Limitations
We report what staff thought, and examined associations between debrief
and outcomes. However, debrief does not happen in isolation from the
rest of teamwork, culture and leadership, and it is therefore not
possible to claim that debrief is the cause of better culture scores.
The problem of associations and apportioning effect is common in
workplace culture studies, where it is (usually) not possible to conduct
experiments in controlled circumstances and changing just one variable
at a time.
A large proportion of our respondents worked in theatres, which may have
affected the results. Future, studies could include a larger number of
staff from a wider clinical setting; however, studying this in a wider
context may be more difficult if the researchers do not understand in
detail what kind of debrief takes place. A larger study could also have
the ability to test specific constructs/questions, with sufficient power
to demonstrate a statistical difference.
We used a limited number of outcomes, and this, together with use of
composite outcomes, is also a limitation. CCB is a published tool that
examines different attributes of NHS organisational culture, whilst the
promoter scores capture work engagement from a different angle. There is
a myriad of possible outcomes that could be used, with resultant
increase in complexity. Nevertheless, our simple and practical approach
suggests that debrief, and its quality, matter.