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Debriefing for technology-enhanced simulation: a systematic review and meta-analysis
Abstract
Objectives: Debriefing is a common feature of technology‐enhanced simulation ( TES ) education. However, evidence for its effectiveness remains unclear. We sought to characterise how debriefing is reported in the TES literature, identify debriefing features that are associated with improved outcomes, and evaluate the effectiveness of debriefing when combined with TES . Methods: We systematically searched databases, including MEDLINE , EMBASE and Scopus, and reviewed previous bibliographies for original comparative studies investigating the use of TES with debriefing in training health care providers. Reviewers, in duplicate, evaluated study quality and abstracted information on instructional design, debriefing and outcomes. Effect sizes ( ES ) were pooled using random‐effects meta‐analysis. Results: From 10 903 potentially eligible studies, we identified 177 studies (11 511 learners) that employed debriefing as part of TES . Key characteristics of debriefing (e.g. duration, educator presence and characteristics, content, structure/method, timing, use of video) were usually incompletely reported. A meta‐analysis of four studies demonstrated that video‐assisted debriefing has negligible and non‐significant effects for time skills ( ES = 0.10) compared with non‐video‐assisted debriefing. Meta‐analysis demonstrated non‐significant effects in favour of expert modelling with short debriefing in comparison with long debriefing (ES range = 0.21–0.74). Among studies comparing terminal with concurrent debriefing, results were variable depending on outcome measures and the context of training (e.g. medical resuscitation versus technical skills). Eight additional studies revealed insight into the roles of other debriefing‐related factors (e.g. multimedia debriefing, learner‐led debriefing, debriefing duration, content of debriefing). Among studies that compared simulation plus debriefing with no intervention, pooled ES s were favourable for all outcomes (ES range = 0.28–2.16). Conclusions: Limited evidence suggests that video‐assisted debriefing yields outcomes similar to those of non‐video‐assisted debriefing. Other debriefing design features show mixed or non‐significant results. As debriefing characteristics are usually incompletely reported, future debriefing research should describe all the key debriefing characteristics along with their associated descriptors.
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“Cheng et al [53] demonstrated that structured debriefing is an influential instructional component, facilitating reflection, performance analysis, and knowledge transfer to clinical contexts.”
From Enhancing Psychiatry Training Using an Agentic AI Simulated Consultation Tool: Prospective Cohort Study (2026) · cites this paper as [53]
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“…learn how to translate resilience into practice, Harald-seid-Driftland et al. found a number of learning principles that are parallel to our debriefing techniques in IPSE, such as using a collaborative approach, creating awareness of adaptive capacities, and sharing examples of good practice [29].”
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“These results were congruent with those obtained in the qualitative analysis, and this was possible because the training program followed international recommendations for the design of activities based on clinical simulation [33], the use of a psychologically safe environment [36,37], and a structured debriefing [38,…”
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“Despite the well-established importance of debriefing in simulation-based learning, existing research is largely concentrated in the healthcare sector (e.g., Cheng et al., 2014, 2020 ).”
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“The debriefing provides a forum for learners to identify performance gaps, discuss areas for improvement, and consolidate lessons that can be applied in later practice [3].”
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Palliative care simulation for internal medicine trainees: development and pilot study
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Case Study: Flipped Classroom with Gamification in a Hybrid Fluid Mechanics Course
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A Novice Guide to Applications of Simulation in the Pediatric Emergency Department
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“” It provides an opportunity for the participants to reflect on their performance with the goal of improving future performance.(34) Debriefing after a simulated or real event can improve the process and subsequent outcomes.”
BackgroundVirtual simulation debriefing in health professions education: a scoping review protocol
Garmaise-Yee, J., Houston, C., Johnson, T., & Sarmiento, S. (2021) · JBI Evidence Synthesis · doi:10.11124/jbies-21-00170 · Cited by 6
Simulation and Quality in Clinical Education
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BackgroundDebriefing in Emergency Medicine
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Self-citationDesigning the simulation learning environment: An active engagement model
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Self-citationReflections in the Lens: Video-Assisted Debriefing Augments Simulation–Based Medical Education*
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BackgroundInfluentialA systematic review of technology in the after-action review (or debrief)
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“Those database searches were combined with a review of the references from literature reviews (Allen et al., 2018; Kim & Yoo, 2020; Sawyer et al., 2016) and meta-analyses (Cheng et al., 2014; Couper et al., 2013; Fernandez, 2014; Keiser & Arthur, 2021, 2022; Tannenbaum & Cerasoli, 2013).”
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“Similarly, Allen et al. (2018) characterize AARs as collaborative efforts aimed at deriving learnings from recent events, and Cheng et al. (2014) view AARs as reflective forums for identifying performance gaps and integrating knowledge for practical application.”
Metadata
- Authors
- Cheng, A., Eppich, W., Grant, V., Sherbino, J., Zendejas, B., & Cook, D. A.
- Affiliations
- University of Calgary (CA)
- Northwestern University (US)
- McMaster University (CA)
- Mayo Clinic (US)
- Corresponding author
- Cheng, Adam
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2014-06-09
- Volume
- 48
- Issue
- 7
- Pages
- 657-666
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W1986133144
- Cited by
- 481
- References
- 48
- Citations by year
- 2026: 51 · 2025: 34 · 2024: 42 · 2023: 24 · 2022: 27 · 2021: 48 · 2020: 58 · 2019: 43 · 2018: 42 · 2017: 35 · 2016: 44 · 2015: 27 · 2014: 5
- FWCI
- 4.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Simulation-Based Education in Healthcare
- Health Sciences › Medicine › Surgery › Surgical Simulation and Training
- Social Sciences › Education › Innovations in Medical Education
- Keywords
- debriefing, simulation-based medical education, video-assisted debriefing
- MeSH terms
- Computer Simulation, Education, Medical, Education, Professional, Health Personnel, Humans, Teaching, Time Factors, Video Recording, Databases, Bibliographic, Problem-Based Learning
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