Blend the PEARLS debrief with CHAT-guided facilitation to extend debriefing from the individual to the team and system¶

Strategy · All strategies
Evidence · 6 claims (3 for, 3 mixed) · 4 studies (3 qualitative, 1 review), q2 · 0 of 4 report an effect size · 6 claims rest on one study

Description¶

The article recommends a blended debrief approach: the four PEARLS phases (reactions, description, analysis, summary) ensure psychological safety, while CHAT-guided facilitation in the analysis phase — orienting participants to laminated best-practice guidelines and activity system elements such as rules — expands the focus "beyond the individual to the team, social and cultural contexts". Facilitators used open questions, played back ISS video, and explicitly referenced the activity system triangle to prompt systemic analysis of contradictions.

Design Implications¶

Context¶

Requirements¶

• Requires a facilitator versed in CHAT terminology, ISS video footage as mirror data, and best-practice guidelines to anchor the analysis phase

Constraints¶

• PEARLS alone is described as keeping the focus on the individual; the blended approach was trialled in one general practice

Target Learners¶

• interprofessional healthcare simulation participants, including non-clinical staff

Target Learning Goals¶

• systemic understanding of emergency care activity
• collective reflection on team practice

Affordances¶

• Chat Expansive Learning Iss Framework

Claims¶

• In a theory-guided in-situ simulation programme, an interprofessional primary care team progressed through the expansive learning cycle from questioning current practice to consolidating new practices [+W]
• Three contradictions emerged in the SimLab process — individualised emergency response, excluded non-clinical staff, and outdated CPR training — and their collaborative resolution drove organisational change [+W]
• Debriefing description phase enacts conversational remembering that turns private recollections into a public, shared epistemic artifact [+W]
• Video-assisted debriefing enhances precision but risks psychological safety and narrows reflection to individual performance [~W]
• High-tech VAD equipment made some participants feel under observation and stressed, and viewing recorded mistakes before teammates was seen as critical in both VAD forms, a potential threat to psychological safety [~W]
• The outside perspective of video-assisted debriefing helped participants observe teammates and see how individual actions related to team performance, though most participants focused mainly on themselves [~W]

Related Strategies¶

• Debriefing
• Simulation Based Medical Training

Examples¶

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Key Sources¶

• O'Hare, S., Kajamaa, A., Conn, R., & Gormley, G. (2025). SimLab: an intervention to promote expansive learning and organisational change in team-based emergency care simulation. Instructional Science. https://doi.org/10.1007/s11251-025-09734-7