A systematic meta-ethnography of simulation debrief practice: A study protocol to investigate debrief interactions and the relationship to participant learning

Abstract

Simulation-based education is now an established and curricula-integrated pedagogical activity in health professions education with the debriefing component seen to be critical to learning. There is limited empirical research examining the debrief activity, specifically addressing the question of how are interactions in simulation debriefing related to participant learning? The research that does exist is disparate, with researchers selecting different foci of interest, thus producing siloed knowledge. There is a need to both synthesise the current literature whilst simultaneously furthering the subject knowledge. This is a protocol to undertake a systematic meta-ethnography in accordance with Noblit and Hare’s established methodology, consisting of seven phases. At the core of this approach is the process of reciprocal translation, where the key interpretations (termed ‘metaphors’) of included studies are juxtaposed with one another to enable new concepts to emerge. This protocol presents the first two phases, covering aspects of question formulation and search strategy utilising PICOS and STARLITE frameworks. We also present the protocol for the deeply interpretive analytical phases (four through six). We provide a comprehensive rationale for undertaking a meta-ethnography, and throughout emphasise the way we intend to navigate the tensions in a predominately positivist systematic review and deeply interpretive nature of a qualitative synthesis. We discuss the issue of quality appraisal in qualitative syntheses and present a modified framework which will function to enable contextual interpretation and bring a sense of collective rigor, and detail why quality appraisal should not be used to exclude articles. Lastly, we highlight the reflexive nature of a meta-ethnography where the final findings are imbued with the researchers’ identity.