Anne van Dalen

66 I Chapter 2 Development of the Amsterdam Black Box debrief model According to the flowchart in Figure 1, a structured debrief model that may be used for postoperative video-assisted team debriefing was developed. In Figure 2, this proposed debrief model, named the Amsterdam Black Box debrief model is presented. The debrief model consists of six steps: (1) introduction, (2) experience, (3) observation, (4) analyze, (5) application, and (6) summarize. This model is presented in Figure 2. An independent debriefer facilitates the debriefing session using the model (i.e., neither the surgeon nor the anesthesiologist). During the short introduction (welcome address and thanking the team members), the purpose of the debriefing is stated, the expectations of the participants are set, and it is emphasized that the debriefing session takes place in a safe environment. Thismeans that everything that will be discussed remains confidential, according to the general privacy regulations. 21,79 If possible, first let the team watch the summarized video clip, as part of the experience step. The debriefer may then ask them to write down any notes or comments. The debriefer may let the team pick an event demonstrated in the video clip (if possible, with the performance report feedback), according to the predefined important debriefing human factor topics: communication, situational awareness, organization, or environment. If needed, the observation step may provide the team the opportunity to add any objective details on the shown event in the video clip (e.g., “what happened exactly?” “what did you do as a respond to the event?”). Next, the debriefer makes start with something positive by asking the team “what went well?” The analyze step is furthermore used to ask the team members questions such as “what could have done better?” “What made you act or react like this?” “What would you have done in this situation?” The debriefer is encouraged to not ask any questions starting with “why,” because the team members may then feel criticized. 80 During the application step, the team may focus on how to apply or perform the discussed issue in the future. After this, the team returns to the experience step, in which the team chooses another event shown in the performance report video clip. This circle of steps may be completed about 2-3 times, depending on the time. Last but not least, the debriefer may ask team members to shortly name the “take home message.” After this, there may be time for the team to say things that have not been on the table yet, things they wish to