In high-stakes environments like healthcare, effective teamwork is critical for patient safety and optimal outcomes. Team debriefing is a vital “transcending concept” in professional communication and quality improvement. It provides a structured opportunity for teams to reflect on a shared experience, identify areas of strength, and pinpoint opportunities for improvement in a psychologically safe environment. For PharmD students and all healthcare professionals, understanding and participating in effective debriefing is essential for fostering a culture of safety, enhancing team performance, and promoting continuous learning. This MCQ quiz will test your knowledge on the key principles and practices of team debriefing.
1. Team debriefing is best defined as a:
- A. Formal performance review of individual team members.
- B. Pre-event planning session to assign roles and anticipate challenges.
- C. Post-event, semi-structured conversation where team members reflect on their actions to improve future performance.
- D. Causal conversation to socialize after a stressful event.
Answer: C. Post-event, semi-structured conversation where team members reflect on their actions to improve future performance.
2. The primary goal of a clinical team debriefing after a patient event is to:
- A. Determine who was at fault for any negative outcomes.
- B. Learn from the experience to improve teamwork, processes, and patient safety for future events.
- C. Complete required hospital documentation.
- D. Allow senior members to critique the performance of junior members.
Answer: B. Learn from the experience to improve teamwork, processes, and patient safety for future events.
3. The concept of “psychological safety” is crucial for an effective debriefing. It means:
- A. The physical environment is free from any hazards.
- B. Team members feel safe to speak up, share perspectives, and admit errors without fear of blame or retribution.
- C. The discussion is kept confidential from hospital administration.
- D. Only positive feedback is allowed.
Answer: B. Team members feel safe to speak up, share perspectives, and admit errors without fear of blame or retribution.
4. A “hot debrief” typically occurs:
- A. Weeks after an event, once all data has been collected.
- B. In a formal conference room setting with senior leadership present.
- C. Immediately or very shortly after an event concludes, while it is still fresh in team members’ minds.
- D. Only after a positive outcome.
Answer: C. Immediately or very shortly after an event concludes, while it is still fresh in team members’ minds.
5. Which of the following is a classic open-ended question to start a debriefing?
- A. “Did everyone do their job correctly?”
- B. “Who was responsible for that delay?”
- C. “From your perspective, what went well?”
- D. “Why didn’t you follow the protocol?”
Answer: C. “From your perspective, what went well?”
6. The “basic assumption” often stated at the beginning of a debriefing is that:
- A. Errors are inevitable and cannot be prevented.
- B. Everyone participated to the best of their ability with the information and resources they had at the time.
- C. Senior team members are not required to participate.
- D. The primary goal is to identify underperforming individuals.
Answer: B. Everyone participated to the best of their ability with the information and resources they had at the time.
7. A key difference between a debriefing and a critique is that a debriefing is ________, while a critique can be ________.
- A. Always negative; always positive
- B. A two-way reflective conversation; often a one-way judgmental assessment
- C. Led by a junior member; led by a senior member
- D. Focused on individuals; focused on systems
Answer: B. A two-way reflective conversation; often a one-way judgmental assessment
8. The role of the facilitator in a team debriefing is to:
- A. Provide all the answers and solutions.
- B. Assign blame for any mistakes made.
- C. Guide the conversation, ensure all voices are heard, and maintain a psychologically safe environment.
- D. Act as a scribe only, without participating in the discussion.
Answer: C. Guide the conversation, ensure all voices are heard, and maintain a psychologically safe environment.
9. During a debriefing after a cardiac arrest, the pharmacist’s contribution would most likely focus on:
- A. The quality of chest compressions.
- B. The timeliness, appropriateness, and preparation of medications administered during the event.
- C. The patient’s underlying diagnosis.
- D. The performance of the defibrillator.
Answer: B. The timeliness, appropriateness, and preparation of medications administered during the event.
10. An effective debriefing should conclude with:
- A. A clear assignment of blame.
- B. A decision to not change any current processes.
- C. One or two key takeaways or actionable items for improvement.
- D. A formal performance review for each team member.
Answer: C. One or two key takeaways or actionable items for improvement.
11. Which of the following statements is most conducive to a successful debriefing?
- A. “Why did you use the wrong dose?”
- B. “Let’s talk about the dosing calculation. What information was available at the time?”
- C. “That was a terrible mistake.”
- D. “I would never have done it that way.”
Answer: B. “Let’s talk about the dosing calculation. What information was available at the time?” (Focuses on process and context, not blame).
12. A “briefing” or “huddle” differs from a debriefing in that a briefing occurs:
- A. After an event to review what happened.
- B. Before an event or shift to establish a plan, assign roles, and anticipate challenges.
