Dr. Muhammad Jawad proposes using SHARP (an acronym comprising five prompts) to improve performance feedback and debriefing for surgical trainees. Currently, trainers often leave before the case is over, missing opportunities for debriefing. SHARP provides a structured format to guide trainers and trainees in setting learning objectives before a case, discussing what went well and concerns after, reviewing learning points, and planning improvements for the future. The five prompts of SHARP are: SET learning objectives, HOW did it go?, ADDRESS concerns, REVIEW learning points, and PLAN ahead. Using SHARP takes little time but can make debriefing more effective for optimizing learning in surgical settings.

1. Operation Debrief
A SHARP Intervention to Improve
Performance Feedback in the OR
Dr. Muhammad Jawad
Post-Graduate Trainee
Surgical Unit III
Services Hospital, Lahore

2. Debriefing
One of the key educational techniques for
optimizing learning in surgical settings.

3. In the majority of cases,
trainers de-scrubbed at the time of skin closure
….leaving the trainee to finish the case alone—
missing the perfect opportunity
for debriefing….. consequently “actions
plans” for improvement were rarely set.

4. What is SHARP?
An acronym that comprises five ‘prompts’
to guide trainers and trainees
in providing/ receiving a structured debrief.

6. Step 1
SET LEARNING OBJECTIVES
Before the case
What would you like to get out of this case?

7. Step 2
HOW DID IT GO?
After the case
What went well?
Why?

8. Step 3
ADDRESS CONCERNS
What did not go so well?
Why?

9. Step 4
REVIEW LEARNING POINTS
Were your learning objectives met for this
case?
What did you learn about your
clinical/technical skills?
What did you learn about your teamwork
skills?

10. Step 5
PLAN AHEAD
What actions can you take to improve your
future practice?

11. Who can use SHARP?
SHARP can be used by anyone who wants a
brief reminder of what to cover in a debriefing
in a time-limited setting.
 Ideally SHARP should be used by both trainee
and trainer in order to ensure joint
responsibility for the debriefing.
REF : The London Handbook for Debriefing

12. For what can SHARP be used?
• Used as a practical aide memoire to help conduct
a debriefing ‘on the ground’.
• To remind trainees of the points that need to be
covered in the post-scenario debriefing
REF : The London Handbook for Debriefing

13. How should SHARP be used?
 First familiarize with the components of SHARP so that
you are comfortable using it.
 The first prompt ‘Set learning objectives’ should be
completed before the case.
 The remaining four prompts should be discussed after
the case. It is recommended that this is done as soon
as possible to ensure immediacy of feedback.
 No training is required in order to use the SHARP tool.
REF : The London Handbook for Debriefing

14. “SHARP forces you to sit
down and talk… make every
moment count.”
Consultant Trainer

15. HAVE YOU DONE YOUR
SHARP…???