Affective Debriefing for Pediatric Critical Care Medicine (PCCM) Fellows

Introduction: Affective debriefing is a structured process centered on the emotional experience of providers. This differs from event review debriefs that are quality-improvement minded. Studies have evaluated both affective and event review debriefs. While debriefing has not demonstrated a significant reduction in burnout, it is exceptionally well received by participants. Finally, PCCM attendings are asked to facilitate debriefs for their teams, and although many fellows participate, the majority do not receive formal training to lead debriefs.


Methods: PCCM fellows at a large academic children’s hospital completed an annual internal survey that included three items related to current debriefing practices and two Likert-scale items assessing aspects of structured debriefs and self-reported confidence in leading debriefs. Following that survey, affective debriefing sessions were added to the fellow curriculum. Sessions are facilitated every other month by palliative care and critical care attendings; it is emphasized that these are not evaluated sessions. The sessions are based on those held by the UPMC Palliative Care Section – a participant presents a difficult case to the group, followed by group discussion and reflection. Quality review committee approval is pending. A 6-month follow up survey will be sent to participants in Fall 2025.


Results: All PCCM fellows in the program (n=14) responded. Pre-intervention survey results show fellows most commonly report debriefing with co-fellows (100%), friends (71%), and immediate family (64%). 10 of 14 fellows (71%) were neutral or not comfortable leading a debriefing session.


Conclusions: Fellows unanimously identified co-fellows as a source of support and few are comfortable leading debriefs. This intervention is a feasible, low-cost intervention that creates a facilitated, time-protected space to debrief with co-fellows. Re-evaluation will assess participant satisfaction and preparedness to lead debriefing sessions with the goal of 75% of participants reporting positive satisfaction with the intervention and a 25% improvement in overall preparedness in leading debriefs. We hypothesize that this intervention will enhance PCCM fellows' sense of wellbeing and improve preparedness to lead debriefing sessions.