How does culture affect experiential training feedback in exported Canadian health professional curricula?

Abstract

ObjectivesTo explore feedback processes of Western-based health professional student training curricula conducted in an Arab clinical teaching setting. MethodsThis qualitative study employed document analysis of in-training evaluation reports (ITERs) used by Canadian nursing, pharmacy, respiratory therapy, paramedic, dental hygiene, and pharmacy technician programs established in Qatar. Six experiential training program coordinators were interviewed between February and May 2016 to explore how national cultural differences are perceived to affect feedback processes between students and clinical supervisors. Interviews were recorded, transcribed, and coded according to a priori cultural themes. ResultsDocument analysis found all programs’ ITERs outlined competency items for students to achieve. Clinical supervisors choose a response option corresponding to their judgment of student performance and may provide additional written feedback in spaces provided. Only one program required formal face-to-face feedback exchange between students and clinical supervisors. Experiential training program coordinators identified that no ITER was expressly culturally adapted, although in some instances, modifications were made for differences in scopes of practice between Canada and Qatar. Power distance was recognized by all coordinators who also identified both student and supervisor reluctance to document potentially negative feedback in ITERs. Instances of collectivism were described as more lenient student assessment by clinical supervisors of the same cultural background. Uncertainty avoidance did not appear to impact feedback processes. ConclusionsOur findings suggest that differences in specific cultural dimensions between Qatar and Canada have implications on the feedback process in experiential training which may be addressed through simple measures to accommodate communication preferences.

Sociocultural factors influencing ‘assessments for learning’ at the clinical workplace – A scoping review

“…The majority of the studies from non-western contexts have measured learners and faculty satisfaction and perceptions regarding validity and educational value, and effectiveness of WPBAs in improving clinical skills of the learners [30]. A few studies however, emphasized students' and supervisors' orientations on the process and purpose of WBA to bring a cultural change towards formative assessments and students' deeper approach to learning [10]. To the best of our knowledge, a study from Indonesia was the rst one to report effect of cultural differences on the perception and implementation of WPBAs [90].…”

“…Studies suggest a strong in uence of socio-cultural factors, such as mindsets and cultural norms manifest in the doctor-patient and teacher-student relationships, on the adoption and implementation of WPBAs [6][7][8]. These sociocultural differences in uence faculty and learner perspectives, subsequently affecting assessor judgment, feedback, and learner behaviors and responsiveness to feedback [9,10]. For example, a study conducted in Saudi Arabia identi ed power hierarchy as the social factor affecting the faculty-student relationship that resulted in inhibition of debate by the students and failure in achieving the desired goal of formative assessments [11].…”

Cultural Considerations in the Formal Process of Simulation Curriculum Adaptation: A Scoping Review

“…23,24,26,29,[32][33][34] Six articles focused on a single site institution in the host context. 10,19,22,27,28,31 Two focused on single site institutions in the home context. 16,25 Three articles gave information on multisite institutions in the host context.…”

“…Most prevalent, in 12 articles, was the transfer of curriculum from home to host. 10,11,[17][18][19]22,24,[26][27][28][30][31][32][33][34] Of those 12, 5 articles included specific references to the bilateral exchange of curriculum. 11,24,26,30,32 Four articles set out to design a "global" or "international curriculum" from the outset.…”

“…Feeding off of cultural awareness and knowledge, there is distinct value in understanding behaviors related to learners' backgrounds, particularly related to learners engaging in reflection and giving feedback. 19,27 4. Cultural encounters Cultural encounters are the crux of SBE.…”