Page 45 - JSOM Spring 2021

Developing a simulation-based curriculum in another culture demonstrating an improvement in theoretical knowledge be-
is not without difficulties. Trainees often have had no previous fore and after the training course.
encounter with simulation-based training. They might expect a
more instructor-centered course and thus not participate fully Conclusion
in debriefings. Exploring nontechnical skills is complicated
4,5
by different conceptions of physicians’ and nurses’ roles. A Our experience shows that developing a medical simulation
6
strong hierarchic gradient might, for example, prevent nurses course in a cross-cultural setting is a demanding experience.
from giving feedback to doctors. Participants might have had Challenges in both the delivery and evaluation of training can
limited previous exposure to procedures and equipment rou- likely be mitigated by preparation as well as emotional intel-
tinely used in Western countries. Their level in basic skills, ligence. Evaluating the outcome of such courses is another
such as medication dosage calculations, can be heterogeneous challenge, which will be possible only by organizing follow-up
and might impair the teaching of more advanced techniques. studies of such training sessions.
Prejudice against the students’ intentions or motivations might
alter the instructor’s evaluation of their performance. Acknowledgments
We would like to thank Marcin Przybysz, OR-6, simulation
Mitigating these cultural difficulties requires a good dose of technician, for his help in conducting the simulations; San-
self-interrogation from instructors, who must remain open drine Caubet, OF-3, military physician, for her help in course
minded and curious about trainees’ motivations and expecta- management; and Mathieu Sahut, military physician, for his
tions. Pappamihiel et al. have highlighted the increasing need help in logistical aspects.
8
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for cross-cultural skills among military medical providers.
Cultural self-awareness is a key competency that must be part Authorship Contributions
of staff selection for training missions. JC participated in the study design, data collection and analy-
sis, and writing of the manuscript. AM, JC, PB, and VB partic-
Practical strategies to reduce the impact of cultural gaps in- ipated in the study design and data collection. PR participated
clude emphasizing the presimulation briefing and explaining in data collection. AP and MP participated in the data collec-
repeatedly how and why a medical simulation session works. tion and reviewing of the manuscript.
Debriefing not only must be nonjudgmental on cultural as-
pects but also acknowledge their existence. The quality of the Financial Disclosure
skills and behaviors expected cannot be downgraded; how- The authors have indicated they have no financial relation-
ever, instructors must be willing to help participants find prac- ships relevant to this article to disclose. This study was not
tical solutions for their individual situations. funded.
The ultimate goal of most partner force training missions is References
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