• V J Grant, T Robinson, H Catena, W Eppich, and A Cheng.
• a Department of Pediatrics and Emergency Medicine, Cumming School of Medicine , University of Calgary , Calgary , Canada.
• Med Teach. 2018 Jul 1; 40 (7): 703-712.

BackgroundSimulation-based education (SBE) has emerged as an essential modality for health professions education. One of the central tenants of effective SBE is reflective practice, typically guided by a facilitated debriefing. The debriefing conversation has the possibility of becoming a difficult conversation based on learner and situation-related factors. Difficult debriefing situations may threaten the learning environment, thus requiring an appreciation and understanding of the various ways that learners may react adversely to simulation and debriefing.AimThis article provides a review of the various phenotypes of difficult debriefing situations and a toolbox of proactive and reactive strategies to help guide the simulation educator to manage these situations, with the ultimate goal of achieving learning objectives.

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