Learning objectives:

  1. Describe three different educational strategies used during debriefing and their associated indications for use
  2. Discuss how learner self-assessment with plus-delta, focused facilitation strategies such as advocacy inquiry, and directive feedback and teaching fit within the PEARLS debriefing framework
  3. Apply the PEARLS blended approach to debriefing using the decision support aid and the PEARLS debriefing tool1

Session details:

During debriefings, simulation educators use various approaches, each with respective advantages and disadvantages. The PEARLS Debriefing Framework and Script (Promoting Excellence And Reflective Learning in Simulation) represents a blended approach designed to promote effective debriefing by integrating three educational strategies to promote learning during debriefings (1) Learner self-assessment (e.g. Plus-Delta); (2) Focused facilitation to explore learners’ perspectives, and (3) Directive Feedback and Teaching. The choice of method used can be adapted to learner group, type of learning objective (declarative or procedural knowledge, technical skills, team-based behaviors), and setting of the simulation (simulation center-based, point of care, etc). We provide guidance to aid in selecting the approach. To support implementation of PEARLS, the attendees will use a PEARLS debriefing tool. The debriefing tool serves as a cognitive aid to ensure effective execution of the basic elements of debriefings. This tool offers scripted language to help facilitators structure the debrief, formulate questions, and avoid common debriefing pitfalls. The course will be broken down into several sections, each providing opportunity for hands-on learning and practice of debriefing with faculty feedback during small group work. Pre-taped videos of simulated resuscitations will be used as content for attendees to practice each of the three different strategies. Attendees will have multiple opportunities to practice the components of debriefing and to apply the PEARLS Framework using the PEARLS Debriefing Tool.

Session outline:

  1. Introduction of session and faculty
  2. Main workshop elements
    1. Welcome/Introductions / Overview of PEARLS framework and debriefing tool (interactive-didactics) Time Allotted: 45 minutes
    2. Video Exercises in Small Groups: (a) Video of simulated resuscitation (b) small group practice with faculty feedback (c) Plus-Delta (30 min); then Directive Feedback/Teaching (30 min), then Break (15 min), then Focused facilitation (45 min) Time Allotted: 120 minutes
    3. Video Exercise-Putting it all Together (60 min) a. Video (simulated resuscitation) b. Practice PEARLS in small groups c. Faculty feedback Time Allotted: 60 minutes
    4. Summary and Evaluations Time Allotted: 15 minutes


Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS): development and rationale for a blended approach to health care simulation debriefing. Simul Healthc. 2015;10(2):106-115.[PubMed]
Walter Eppich

Walter Eppich

Director, Faculty Development at the Department of Medical Education, Northwestern University Feinberg School of Medicine
Walter Eppich practices pediatric emergency medicine at the Ann & Robert H. Lurie Children’s Hospital of Chicago. He teaches about simulation, faculty development, and debriefing around the world. A candidate for a PhD in Medical Education at Maastricht University in the Netherlands, Walter studies the role of talk as a medium of learning for individuals and teams. He is a co-founder of Debrief2Learn.
Walter Eppich
Walter Eppich

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