Table 3 Keywords and data for debriefing as laisséz-faire

- Collegial conversation

Field note 4

The students, dressed in white clinical clothes, burst into the room after the simulation and try to grab a chair. You can hear a voice outside the room saying: “We will need more chairs in here.” The students talk to each other and then the instructor, dressed in green clinical clothes, comes in and while she is trying to find a chair she says: “OK, good folks. So, let’s have free comments from all of you, actors as well as those who observed!” And then she leans back in her chair. One of the medical student starts immediately and says: “Well I still haven’t phoned the doctor on call. I, it is hard to remember to phone the doctor on call. I just, oh yes the doctor on call.” And she and the other students as well as the instructor laugh a bit and the instructor says: “Well absolutely, it could have been a good idea but it went well anyway. Somebody else? “(Site 1)

- Without structure and clear aim

- Spontaneously

- Open inquiry approach

- Ad hoc reflection

- Reinforce good professional performance

Field note 5

- Focus on future professional practice

Everybody has just sat down around the table and one of the acting nurse students says “When you are standing and working on setting up an IV drip or things like that, then you do not follow what happens up there [refer to the upper part of the patients body] but you keep an overall awareness about what is happening. It felt like we had a good leader keeping control.” Another of the acting nurse students continues: “It was very good that you went through A, B, C all over again and again since the patient’s condition could have deteriorated and then it would be easy to miss if you just stopped. It was also loud and clear [refer to the medical students voice]”. Another nursing student continues: “I, as an observer, thought that you had good team work, that you were calm and that you talked to each other. I didn’t experience that some of you were standing [she makes her body rigid, folds her arms across her chest and just looks around], I think thateverybody was working together and it was clear.” The instructor: “Systematic, yes!”. One of the observing medical students turns to the acting medical students and says: “I thought that you were magnificent but I have some criticisms because there are improvements that you can make. Some things that I can go through quickly. You do not look up when you give an order. You say: start an IV line. I think that it would be good if you [she exemplifies by point to some persons with her hand] so they knew”. The instructor interrupts and says: “Can I stay there? What do those of you who were working in there think about this comment? How was it?” One of the acting nurse student: “Well it was loud and clear but I get what you mean, that somebody really gets an order to do something.” The instructor: “Who is somebody? You do not have somebody written on your name tag so use the names so it is clear.” (Site 1)

Quote 1

Instructor 1 argues: “You can do things in different ways [relates back to the scenario where one of the medical students could have delegated the task of calling the doctor on call] and this is the purpose of this day, that you can think I can do this or I can do that. Then you have thought about it once before you are placed in a real situation in a couple of weeks.” (Site 1)