How Cultural-Historical Activity Theory can Inform Interprofessional Team Debriefings

Cultural-historical activity theory (CHAT) foregrounds context in work activities and provides simulation educators a valuable lens to view simulations and debriefings. CHAT offers a complementary conceptual framework when used in conjunction with established debriefing strategies. CHAT focuses attention on work activities as goal-directed social encounters and makes the activity system the basic unit of analysis. Activity systems include the individual(s) involved, their objective(s), and the tools/mediating artifacts used to achieve those objectives within contexts that contain rules, communities, and clear divisions of labor. CHAT may help simulation educators in a number of ways: (a) to reframe how they observe and interpret complex social interactions within team simulations, (b) to help identify and prioritize topics for debriefing, (c) to explore contextual factors promoting or impeding safe and effective patient care, and (d) to facilitate discussion beyond lessons from the concrete simulation event to generalize learning to future clinical practice.