Royal College of Surgeons in Ireland
Embracing informed learner self-assessment during debriefing.pdf (1.67 MB)

Embracing informed learner self-assessment during debriefing: the art of plus-delta

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journal contribution
posted on 2022-11-28, 16:50 authored by A Cheng, Walter Eppich, C Epps, M Kolbe, M Meguerdichian, V Grant

The healthcare simulation field has no shortage of debriefing options. Some demand considerable skill which serves as a barrier to more widespread implementation. The plus-delta approach to debriefing offers the advantages of conceptual simplicity and ease of implementation. Importantly, plus-delta promotes learners' capacity for a self-assessment, a skill vital for safe clinical practice and yet a notorious deficiency in professional practice. The plus-delta approach confers the benefits of promoting uptake of debriefing in time-limited settings by educators with both fundamental but also advanced skills, and enhancing essential capacity for critical self-assessment informed by objective performance feedback. In this paper, we describe the role of plus-delta in debriefing, provide guidance for incorporating informed learner self-assessment into debriefings, and highlight four opportunities for improving the art of the plus delta: (a) exploring the big picture vs. specific performance issues, (b) choosing between single vs. double-barreled questions, (c) unpacking positive performance, and (d) managing perception mismatches. 



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Published Citation

Cheng A. et al. Embracing informed learner self-assessment during debriefing: the art of plus-delta. Adv Simul (Lond). 2021;6(1):22.

Publication Date

5 June 2021

PubMed ID



  • SIM Centre for Simulation Education and Research


BioMed Central


  • Published Version (Version of Record)