- C. Only when a critical error has occurred.
- D. Without a designated leader.
Answer: B. Before an event or shift to establish a plan, assign roles, and anticipate challenges.
13. In a debriefing, focusing on “what” happened rather than “who” did it helps to:
- A. Identify the single person responsible.
- B. Keep the focus on systems and processes, promoting a safer environment for discussion.
- C. Make the debriefing shorter.
- D. Avoid discussing negative aspects of the event.
Answer: B. Keep the focus on systems and processes, promoting a safer environment for discussion.
14. To encourage participation from all team members, including more junior or introverted ones, a facilitator should:
- A. Only ask questions to the most senior person present.
- B. Use round-robin techniques or explicitly invite input from specific individuals (“Sarah, as the bedside nurse, what did you observe?”).
- C. Assume that silence means agreement.
- D. End the meeting if not everyone speaks within the first two minutes.
Answer: B. Use round-robin techniques or explicitly invite input from specific individuals (“Sarah, as the bedside nurse, what did you observe?”).
15. Debriefing is a critical component of which educational methodology in healthcare?
- A. Didactic lectures
- B. Simulation-based training
- C. Independent reading assignments
- D. Multiple-choice question exams
Answer: B. Simulation-based training
16. One of the main benefits of regular team debriefing is the development of a shared:
- A. Blame for errors.
- B. Dislike for certain procedures.
- C. Mental model, where team members have a common understanding of how the team operates and each other’s roles.
- D. Vacation schedule.
Answer: C. Mental model, where team members have a common understanding of how the team operates and each other’s roles.
17. After a medication error, a debriefing can serve as an important data-gathering step for a more formal:
- A. Performance improvement plan for an individual.
- B. Root Cause Analysis (RCA).
- C. Billing and reimbursement audit.
- D. Press release.
Answer: B. Root Cause Analysis (RCA).
18. A facilitator asks, “What could we do differently next time to ensure the resuscitation medications are available more quickly?” This question is focused on:
- A. Blaming the pharmacy for being slow.
- B. Identifying actionable solutions and system improvements.
- C. Critiquing the code leader’s performance.
- D. Discussing an irrelevant topic.
Answer: B. Identifying actionable solutions and system improvements.
19. A barrier to effective debriefing is:
- A. A culture of psychological safety.
- B. A hierarchical culture where junior members are discouraged from speaking up.
- C. A focus on learning and improvement.
- D. The use of a structured format.
Answer: B. A hierarchical culture where junior members are discouraged from speaking up.
20. The “Plus-Delta” model is a simple debriefing format. “Plus” refers to ________, and “Delta” refers to ________.
- A. Positive aspects; negative aspects
- B. Things to keep doing; things to change
- C. Additions to the team; subtractions from the team
- D. Patient vital signs; changes in vital signs
Answer: B. Things to keep doing; things to change
21. A debriefing session should ideally include:
- A. Only the physicians involved.
- B. Only the nurses involved.
- C. All members of the clinical team who participated in the event, regardless of their role or seniority.
- D. Only senior administrators.
Answer: C. All members of the clinical team who participated in the event, regardless of their role or seniority.
22. How does debriefing contribute to team resilience?
- A. By focusing only on mistakes.
- B. By allowing team members to process stressful events, validate their experiences, and receive peer support in a constructive manner.
- C. By ensuring that such events never happen again.
- D. By increasing the workload of each team member.
Answer: B. By allowing team members to process stressful events, validate their experiences, and receive peer support in a constructive manner.
23. “Advocacy-Inquiry” is a debriefing technique where a facilitator might say:
- A. “You made a mistake when you drew up that medication.”
- B. “I saw that the medication was administered late. I’m curious what your thought process was at that moment.”
- C. “Why were you late with that medication?”
- D. “Next time, don’t be late with the medication.”
Answer: B. “I saw that the medication was administered late. I’m curious what your thought process was at that moment.” (Advocates for an observation, then inquires about the person’s perspective).
24. The ideal outcome of a debriefing on a medication near-miss is that:
- A. The person who caught the error is given a promotion.
- B. The person who made the initial error is disciplined.
- C. The team identifies a system vulnerability (e.g., confusing label, workflow flaw) and develops a plan to fix it.
- D. The event is not documented to avoid liability.
Answer: C. The team identifies a system vulnerability (e.g., confusing label, workflow flaw) and develops a plan to fix it.
25. Which statement reflects a focus on process rather than person in a debriefing?
- A. “Why did you forget to check the patient’s allergy?”
- B. “The allergy information wasn’t easily visible in the electronic record. How can we improve the system to make it more prominent?”
- C. “You are not a careful nurse.”
