TY - JOUR

T1 - Cultural differences in simulation debriefing

T2 - A qualitative analysis

AU - Rana, Sharara Chami

AU - Francis, Ulmer

AU - Zavi, Lakissian

AU - Ella, Scott

AU - Honein-Abou Haidar, Gladys

AU - Peter, Dieckmann

N1 - Publisher Copyright: © 2023

PY - 2023

Y1 - 2023

N2 - Context: Simulation is a social practice impacted by norms, values, and beliefs. We seek to explore the relationship between cultural factors and participant behaviour patterns as perceived by debriefers during healthcare simulation debriefings. Our research question focuses on elucidating factors that influence debreifing dynamics between and among debriefers and learners according to Hofstede's cultural dimension: the Power Distance Index. Methods and materials: The study employed inductive qualitative analysis following Braun and Clark's 6-step approach to explore debriefers' perceived barriers to discussing non-technical skills including closed-loop communication, situational awareness, and cultural aspects of healthcare simulation debriefing. This study is a complementation to previously published quantitative paper, the qualitative findings are derived from the third section of the interview guide developed by the authors which focused on aspects of the debriefing such as debriefers' perceptions of participant familiarity with non-technical skills and cultural sensitivity. Findings: The responses of 57 debriefers from 26 countries were analysed; 36 (64%) of whom practiced simulation in low power distance index (PDI) countries and 31 (36%) practiced in high PDI countries. We identified three major themes: I. Group dynamics, encompassing challenges of hierarchy, ‘speaking up’, fear of ‘losing face’ and ‘judgement’. II. Conceptual clarity about debriefing medical/technical content and the challenges of ‘language’ and III. Institutional ‘skepticism’ toward simulation as a relatively new method of teaching in many parts of the world. Insights: The findings confirm the social nature of simulation debriefings, where the interactions are guided by motivations and rules, and where more variability can be found within a culture than between cultures. Acknowledging these differences could lead to cultivating new integrative perspectives for all levels of the healthcare system.

AB - Context: Simulation is a social practice impacted by norms, values, and beliefs. We seek to explore the relationship between cultural factors and participant behaviour patterns as perceived by debriefers during healthcare simulation debriefings. Our research question focuses on elucidating factors that influence debreifing dynamics between and among debriefers and learners according to Hofstede's cultural dimension: the Power Distance Index. Methods and materials: The study employed inductive qualitative analysis following Braun and Clark's 6-step approach to explore debriefers' perceived barriers to discussing non-technical skills including closed-loop communication, situational awareness, and cultural aspects of healthcare simulation debriefing. This study is a complementation to previously published quantitative paper, the qualitative findings are derived from the third section of the interview guide developed by the authors which focused on aspects of the debriefing such as debriefers' perceptions of participant familiarity with non-technical skills and cultural sensitivity. Findings: The responses of 57 debriefers from 26 countries were analysed; 36 (64%) of whom practiced simulation in low power distance index (PDI) countries and 31 (36%) practiced in high PDI countries. We identified three major themes: I. Group dynamics, encompassing challenges of hierarchy, ‘speaking up’, fear of ‘losing face’ and ‘judgement’. II. Conceptual clarity about debriefing medical/technical content and the challenges of ‘language’ and III. Institutional ‘skepticism’ toward simulation as a relatively new method of teaching in many parts of the world. Insights: The findings confirm the social nature of simulation debriefings, where the interactions are guided by motivations and rules, and where more variability can be found within a culture than between cultures. Acknowledging these differences could lead to cultivating new integrative perspectives for all levels of the healthcare system.

KW - Culture

KW - Debriefing

KW - Healthcare

KW - Simulation

U2 - 10.1016/j.heliyon.2023.e14904

DO - 10.1016/j.heliyon.2023.e14904

M3 - Journal article

C2 - 37064463

AN - SCOPUS:85151358075

VL - 9

JO - Heliyon

JF - Heliyon

SN - 2405-8440

IS - 4

M1 - e14904

ER -