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Cultural differences in simulation debriefing: A qualitative analysis.

Sharara-Chami Rana¹, Ulmer Francis², Lakissian Zavi³

¹Pediatric Critical Care, Inova LJ Murphy Children's Hospital, University of Virginia, USA.

|April 17, 2023

Summary

Cultural factors significantly influence healthcare simulation debriefings. Understanding these dynamics, particularly power distance, is key to improving communication and learning in simulation-based education globally.

Keywords:

Culture Debriefing Healthcare Simulation

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Area of Science:

Healthcare education research
Medical simulation
Cross-cultural psychology

Background:

Healthcare simulation is a social practice influenced by cultural norms, values, and beliefs.
Understanding cultural factors is crucial for effective debriefing dynamics in simulation.
Previous research has highlighted the importance of non-technical skills in simulation.

Purpose of the Study:

To explore the relationship between cultural factors and participant behavior in healthcare simulation debriefings.
To identify factors influencing debriefing dynamics based on Hofstede's cultural dimension: the Power Distance Index (PDI).
To elucidate perceived barriers to discussing non-technical skills and cultural aspects during debriefing.

Main Methods:

Inductive qualitative analysis using Braun and Clark's 6-step approach.
Analysis of responses from 57 debriefers across 26 countries.
Interviews focused on debriefers' perceptions of non-technical skills and cultural sensitivity.

Main Results:

Three major themes emerged: group dynamics (hierarchy, speaking up, face-saving), conceptual clarity (language barriers), and institutional skepticism towards simulation.
Significant differences in debriefing dynamics were observed between low and high Power Distance Index (PDI) countries.
Variability within cultures was greater than variability between cultures, emphasizing the social nature of simulation debriefings.

Conclusions:

Healthcare simulation debriefings are social interactions shaped by cultural norms and individual motivations.
Acknowledging cultural differences, particularly related to PDI, can enhance debriefing effectiveness.
Developing integrative perspectives considering cultural nuances is essential for improving healthcare simulation globally.