National Survey of Neonatal–Perinatal Medicine Fellows on Postresuscitation Debriefing

Abstract

Objective

Debriefing can be a powerful tool to facilitate improvement of performance after a resuscitation event. This study characterizes the debriefing experience of neonatal–perinatal medicine (NPM) fellows in the neonatal intensive care unit (NICU), operating room, and delivery room in the United States.

Study Design

An anonymous 13-item electronic survey was distributed to NPM program directors across the United States, who were asked to forward it to their respective NPM fellows. The survey addressed the frequency and timing of debriefings, access to formal training, and comfort levels with debriefing.

Result

Ninety-five responses were collected, with all participants having taken part in at least one medical resuscitation. Debriefings occurred approximately 25% of the time following a resuscitation, typically within 6 hours. Twenty percent of respondents reported feeling somewhat or very uncomfortable leading a debriefing, while 84% believed debriefings improve team performance. Despite 72% reporting no formal debriefing training, 94% expressed interest in receiving such training.

Conclusion

This national survey on NPM fellows highlights inconsistent debriefing practices despite recognized benefits. Limited formal training remains a barrier, but a strong interest in further education presents an opportunity to improve training through the incorporation of structured debriefing frameworks into fellowship curricula.

Key Points

• Although NPM fellows often debrief resuscitations, 72% reported no formal training.

• Formal debriefing training can improve debriefing quality and enhance patient outcomes.

• NPM programs should implement structured debriefing to better prepare their fellows.

Keywords

neonatal - debriefing - resuscitation - delivery room - NICU

Publication History

Received: 09 October 2024

Accepted: 20 April 2025

Article published online:
12 May 2025

• References

• 1 Mullan PC, Wuestner E, Kerr TD, Christopher DP, Patel B. Implementation of an in situ qualitative debriefing tool for resuscitations. Resuscitation 2013; 84 (07) 946-951
• 2 Patterson MD, Geis GL, Falcone RA, LeMaster T, Wears RL. In situ simulation: detection of safety threats and teamwork training in a high risk emergency department. BMJ Qual Saf 2013; 22 (06) 468-477
• 3 Geis GL, Pio B, Pendergrass TL, Moyer MR, Patterson MD. Simulation to assess the safety of new healthcare teams and new facilities. Simul Healthc 2011; 6 (03) 125-133
• 4 Berg KM, Cheng A, Panchal AR. et al; Adult Basic and Advanced Life Support, Pediatric Basic and Advanced Life Support, Neonatal Life Support, and Resuscitation Education Science Writing Groups. Part 7: systems of care: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2020; 142 (16_suppl_2): S580-S604
• 5 Zinns LE, O'Connell KJ, Mullan PC, Ryan LM, Wratney AT. National survey of pediatric emergency medicine fellows on debriefing after medical resuscitations. Pediatr Emerg Care 2015; 31 (08) 551-554
• 6 Kessler DO, Cheng A, Mullan PC. Debriefing in the emergency department after clinical events: a practical guide. Ann Emerg Med 2015; 65 (06) 690-698
• 7 Evans TR, Burns C, Essex R. et al. A systematic scoping review on the evidence behind debriefing practices for the wellbeing/emotional outcomes of healthcare workers. Front Psychiatry 2023; 14: 1078797
• 8 Sather NK, Zinns LE, Brennan G, Guo L, Khan N, Havalad V. Survey of pediatric critical care fellows on postresuscitation debriefing. J Patient Cent Res Rev 2023; 10 (04) 247-254
• 9 Aponte-Patel L, Salavitabar A, Fazzio P, Geneslaw AS, Good P, Sen AI. Implementation of a formal debriefing program after pediatric rapid response team activations. J Grad Med Educ 2018; 10 (02) 203-208
• 10 Gillen J, Koncicki ML, Hough RF. et al. The impact of a fellow-driven debriefing program after pediatric cardiac arrests. BMC Med Educ 2019; 19 (01) 272
• 11 Cincotta DR, Quinn N, Grindlay J. et al. Debriefing immediately after intubation in a children's emergency department is feasible and contributes to measurable improvements in patient safety. Emerg Med Australas 2021; 33 (05) 780-787
• 12 Sandhu N, Eppich W, Mikrogianakis A, Grant V, Robinson T, Cheng A. Canadian Pediatric Simulation Network (CPSN) Debriefing Consensus Group. Postresuscitation debriefing in the pediatric emergency department: a national needs assessment. CJEM 2014; 16 (05) 383-392
• 13 Theophilos T, Magyar J, Babl FE. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Debriefing critical incidents in the paediatric emergency department: current practice and perceived needs in Australia and New Zealand. Emerg Med Australas 2009; 21 (06) 479-483
• 14 Ireland S, Gilchrist J, Maconochie I. Debriefing after failed paediatric resuscitation: a survey of current UK practice. Emerg Med J 2008; 25 (06) 328-330
• 15 Coggins A, Zaklama R, Szabo RA. et al. Twelve tips for facilitating and implementing clinical debriefing programmes. Med Teach 2021; 43 (05) 509-517
• 16 Rock L, Rudolph J, Fey M. et al. “Circle up”: workflow adaptation and psychological support via briefing, debriefing, and peer support. NEJM Catalyst. Accessed May 1, 2025 at: https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0240?targetBtn=articleToolSaveBtn
• 17 de Koning R, Egiz A, Kotecha J. et al. Survey fatigue during the COVID-19 pandemic: an analysis of neurosurgery survey response rates. Front Surg 2021; 8: 690680