants;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ethe focus of the description allows greater precision in the analysis;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ethe early identification of critical aspects that will be key during the analysis;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ethe ability to compare performance across different moments and agents; and\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ethe customization of the description according to the different roles.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eConsequently, giving the forgoing, several questions emerge for future research: To what extent are the description able to capture the key events of the simulation? Are they consistent in different contexts and with different facilitators? How effective is each one in eliciting event recall among different participant profiles? How does each strategy influence the cognitive load of the debriefer?\u003c/p\u003e \u003cp\u003eThese are promising questions and considerations that call for further practice and research. At the same time, we must not forget that debriefing combines both technique and art, structure and flexibility.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNS made a substantial contribution to the conception and design and was involved in drafting the manuscript and critical revisions. SN was involved in the critical revision of the manuscript.\u0026nbsp;NS, SO, AC and AG applied the different techniques with professional participants and undergraduate students in medicine, nursing, and social education. AG contributed to the acquisition of data and assisted in drafting specific sections of the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis project has received funding from REDICE-22-3386 and REDICE24-3669 from the University of Barcelona.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDufrene, C., \u0026amp; Young, A. (2014). Successful debriefing. Best methods to achieve positive learning outcomes: a literature review. \u003cem\u003eNurse Education Today\u003c/em\u003e, \u003cem\u003e34\u003c/em\u003e(3)372-376.\u003c/li\u003e\n\u003cli\u003eShinnick, M. A., Woo, M., Horwich, T. B., \u0026amp; Steadman, R. (2011). Debriefing: The most important component in simulation? \u003cem\u003eClinical Simulation in Nursing\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(3), e105-e111. \u003c/li\u003e\n\u003cli\u003eDismukes, R. K., Gaba, D. M., \u0026amp; Howard, S. K. (2006). So many roads: Facilitated debriefing in healthcare. \u003cem\u003eSimulation in Healthcare\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e(1), 23-25.\u003c/li\u003e\n\u003cli\u003eDreifuerst, K. (2009). The essentials of debriefing in simulation learning: A concept analysis. \u003cem\u003eNursing Education Perspectives\u003c/em\u003e, \u003cem\u003e30\u003c/em\u003e(2), 109-114.\u003c/li\u003e\n\u003cli\u003eFanning, R., \u0026amp; Gaba, D. (2007). The role of debriefing in simulation-based learning. \u003cem\u003eSociety for Simulation in Healthcare\u003c/em\u003e, \u003cem\u003e2\u003c/em\u003e(2), 115-125.\u003c/li\u003e\n\u003cli\u003eOriot, D., \u0026amp; Alinier, G. (2017). Pocket book for simulation debriefing in healthcare. Springer. \u003c/li\u003e\n\u003cli\u003eRoussin, C. J., \u0026amp; Weinstock, P. (2017). SimZones: An Organizational Innovation for Simulation Programs and Centers. \u003cem\u003eAcademic Medicine\u003c/em\u003e, \u003cem\u003e92\u003c/em\u003e(8), 1114-1120. \u003c/li\u003e\n\u003cli\u003eDieckmann, P., Molin Friis, S., Lippert, A., \u0026amp; Ostergaard, D. (2009). The art and science of debriefing in simulation: ideal and practice. \u003cem\u003eMedical Teacher, 31\u003c/em\u003e(7): e287\u0026ndash;94.\u003c/li\u003e\n\u003cli\u003eRudolph, J.W., Simon, R., Dufrene, R.L., \u0026amp; Raemer, D.B. (2006). There\u0026rsquo;s no such thing as \u0026ldquo;nonjudgmental\u0026rdquo; debriefing: a theory and method for debriefing with good judgment. \u003cem\u003eSimulation in Healthcare\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e(1):49\u0026ndash;55.\u003c/li\u003e\n\u003cli\u003eEppich, W., \u0026amp; Cheng, A. (2015) Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simulation in Healthcare, \u003cem\u003e10\u003c/em\u003e(2):106\u0026ndash;15.\u003c/li\u003e\n\u003cli\u003eSteinwachs, B. (1992). How to facilitate a debriefing. \u003cem\u003eSimulation\u0026amp;Gaming\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(2): 186-195.\u003c/li\u003e\n\u003cli\u003eOriot, D., \u0026amp; Alinier, D. (2018). \u003cem\u003ePocket book for Simulation Debriefing in Healthcare\u003c/em\u003e. Springer. \u003c/li\u003e\n\u003cli\u003eOriot, D., \u0026amp; Alinier, D. (2019). \u003cem\u003eLa simulation en sant\u0026eacute;. Le d\u0026eacute;briefing cl\u0026eacute;s en mains\u003c/em\u003e. Elsevier Masson. \u003c/li\u003e\n\u003cli\u003eSecheresse, T., \u0026amp; Nonglaton, S. (2019). The \u0026ldquo;Timeline Debriefing Tool\u0026rdquo;: a tool for structuring the debriefing description phase. \u003cem\u003eAdvances in Simulation\u003c/em\u003e, \u003cem\u003e4\u003c/em\u003e(29), 1-6. \u003c/li\u003e\n\u003cli\u003eDieckmann, P., Sharara-Chami, R., \u0026amp; Langli, H. (2023). Debriefing Practices in Simulation-Based Education. In: \u003cem\u003eClinical Education for the Health Professions: Theory and Practice\u003c/em\u003e (pp. 699-715). Springer Nature.\u003c/li\u003e\n\u003cli\u003eTeschner, R. (2018). Debrief to win. How America\u0026rsquo;s Top Guns Practice Accountable Leadership\u0026hellip; and How you can, too! VMax Group-RTI Press.\u003c/li\u003e\n\u003cli\u003eRockstraw, L. (2023). Essentials of Debriefing and Feedback. In: Kutzin, J.M., Waxman, K., L\u0026oacute;pez, C.M., \u0026amp; Kiegaldie, D. (eds). \u003cem\u003eComprehensive Healthcare Simulation: Nursing \u003c/em\u003e(pp. 19-23). Springer International Publisher. \u003c/li\u003e\n\u003cli\u003eBudson, A., \u0026amp; Kensinger, E. (2024). \u003cem\u003ePor qu\u0026eacute; olvidamos y c\u0026oacute;mo recordar mejor. La ciencia que estudia la memoria\u003c/em\u003e. Pinolia.