Implementation of hot debriefing in intensive care units through in-situ simulation: A controlled before-and-after study of its effect on healthcare providers' burnout

Paul Palardy; Donatien Huard; Nicolas Grillot; Pierre-Joachim Mahé; Karim Lakhal; Corinne Lejus-Bourdeau

doi:10.1016/j.accpm.2025.101697

Implementation of hot debriefing in intensive care units through in-situ simulation: A controlled before-and-after study of its effect on healthcare providers' burnout

Anaesth Crit Care Pain Med. 2025 Nov 14;45(4):101697. doi: 10.1016/j.accpm.2025.101697. Online ahead of print.

Authors

Paul Palardy¹, Donatien Huard¹, Nicolas Grillot¹, Pierre-Joachim Mahé¹, Karim Lakhal², Corinne Lejus-Bourdeau³

Affiliations

¹ Nantes Université, CHU Nantes, Service d'Anesthésie Réanimation Chirurgicale, Hôtel Dieu - Hôpital Mère Enfant, F-44000 Nantes, France.
² Nantes Université, CHU Nantes, Service d'Anesthésie Réanimation Chirurgicale, Hôpital Laennec, F-44000 Nantes, France.
³ Nantes Université, CHU Nantes, Service d'Anesthésie Réanimation Chirurgicale, Hôtel Dieu - Hôpital Mère Enfant, F-44000 Nantes, France. Electronic address: corinne.lejus@chu-nantes.fr.

PMID: 41242389
DOI: 10.1016/j.accpm.2025.101697

Abstract

Context: The incidence of burnout is high among healthcare providers in intensive care units. Hot debriefing after critical situations remains rare. The main objective of this prospective, controlled, bicentric, before-and-after study was to evaluate the impact of implementing systematic debriefing, using a high-fidelity in-situ simulation program.

Methods: The study involved healthcare providers in two intensive care units. In one unit (debrief group), the physicians received theoretical training in debriefing, followed by practice during a 6-day interprofessional in-situ high-fidelity simulation program. Then, for 6 months, hot debriefing was encouraged after each critical situation. The other unit (control group) showed no change. A before-and-after online survey assessed psychosocial risk factors, work-related distress, and the number of debriefings in both units. The main endpoint was the incidence of severe burnout assessed by the Maslach Burnout Inventory (MBI).

Results: Sixteen physicians were trained to debrief, 133 professionals participated in the simulation program, and the survey was completed by 54 (debrief group) and 40 (control group) professionals. Severe burnout incidence did not vary before (9.3% and 7.5% respectively in the debrief and control groups) and after (1.8% and 10%) the study between groups (p = 0.358). In the debrief group, the rate of participation in hot debriefing increased from 22.2% to 53.7% and the MBI score and its accomplishment component were improved in the nurse subgroup.

Conclusion: The in-situ simulation program was effective in implementing hot debriefing in the intensive care unit. Despite no change in the overall burnout prevalence, a favorable effect on nurses occurred in the debrief group.

Keywords: Burnout; Debriefing; High-fidelity simulation; In-situ simulation; Intensive care unit.