The COVID-19 Online Learning Transition and the Plus/Delta Debriefing Model

As a result of the COVID-19 pandemic, the Harvard Medical School Master of Medical Sciences in Medical Education program implemented the Plus/Delta debriefing model to collect real-time learner feedback and facilitate continuous quality improvement within our assessment and program evaluation module, which rapidly transitioned online. The model is grounded in quality improvement methodology and encourages bidirectional rather than top-down feedback. Learners identified specifically what went well with each module session (Plus) and how to improve for the next time (Delta). After each session, narrative responses were reviewed, aggregated into meaningful categories, and implemented when possible. Implemented improvements focused on increasing session interactivity and enhancing communication. Learners pointed to the uniqueness of the model and applauded efforts to embed them in the cocreation process. Asking learners to debrief their experience-especially during a module which is iteratively redesigned week-by-week-can offer a realistic view of what is working and what needs further refinement. As we continue to navigate the COVID-19 pandemic, rapid, continuous educational quality improvement deserves renewed emphasis. Implementing the Plus/Delta debriefing model into longitudinal online teaching sessions is a translatable, easily replicable, and free method of receiving immediate and valuable learner feedback.