After Action Review for Healthcare Simulation: Applications to Emergency Medicine

Introduction: Debriefing is a post-event analysis which is a fundamental part of the learning process by simulation. It is an experiential learning activity with the objective to improve individual and team global performances. After Action Review (AAR) is a debriefing technique that was developed by the US Army exploring intent behind the actions during simulation. The objective of this work is to describe the principles of AAR as a technique and to determine its interest, advantages, and disadvantages in healthcare simulation, particularly in emergency medicine. Methods: We conducted a narrative review of the literature assessing AAR in debriefing in simulation learning. Eligible data were extracted from Medline, Web of Science, ScienceDirect, Pascal & Francis, and Defense Technical Information Center. Relevant manuscripts were included if they responded to the following criteria: simulation learning and AAR as debriefing technique. Results: Fifteen manuscripts were included. AAR allowed an objective and non-punitive analysis of the simulation. Its main strengths were to ensure a collective analysis of the team performance and to suggest relevant corrective measures. Its main limits were a lack of individual debriefing and its ineffectiveness if the debriefer is insufficiently experienced. Conclusion: AAR is a debriefing approach that promotes learning and improves team performance.