- D. “The patient’s allergy was not important in this case.”
Answer: B. “The allergy information wasn’t easily visible in the electronic record. How can we improve the system to make it more prominent?”
26. A facilitator says, “Let’s make sure we hear from pharmacy and respiratory therapy on this point.” This action is intended to:
- A. End the meeting quickly.
- B. Ensure inclusivity and solicit diverse professional perspectives.
- C. Put those two departments on the spot.
- D. Switch topics.
Answer: B. Ensure inclusivity and solicit diverse professional perspectives.
27. Debriefing can improve interprofessional communication by:
- A. Allowing team members to practice giving and receiving feedback in a safe, structured way.
- B. Highlighting which profession performs the best.
- C. Reducing the need for communication during actual events.
- D. Replacing all other forms of team meetings.
Answer: A. Allowing team members to practice giving and receiving feedback in a safe, structured way.
28. One reason debriefing is important after a successful event (not just after an error) is to:
- A. Identify who should get credit.
- B. Reinforce and understand the factors and behaviors that led to the success so they can be replicated.
- C. Point out that the success was likely due to luck.
- D. Fulfill a documentation requirement only.
Answer: B. Reinforce and understand the factors and behaviors that led to the success so they can be replicated.
29. The DASH (Debriefing Assessment for Simulation in Healthcare) tool is used to:
- A. Assess a patient’s clinical condition.
- B. Evaluate the quality of a debriefing session and provide feedback to the facilitator.
- C. Document medication errors.
- D. Assign tasks to team members before an event.
Answer: B. Evaluate the quality of a debriefing session and provide feedback to the facilitator.
30. The “basic assumption” is particularly important in debriefing because it:
- A. Allows the facilitator to assume everyone made mistakes.
- B. Sets a non-punitive tone and pre-empts defensiveness.
- C. Guarantees that no negative feedback will be given.
- D. Is a legal requirement for all hospital meetings.
Answer: B. Sets a non-punitive tone and pre-empts defensiveness.
31. What is a potential pitfall of an unstructured debriefing session?
- A. It may become a “gripe session” or focus on blaming without clear learning objectives or actionable outcomes.
- B. It is always more efficient than a structured debrief.
- C. It ensures all team members participate equally.
- D. It is more likely to result in system improvements.
Answer: A. It may become a “gripe session” or focus on blaming without clear learning objectives or actionable outcomes.
32. A pharmacist participating in a debrief should be prepared to discuss:
- A. Only the errors made by other professions.
- B. Their own actions and thought processes related to medication use during the event.
- C. The hospital’s budget.
- D. Patient billing information.
Answer: B. Their own actions and thought processes related to medication use during the event.
33. How can a team debriefing support a “just culture”?
- A. By ensuring all errors are punished equally.
- B. By helping to differentiate between system errors, human errors, and at-risk or reckless behaviors in a reflective context.
- C. By ignoring all human factors and focusing only on technology.
- D. By keeping all discussions secret from safety officers.
Answer: B. By helping to differentiate between system errors, human errors, and at-risk or reckless behaviors in a reflective context.
34. The question “What was most challenging for you during that situation?” is designed to:
- A. Identify personal weaknesses to be used in performance reviews.
- B. Elicit reflection on personal experience and potential system or situational pressures.
- C. Blame the individual for finding the situation challenging.
- D. Test the person’s emotional resilience.
Answer: B. Elicit reflection on personal experience and potential system or situational pressures.
35. An effective facilitator will often use _________ to restate and clarify team members’ contributions during a debrief.
- A. Confrontational questions
- B. Their own opinions
- C. Paraphrasing and summarizing
- D. Complex medical jargon
Answer: C. Paraphrasing and summarizing
36. Including a discussion of team dynamics (e.g., communication, leadership, role clarity) in a debrief is important because:
- A. It is less important than discussing clinical decisions.
- B. These factors are often key determinants of team performance and patient safety.
- C. It allows team members to critique each other’s personalities.
- D. It is required for insurance reimbursement.
Answer: B. These factors are often key determinants of team performance and patient safety.
37. “Crisis resource management” (CRM) skills are often the focus of debriefings after simulations or critical events. These skills include:
- A. Only knowledge of drug doses.
- B. Teamwork, communication, situational awareness, and decision-making under pressure.
- C. Only technical procedural skills.
- D. The ability to work alone effectively.
Answer: B. Teamwork, communication, situational awareness, and decision-making under pressure.
38. The outcome of a debriefing should ideally be documented so that:
- A. Individuals can be reprimanded later.
- B. Action items and learning points can be tracked and implemented.
- C. The discussion can be used in legal proceedings.
