<?xml version="1.0" encoding="UTF-8" standalone="no"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="letter" dtd-version="1.2" xml:lang="en">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">johs</journal-id>
<journal-title-group>
<journal-title>Journal of Healthcare Simulation</journal-title>
<abbrev-journal-title>J Healthc Simul</abbrev-journal-title>
</journal-title-group>
<issn publication-format="electronic">2754-4524</issn>
<publisher>
<publisher-name>Association for Simulated Practice in Healthcare</publisher-name>
<publisher-loc>London, UK</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">divw2372</article-id>
<article-id pub-id-type="doi">10.54531/DIVW2372</article-id>
<article-categories>
<subj-group subj-group-type="display-article-type"><subject>Letter</subject></subj-group>
</article-categories>
<title-group>
<article-title>Letter to the editor: approaches to meta-debriefing</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0988-9267</contrib-id><name><surname>Harrison</surname><given-names>Neil</given-names></name><xref ref-type="aff" rid="AF0001"><sup>1</sup></xref><xref ref-type="corresp" rid="c1"/></contrib>
<contrib contrib-type="author" corresp="no"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9630-927X</contrib-id><name><surname>Somerville</surname><given-names>Susan</given-names></name><xref ref-type="aff" rid="AF0001"><sup>1</sup></xref></contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Lewis</surname><given-names>Steven</given-names></name><xref ref-type="aff" rid="AF0001"><sup>1</sup></xref></contrib>
<aff id="AF0001"><label>1</label><institution>Dundee Institute for Healthcare Simulation, Faculty of Health, University of Dundee</institution>, Dundee, <country>UK</country></aff>
</contrib-group>
<author-notes>
<corresp id="c1"><bold>Corresponding author:</bold> Neil Harrison, <email xlink:href="n.x.harrison@dundee.ac.uk">n.x.harrison@dundee.ac.uk</email></corresp>
</author-notes>
<pub-date iso-8601-date="2026-07-03" pub-type="epub"><day>03</day><month>07</month><year>2026</year></pub-date>
<fpage>1</fpage>
<lpage>2</lpage>
<history>
<date date-type="received"><day>04</day><month>06</month><year>2026</year></date>
<date date-type="accepted"><day>10</day><month>06</month><year>2026</year></date>
</history>
<permissions>
<copyright-statement>© The Author(s). 2026</copyright-statement>
<copyright-year>2026</copyright-year>
<license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by-sa/4.0/">
<license-p>This article is distributed under the terms of the Creative Commons Attribution-Share Alike 4.0 International License (<ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-sa/4.0/">https://creativecommons.org/licenses/by-sa/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated).</license-p></license>
</permissions>
<self-uri xlink:href="divw2372.pdf" xlink:title="pdf"/>
<kwd-group><title>Keywords:</title>
<kwd>debriefing</kwd>
<kwd>education</kwd>
<kwd>faculty development (simulation educator or simulation technician)</kwd>
<kwd>health professions education</kwd>
<kwd>medical education</kwd>
<kwd>nursing education</kwd>
<kwd>simulation</kwd>
</kwd-group>
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<meta-value>PAP</meta-value>
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<custom-meta>
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<meta-value>2026-07-03T18:30:17</meta-value>
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</front>
<body>
<p>To the editor-in-chief,</p>
<p>We congratulate Oliver et al. [<xref ref-type="bibr" rid="CIT0001">1</xref>] on their recent publication, amplifying their work on the Meta-Debrief Club, which continues to be a worthy innovation, improving the facilitation of simulation debriefing. This innovation was explored by Kumar et al. in 2025 [<xref ref-type="bibr" rid="CIT0002">2</xref>], and prior to this, the Scottish simulation community has benefitted from employing meta-debriefing in our educational contexts for several years [<xref ref-type="bibr" rid="CIT0003">3</xref>,<xref ref-type="bibr" rid="CIT0004">4</xref>]. Over this time, we have come to realise that we approach meta-debriefing in a variety of ways. In Dundee, we approach meta-debriefing differently and, whilst we fully align with our colleagues’ previous publications, we suggest that alternative approaches may provide opportunities for even greater benefits in simulation faculty development.</p>
