Comparing two post-resuscitation debriefing frameworks: a randomized cross-over simulation study

BACKGROUND: Post-resuscitation debriefing (PRD) enhances individual and team performance in emergency care, thereby improving patient outcomes and provider well-being. Despite support from the European Resuscitation Council and the American Heart Association, the optimal PRD framework remains undefined. This study compares how team members experience PRD when conducted using either the DISCERN or Post-Code Pause (PCP) debriefing framework in pre-hospital cardiac arrest simulations. METHODS: In a randomized cross-over study, 40 medical doctors participated in four advanced life support (ALS) simulation scenarios. Participants acted exclusively within their usual roles as team leaders, while the remaining team members performed standardized roles in accordance with the scenario scripts. Each participant experienced two DISCERN and two PCP debriefings, with the order randomized. The primary outcome was the total score on the Debriefing Experience Scale (DES), with item scores as secondary outcomes. Linear models with generalized estimating equations (GEE) were used to account for repeated measures when comparing the mean scores between the debriefing frameworks. RESULTS: A total of 158 DES questionnaires were analyzed. Mean total DES scores were 4.15 (4.02; 4.28) for PCP and 4.16 (4.02; 4.29) for DISCERN (p = 0.93 for the comparison). These scores indicate a favorable debriefing experience for both frameworks. At the DES item level, no statistically significant differences were observed between frameworks, except for perceived physical comfort in the debriefing environment, which was rated significantly higher for DISCERN (DISCERN = 4.44 (4.27; 4.62), PCP = 4.13 (3.96; 4.30), p = < 0.0001). CONCLUSION: DISCERN and PCP provide similarly favorable debriefing experiences following simulated cardiac arrest scenarios, with no significant difference in overall DES scores. These findings suggest that both frameworks can be implemented without compromising perceived debriefing quality. Further research should include more professionally diverse participant samples and assess long-term debriefing outcomes. TRIAL REGISTRATION: Clinical Trial Center UZ Leuven, S65846 September 2021.