Aims The Paediatric Objective Structured Assessment of Debriefing (OSAD) tool is a validated tool developed to measure the quality of debriefing in full patient simulation. This study aims to improve the usability of OSAD to peer review debriefing across a simulation network.

Methods Peer review of debriefing practices within in situ paediatric simulations was assessed using questionnaires and semistructured interviews across 11 hospitals to identify variation in debriefing practices.

Peer reviewers were interviewed to assess the usability of OSAD and to identify barriers to quality assurance. Interviews were transcribed verbatim and analysed using an inductive approach to illicit iterative codes. These were then refined to create meaningful units, which, in combination with the results from the questionnaire study, inform the key findings of this study.The Model for Improvement approach was used to test and refine a pocketsize aide memoire of the OSAD tool that is more useable for peer review of debriefing.

Results The questionnaire study demonstrated variation in debriefing across the network. 65% used a structured debriefing approach (59% used OSAD) and peer review was rarely used for quality assurance (18%) but was deemed successful where used. Thematic analysis demonstrated that the OSAD tool was considered beneficial to providing a debriefing structure, promoting peer review and providing a safe means for constructive feedback. Suggestions to support and promote its use in debriefing practices resulted in a pocketsize aide memoire to accompany the detailed tool, which was tested and refined by simulation experts.

Conclusion A peer-review approach to debriefing using the OSAD can enhance debriefing practices and promote quality assurance. The OSAD tool for peer review of debriefing has demonstrated benefit for providing a debriefing structure and supports constructive feedback. A simplified aide memoire to accompany OSAD supports its implementation for peer review and the delivery of high standards within debriefing practices.