364 - Pediatric Emergency Medicine (PEM) Fellows Experiences with Critical Event Debriefing: A National Cross-Sectional Analysis

Poster Number: 364
Publication Number: 364.211

Alexandria Georgadarellis, Yale-New Haven Children's Hospital, New Haven, CT, United States; Brielle Stanton. Skotnicki, UPMC Childrens Hospital of Pittsburgh, wexford, PA, United States; Melissa L. Langhan, Yale university, New Haven, CT, United States; Danielle Graff, University of Louisville, Louisville, KY, United States; Shiva Zargham, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States

Background: Debriefing, an intentional reflective activity after a resuscitation and/or critical event, is an integral aspect of processing events. Training in debriefing is not a fellowship educational requirement in PEM, but may prove extremely beneficial in this often intense, high acuity field.

Objective: This study aimed to determine the frequency of debriefing practices and training experience amongst PEM fellows.

Design/Methods: With consultation from experts in physician debriefing, a survey was designed with content informed by validated questions. This was piloted by five PEM fellows from different institutions and revised as needed. The final electronic survey was distributed to PEM fellowship leaders, who were asked to distribute it to their fellows. PEM fellowship leaders completed their own leadership survey to assess current training and to report the number of fellows to whom it was distributed. The study explored the frequency of specific debriefing styles and tools, along with the frequency of experiences for fellows. Results were analyzed using descriptive and quantitative statistics.

Results: A total of 53/161 PEM fellowship leaders within the US and Canada completed the survey (response rate 33%). Only 25% of programs had a formal debriefing curriculum and 22% of fellowship leaders were satisfied with the current training their fellows received. A total of 92/352 fellows completed the survey (response rate 26%; table 1). Of the fellows, 51% felt comfortable conducting debriefs. However, only 30% were trained to conduct debriefs and 66% had led 0-1 debriefs in the ED. Only 21% of fellows were satisfied with their training on debriefs and 75% of fellows were interested in formal debriefing training. The most frequently used debriefing styles were group debriefs and hot debriefs (debriefs completed on the day of the event). The most frequently used debriefing tools were STOP5, REFLECT, and PEARLS, though the majority of respondents did not use any specific tools (figure 1). Time constraints and heavy workloads were the biggest barriers to conducting debriefs within the ED.

Conclusion(s): Most PEM fellowship programs do not have a formal debriefing curriculum or training in debriefing, and fellows and program leadership are interested in having this training. This data will help inform development of a formal toolkit for enhancing debriefing training among PEM fellows.