\u003c/li\u003e\n\u003cli\u003eThiagarajan, S. (1992). Using games for debriefing. \u003cem\u003eSimulation\u0026amp;Gaming\u003c/em\u003e, \u003cem\u003e23\u003c/em\u003e(2), 161-173.\u003c/li\u003e\n\u003cli\u003eSchw\u0026auml;gele, S., Z\u0026uuml;rn, B., Lukosch, H., \u0026amp; Freese, M. (2021). Design of an Impulse-Debriefing-Spiral for Simulation Game Facilitation. \u003cem\u003eSimulation \u0026amp; Gaming\u003c/em\u003e, \u003cem\u003e52\u003c/em\u003e(3): 364-372.\u003c/li\u003e\n\u003cli\u003eKriz, W. (2010). A Systemic-Constructivist Approach to the Facilitation and Debriefing of Simulations and Games. \u003cem\u003eSimulation \u0026amp; Gaming\u003c/em\u003e, \u003cem\u003e41\u003c/em\u003e(5) 663\u0026ndash;680.\u003c/li\u003e\n\u003cli\u003eKolbe, M., Schmutz, S., Seelandt, J.C., Eppich, W.J., \u0026amp; Schmutz, J.B. (2021). Team debriefings in healthcare: aligning intention and impact. \u003cem\u003eBMJ Quality \u0026amp; Safety\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e, 374: n2042. \u003c/li\u003e\n\u003cli\u003eDunsmoor, J., Murty, V., Davachi, L., \u0026amp; Phelps, E. (2015). Emotional learning selectively and retroactively strengthens episodic memories for related events\u0026rdquo;. \u003cem\u003eNature\u003c/em\u003e, 520(7547), 345-348.\u003c/li\u003e\n\u003cli\u003eMeguerdichian, M., Bajaj, K., Ivanhoe, R. Lin, Y., Sloma, A., de Roche, A., Altonen, B., Bentley, S., Cheng, A., \u0026amp; Walker, K. (2002). Impact of the PEARLS Healthcare Debriefing cognitive aid on facilitator cognitive load, workload, and debriefing quality: a pilot study. \u003cem\u003eAdvances in Simulation\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(40), 1-9. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"advances-in-simulation","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"asim","sideBox":"Learn more about [Advances in Simulation](http://advancesinsimulation.biomedcentral.com/)","snPcode":"41077","submissionUrl":"https://submission.springernature.com/new-submission/41077/3","title":"Advances in Simulation","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"debriefing, description phase, visualization techniques, simulation-based education","lastPublishedDoi":"10.21203/rs.3.rs-8462808/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8462808/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe description phase of debriefing in simulation is an essential moment for reconstructing the sequence of events, consolidating learning, and preparing a rigorous analytical reflection. It is configured as a primarily collective process aimed at generating a shared mental model of what occurred, labeling the key elements of the experience, and facilitating their retention in long-term memory. It also enables the precise identification of turning points and critical decisions, linking actions with their clinical, relational, and organizational consequences.\u003c/p\u003e \u003cp\u003eBuilding on an ecosystem of variables\u0026mdash;type and complexity of the simulation, nature of the objectives (technical and non-technical), characteristics and experience of participants, number of agents involved, time available, and facilitator expertise\u0026mdash;the description phase can be structured through different visual and narrative techniques. These include chronological axes by levels, by agents, or by objectives, as well as contrast, 5W, and event matrices, which allow information to be organized according to roles, sequences, resources, and macro-sequences of action. This repertoire of structures supports methodological customization of debriefing, enhances the clarity and organization of information, promotes early identification of critical aspects, and increases the precision of subsequent analysis.\u003c/p\u003e \u003cp\u003eSuch diversification of descriptive techniques raises challenges related to the need for specific training, the risk of selecting structures based on merely formal criteria, and the time constraints inherent to many simulation activities. Further research is proposed on the comparative impact of each technique in different contexts, as well as on their influence on the cognitive load of facilitators and participants. These techniques ultimately offer flexible and purposeful frameworks for aligning case reconstruction with educational objectives and with the specific needs of each group.\u003c/p\u003e","manuscriptTitle":"Diversifying Description Phase Techniques During Debriefing","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-19 10:10:17","doi":"10.21203/rs.3.rs-8462808/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"226227973146264529508297491916331718082","date":"2026-01-15T15:05:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-14T16:14:27+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-30T09:45:25+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-30T09:44:46+00:00","index":"","fulltext":""},{"type":"submitted","content":"Advances in Simulation","date":"2025-12-27T18:53:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"advances-in-simulation","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"asim","sideBox":"Learn more about [Advances in Simulation](http://advancesinsimulation.biomedcentral.com/)","snPcode":"41077","submissionUrl":"https://submission.springernature.com/new-submission/41077/3","title":"Advances in Simulation","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"706a985a-5c63-4f71-9ee8-1be3e34e9fe0","owner":[],"postedDate":"January 19th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-19T10:10:17+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-19 10:10:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8462808","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8462808","identity":"rs-8462808","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}