<p>Kumar et al. [<xref ref-type="bibr" rid="CIT0002">2</xref>] define the role of meta-debriefing as refining the art of educator-led debriefing. Our version of simulation faculty meta-debriefing is situated in a postgraduate module in simulation and short faculty development courses, and our meta-debriefing conversations consider all phases of a simulation: the pre-brief, immersion and debrief. Although purposeful development of simulation debriefing remains critical, we feel it is best developed when faculty are encouraged to reflect on how all three phases interact and impact each other. For example, the way in which intended learning outcomes are defined and shared by faculty within the pre-brief can influence how the debrief phase subsequently unfolds [<xref ref-type="bibr" rid="CIT0005">5</xref>]. Moreover, debriefing conversations rely on the educator–learner relationship, and so the educator’s approach to the pre-brief is key in establishing these fertile learning relationships. In our experience, it is often difficult and at times unhelpful to confine a meta-debriefing conversation to the debrief phase. Failing to consider events in the pre-brief and immersion phases may confine the meta-debriefing to focus on the technique or frameworks for debriefing, which are important, but negates the purpose of simulation as a pedagogy for those learning how to design and apply simulation in diverse contexts. Meta-debriefing all three phases of the simulation learning event also provides the potential to move beyond improving the debriefing skills of the individual facilitator, to building shared knowledge, skills and understanding in the theory-informed design of simulation sessions and curricula.</p>
<p>Kumar et al. [<xref ref-type="bibr" rid="CIT0002">2</xref>] recognise the interplay of the debrief with other phases in their description of meta-debriefing. They consider the pillar of psychological safety and the importance of the simulation debriefer feeling safe to receive feedback during the meta-debrief conversation. To encourage psychological safety, Oliver et al. [<xref ref-type="bibr" rid="CIT0001">1</xref>] advocate a pre-briefing for the meta-debriefing process, emphasising the previously appreciated critical nature of the pre-brief and its impact on the debrief [<xref ref-type="bibr" rid="CIT0006">6</xref>]. Similarly, during the meta-debriefing conversation, we feel it is potentially unhelpful to neglect the impact of the pre-brief phase on psychological safety and how that carries through to the debrief. Considering how psychological safety is established, monitored and maintained through the three phases of simulation allows richer discussion, either to understand what has occurred during the debrief or to improve debriefing skills through the educator’s approach to their pre-brief. Similarly, opportunities arise from meta-debriefing the immersion phase. Understanding the impact of simulation activity design on debriefing allows the conversation to go beyond the development of the individual debriefer. This lends itself to discussion which allows broader development of skills in designing simulations, leading to more impactful debriefing conversations.</p>
<p>In summary, our approach to meta-debriefing has a different, but hopefully complementary function, as it forms part of a broader simulation faculty development agenda rather than focusing solely on ‘debriefing the debrief’ [<xref ref-type="bibr" rid="CIT0001">1</xref>] and refining the art of debriefing. As such, we propose an alternative definition of meta-debriefing, reflecting this purpose:
<disp-quote><p>Meta-debriefing is a faculty-led technique to retrospectively explore a simulation event in terms of its design and implementation, for the purpose of faculty development.</p></disp-quote></p>
<p>We would be delighted to hear from the authors and others.</p>
<p>Sincerely,</p>
<p>Neil Harrison, Susan Somerville and Steven Lewis</p>
</body>
<back>
<sec id="s1"><title>Declarations<span id="s1" nov-type="cross-ref"/></title>
<sec id="s2" sec-type="author-contributions"><title>Authors’ contributions</title>
<p>None declared.</p>
</sec>
<sec id="s3" sec-type="funding-statement"><title>Funding</title>
<p>None declared.</p>
</sec>
<sec id="s4" sec-type="data-availability"><title>Availability of data and materials</title>
<p>None declared.</p>
</sec>
<sec id="s5" sec-type="ethics-statement"><title>Ethics approval and consent to participate</title>
<p>None declared.</p>
</sec>
<sec id="s6" sec-type="COI-statement"><title>Competing interests</title>
<p>None declared.</p>
</sec>
</sec>
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