Anne van Dalen

Summary and General Discussion I 263 Team debriefing There is a large variety of approaches to team debriefing available in the current medical literature. 69 However, healthcare professionals arrive to the OR with various sets of experiences, ingrained personality traits, and established relationship patterns. All of them may benefit from team debriefing considerably, but most of them often do not yet have sufficient or any experience in structured team debriefing. 70 71 Moreover, team debriefing usually takes place in a simulation setting, but is considered to be an even more powerful learning experience for the OR team when it takes place following the real clinical setting instead, such as after actual surgical procedures. 25 For this, the use of a standardized debrief model is recommended. Using video recordings during the debriefings is recommended as well, as they provide objective feedback. 72 However, peer- reviewed articles on how to actually debrief with the use of a Black Box and especially on how to optimally translate it into clinical practice appeared to be lacking. No debrief model suitable for postoperative video-assisted team debriefing was found in the current medical literature. 69 Therefore, the identified approaches, elements, and methods on how to debrief the OR team with the use of a Black Box were summarized in the structured Amsterdam Black Box debrief model. The participants who experienced the use of this debrief model believed the Black Box debrief sessions were useful and educational, and believed that their time was well spent. 51 The establishment of a safe environment, facilitating an open, honest, and positive discussion, characterizes a good team debriefing session. 86 As summarized in this thesis, honest participation means that the participants can safely ask themselves and each other “what went well, what could be better, and what should we do differently next time?” 69 73 Participants develop a high level of reflection by creating their own conclusions and motivation for change. 71 The team debriefings should be scheduled outside the immediate OR environment on a round table setup, so the team can sit comfortably, on eye level, and on neutral ground. 71 Hospital directorates who support participation of debriefings should facilitate in allocating time, making it possible to attend the debriefings preferably