Table 2 Selected quotes
Theme 1: Participant Anxiety | |
Anticipation | “I could feel my anxiety going up and up and then when I actually got there, I was just paralysed” Participant 10 “I was that stressed that like, I needed to get out – but I couldn’t get out, so I had to go through” Participant 5 “if you have tachycardia going into a sim then I think that’s pretty normal!” Participant 10 “You don’t really know what’s going to happen, that sort of thing, knowing what’s going—what we’re going to face” Participant 6 “it comes down to that fear, the fear of not knowing. The fear of doing something wrong. Probably the fear of being judged…yeah you know the worst things” Participant 9 “I could feel my heart racing” Participant 4 “I get sweaty and nauseated” Participant 1 |
Reputational ramifications | “There’s no way that can’t impact on someone’s impression of you, do you know what I mean?” Participant 8 “I didn’t want to look bad in front of other people who might come across my name in the future” Participant 10 “A lot of the big bosses were [running the sim]” Participant 10 “you don’t want to disappoint…you don’t want them to think you didn’t know how to do this procedure or how to manage this emergency” Participant 1 “the fall out afterwards thinking you haven’t done a good job” Participant 10 “you sort of start to question your ability and your own skill I guess” Participant 9 |
Under scrutiny | “it’s a performance” Participant 3 “I’m not comfortable when someone is watching” Participant 7 “[being watched] hinders a proper execution of your job” Participant 7 “I think people perform a bit differently when they know they’re being filmed. I think people don’t perform naturally and which is a bit of a laugh actually” Participant 3 “With like the video recording you get to see how you were doing and how everybody was doing…you can see like an overview” Participant 2 “That could be what I’m doing during real resus” Participant 2 |
Anxiety as inevitable | “I think that anxiety is kind of part of the point. Like that’s kind of the purpose of it” Participant 8 “they are meant to do that—to pressure us…they’re just doing their job” Participant 7 |
Theme 2: Protective Behaviours | |
Defensiveness | ““Suddenly everyone got their backs up…now I’m just gonna armour up and perform well myself” Participant 6 “I’m always a little bit standoffish, but yeah, I think it just goes back to that fear” Participant 11 “I started blaming the simulation and then the whole thing goes…” Participant 6 |
Group shielding | “It was kind of personal…just focussing on a mistake that person has done…we are also team members…this is a team effort not a one man show.” Participant 2 “There’s no way I’m bringing my paediatric registrars into a sim situation…because previously they have been so traumatised” Participant 10 |
Avoidance | “I was purposefully avoiding it due to previous trauma with sim and that’s also why I was facilitating the study days so I wasn’t on the receiving end…it was organised by me for that reason.” Participant 10 “I’m such a hypocrite because I’m like “away you go”[to the junior nurses]” Participant 9 “it was just so appalling and we’re not coming back” Participant 10 |
Theme 3: Perception of the Facilitator | |
Practice what you preach | “ I feel some [educators] say [the pre-brief] but they don’t come across as genuine…or they then go and talk about their performance behind their back or something. So then it’s basically like a lie.” Participant 6 “I don’t think it just breaks down the trust for that session…it sets the culture. So I think you have to set it from the beginning and be consistent” Participant 6 “if someone uses [that word] on me I just shut down” Participant 10 “if it’s going to be advertised as this learning – this psychological safe environment – it needs to – that’s what it needs to do” Participant 6 |
Build trust | “a bit of a spiel” Participant 6 “they always say, you know, none of this goes beyond this room and all that sort of stuff” Participant 1 “it’s always stressed it’s a safe environment etcetera etcetera. But I don’t know, you still worry about it.” Participant 12 |
Communicate vulnerability | “…they [the facilitators] recognised that they were also learning. So they were learning how to be facilitators and so now they have grown. So that was really helpful for me to understand that.” Participant 10 “[it was an] absolute change… like a moment in time changed my life…this has actually happened to others—to multiple people—and now they’re trying to work to change that. It’s like I was validated.” Participant 10 |
Be open and curious | “If that can be explained to you at the start, you know, this is all about being open and curious” Participant 10 “…whereas reflecting back, if they’d [the facilitators] said to me “what was going on?”… I would have been able to be more honest.” Participant 6 |