- D. It can be posted on social media.
Answer: B. Action items and learning points can be tracked and implemented.
39. Debriefing can help reduce “second victim” syndrome among healthcare providers, which refers to:
- A. The patient’s family members.
- B. The emotional trauma and stress experienced by a provider after being involved in an adverse event or medical error.
- C. A second patient being harmed by the same error.
- D. A provider who was not involved in the event.
Answer: B. The emotional trauma and stress experienced by a provider after being involved in an adverse event or medical error.
40. A leader who actively promotes and participates in regular debriefings demonstrates a commitment to:
- A. A hierarchical, top-down culture.
- B. Maintaining the status quo.
- C. A culture of continuous learning and improvement.
- D. Reducing team communication.
Answer: C. A culture of continuous learning and improvement.
41. During a debrief, if a team member becomes defensive, a good strategy for the facilitator is to:
- A. Argue with them to prove they are wrong.
- B. Move on to the next person immediately.
- C. Reiterate the “basic assumption” of good intentions and use reflective listening to acknowledge their perspective before gently re-focusing on the process.
- D. End the debriefing.
Answer: C. Reiterate the “basic assumption” of good intentions and use reflective listening to acknowledge their perspective before gently re-focusing on the process.
42. Which of the following is an example of an “actionable takeaway” from a debrief?
- A. “We should all try to communicate better.”
- B. “The code cart medication drawer is disorganized. Let’s create a standardized layout and label it clearly by next week.”
- C. “Dr. Smith was too slow.”
- D. “The patient was very sick.”
Answer: B. “The code cart medication drawer is disorganized. Let’s create a standardized layout and label it clearly by next week.”
43. The “analysis” phase of a debriefing model typically involves:
- A. Only describing the events that occurred.
- B. Discussing why the events occurred, exploring the thought processes and contributing factors.
- C. Only summarizing the key learning points.
- D. Only venting emotions about the event.
Answer: B. Discussing why the events occurred, exploring the thought processes and contributing factors.
44. A major benefit of interprofessional debriefing is that it:
- A. Allows each profession to see how their actions are viewed by and impact other team members.
- B. Confirms that physicians are the only important members of the team.
- C. Is less effective than single-profession debriefings.
- D. Takes less time than individual reflection.
Answer: A. Allows each profession to see how their actions are viewed by and impact other team members.
45. For a student pharmacist, participating in a debriefing is a valuable opportunity to:
- A. Stay silent and observe without engaging.
- B. Understand real-world team dynamics and see how system-based practice and communication skills are applied to improve patient care.
- C. Correct the attending physician’s clinical reasoning.
- D. Document errors for their preceptor’s review.
Answer: B. Understand real-world team dynamics and see how system-based practice and communication skills are applied to improve patient care.
46. If a debriefing uncovers a significant knowledge gap in the team, an appropriate action item would be to:
- A. Discipline the team members involved.
- B. Arrange for a brief educational session or create a cognitive aid (e.g., a checklist, a new protocol).
- C. Ignore the knowledge gap as it is unlikely to recur.
- D. Assume the knowledge gap is not important.
Answer: B. Arrange for a brief educational session or create a cognitive aid (e.g., a checklist, a new protocol).
47. A debriefing should be a “no-rank” environment. This means:
- A. Only the highest-ranking person can speak.
- B. Everyone’s input is valued equally, regardless of their title, seniority, or profession.
- C. There is no designated leader for the team.
- D. Performance is not ranked during the session.
Answer: B. Everyone’s input is valued equally, regardless of their title, seniority, or profession.
48. What is the difference between a “hot” debrief and a more formal, “cold” debrief?
- A. Hot debriefs are for successes, cold debriefs are for failures.
- B. Hot debriefs are immediate and focus on key issues, while cold debriefs are scheduled later and allow for more in-depth analysis and data gathering.
- C. Hot debriefs are always longer than cold debriefs.
- D. Only senior leaders attend cold debriefs.
Answer: B. Hot debriefs are immediate and focus on key issues, while cold debriefs are scheduled later and allow for more in-depth analysis and data gathering.
49. The question “What one thing could we improve for the next time?” is designed to:
- A. Find a single person to blame.
- B. Generate a focused, actionable improvement plan.
- C. End the discussion on a negative note.
- D. Prove that the process is flawed.
Answer: B. Generate a focused, actionable improvement plan.
50. The ultimate reason to practice team debriefing in healthcare is to:
- A. Fulfill a JCAHO requirement.
- B. Improve teamwork and reduce patient harm.
- C. Create more meetings for staff to attend.
- D. Identify the weakest link on the team.
Answer: B. Improve teamwork and reduce patient harm.