Faculty Debriefing Resources

Why Debriefing is Central to Medical Student Simulation

In undergraduate medical education, simulation is most powerful when it is paired with structured debriefing. For medical students, the debrief creates intentional space to reflect on clinical reasoning, communication and teamwork, and to link the simulation directly to LCME-required competencies such as problem solving, decision making and communication skills.

AAMC guidance on educational technology and simulation emphasizes that learning gains come from focused formative feedback and reviewing performance with faculty and peers — activities that occur primarily during debriefing. National AAMC surveys show that nearly all U.S. and Canadian medical schools now use simulation to assess competencies and provide structured feedback, underscoring debriefing as a core strategy for medical student learning and assessment.

Empirical work in simulation-based medical education demonstrates that structured debriefing improves learners’ satisfaction, perceived usefulness and self-reported learning, and that debriefing is an efficient way to increase learning benefits relative to running additional scenarios. BioMed Central+1 MedEdPORTAL reports of medical student simulation activities similarly highlight debriefing as the component students rate most highly for improving clinical judgment and integrating new knowledge.

Together, LCME expectations for active learning and timely feedback, AAMC recommendations for simulation use, and outcomes research in medical students all point to the same conclusion: the quality of the debrief is often more important than the complexity of the simulation itself.

PEARLS Healthcare Debriefing Tool

To support consistent, high-quality debriefing with medical students, our Simulation Center promotes the PEARLS (Promoting Excellence And Reflective Learning in Simulation) Healthcare Debriefing Tool.

PEARLS is an evidence-based, blended debriefing framework that helps faculty:

  • Establish psychological safety and clarify debriefing goals.
  • Use learner self-assessment to surface reasoning and frames.
  • Guide a focused discussion using facilitated discovery.
  • Offer clear, behavior-specific feedback with good judgment.
  • Close with key take-home points and explicit transfer to clinical practice.

The PEARLS approach and Healthcare Debriefing Tool were developed to make high-quality debriefing more accessible to faculty across health professions and are supported by a robust literature base in simulation debriefing and faculty development.

ACCESS PEARLS Healthcare Debriefing Tool

How We Use PEARLS in Our Simulation Center

Below is a suggested local workflow you can adapt for clerkships, preclinical courses and interprofessional sessions involving medical students.

  1. Before the session
    • Faculty review the PEARLS framework and identify the main focus for debriefing (e.g., diagnostic reasoning, handoffs, team communication).
    • Facilitators keep a one-page PEARLS quick guide (see below) handy during the scenario and debrief.
  2. During the prebrief
    • Inform students that the session will end with a structured debriefing using PEARLS.
    • Set expectations for psychological safety (e.g., “This is a learning space; errors are expected and debriefed, not judged.”).
    • Briefly outline the debrief structure: reactions → analysis → summary and application.
  3. During the debrief (15-30 minutes)
    • Reactions and description (1-3 min): Invite brief emotional reactions and a concise recap of events.
    • Analysis (10-20 min):
      • Start with learner self-assessment (“What went well?” “What would you do differently?”).
      • Use focused facilitation questions to explore clinical reasoning, teamwork and systems issues.
      • When needed, provide directive feedback using PEARLS “with good judgment” language to anchor feedback in shared observations.
    • Summary and transfer (3-5 min): Co-create key learning points and explicitly link them to clerkship EPA/competency expectations and LCME-aligned program objectives.
  4. After the session
    • Facilitators document two to three key debrief themes and follow-up items (e.g., curricular gaps, systems issues).
    • New faculty can use PEARLS plus peer observation or tools like DASH to receive feedback on their debriefing skills.

UMKC FACULTY DEBRIEFING GUIDE AND TOOLKIT

References

Association of American Medical Colleges. Simulation in Medical Education. Washington, DC: AAMC; 2014.

Association of American Medical Colleges. Medical Simulation in Medical Education Survey Report. Washington, DC: AAMC; 2023.

Association of American Medical Colleges. Effective Use of Educational Technology in Medical Education. Washington, DC: AAMC; 2007.

Liaison Committee on Medical Education. Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the MD Degree (2023–24).

Daniel-Underwood L. Using High-Fidelity Medical Simulation to Assess Critical Thinking Skills of Senior Baccalaureate Nursing Students. [dissertation].

McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? Acad Med. 2011;86(6):706-711.

Abegglen S, Schlegel C, Sauter TC, et al. Debriefing interaction patterns and learning outcomes in simulation-based medical education. Adv Simul (Lond). 2022;7(1):12.

Schauberger CW, Simon LV, et al. First Call Simulation: Preparing for Acute Patient Deterioration on the Wards. MedEdPORTAL. 2020;16:10982.

Eppich W, Cheng A. Promoting Excellence and Reflective Learning in Simulation (PEARLS): Development and rationale for a blended approach to health care simulation debriefing. Simul Healthc. 2015;10(2):106-115.

Bajaj K, Meguerdichian M, Thoma B, et al. The PEARLS Healthcare Debriefing Tool. Acad Med. 2018;93(2):336.