Cultural Allyship

The Brief:

This case study will outline the implementation of a simulation-based workshop designed to support nurses, midwives and Allied Health Professionals (AHPs) with the necessary skills to be allies to internationally educated nurses, midwives and AHPs who are vital to maintaining healthcare services. This project examines the collaborative design, development, implementation and impact of the workshop on participants’ understanding of this.

The Problem:

Allyship can be a difficult concept and skill to grasp but is essential in any setting. Healthcare staff required support in developing an understanding surrounding what allyship is, why it is necessary, what the characteristics and behaviours of an ally are and what benefits allies bring to the workplace. An additional desired outcome was to understand that allyship is not a tick box skill but a journey of understanding and development.

The Requirement:

SimComm Academy partnered with trusts in the local region to develop and deliver a series of eight face-to-face simulation-based workshops, providing staff with the opportunity to learn about cultural humility, effective cross-cultural communication, strategies for fostering inclusivity, and developing an understanding of the “STEPS” technique. It was essential to ensure that the scenarios used were based upon authentic lived experiences.

The Outcome:

Qualitative data was collected from across the region through focus group discussions and semi-structured interviews with internationally educated registrants and with Trust leads for diversity and inclusion. The findings were analysed and authentic story boards and scripts for scenarios were developed, cross checking back to source. The lived experiences of internationally educated registrants included multiple challenges including language, pronunciation, culture shock, and a lack of social support.

The workshop centred on the four pillars of allyship, which include asking, listening, speaking up and standing up. Course content consisted of a discussion surrounding the “Wheel of Advantage” followed by watching and reflecting on a variety of films, forum theatre and observational simulation, delivered by actors. Participants were given the opportunity to interact with actor role players who were taking on the roles of healthcare colleagues in a variety of scenarios, covering different themes in a range of settings, including; healthcare professionals interacting with another internationally-trained member of staff in the staffroom, an internationally-educated midwife having a “catch-up” meeting with her UK-trained line manager and some healthcare professionals reviewing and short-listing job applications from a range of individuals.

The simulated scenarios were then followed by structured debriefs facilitated by experts, drawing out identified themes and learning objectives and providing the opportunity for reflection upon participants’ previous experiences and perspectives. At the end of the workshop, participants were asked to share a “pledge,” outlining a commitment of something that they would personally do differently moving forwards.

Tangible Results:

Analysis of the evaluations demonstrate a clear shift in knowledge from before the workshop to after the workshop. This is shown in figure 1; before the workshop 59% of the responders expressed either limited or no knowledge in at least one topic area. Following the workshop, 88% of responders expressed excellent or good knowledge in all topic areas and none expressed limited or no knowledge.

Figure 1: Before and after breakdown of responders’ responses

The evaluation forms also allow us to delve further into how respondents felt about certain areas of the workshop. A full breakdown of the question-based responses is shown in figure 2.

Figure 2: Full breakdown of responder’s’ responses

Some of the key questions, which indicate the overall value of the workshop, are highlighted below. Figure 3 shows responses to question 24, “I can reflect on how to navigate the journey of allyship.” This highlights how participants were encouraged to think critically about their role as allies, assessing their ability to engage in introspection and self-awareness regarding the journey of allyship. It is revealing that before the workshop around 40% of respondents answered that they had limited or neutral knowledge, and that after the workshop all respondents felt they had excellent or good knowledge surrounding navigating their journey.

Figure 3. Responses to the question, “I can reflect on how to navigate the journey of allyship”.

The evaluation forms also encouraged the participants to write down any qualitative comments they had on the workshop. This data shows key aspects of the workshop which the respondents found particularly valuable and gives them an opportunity to suggest components of the workshop which are less useful. Role play and in-person scenarios were the aspects that were reported to have been the most useful with 14 out of 18 respondents highlighting its value to them. The only response to the question of what was not useful was “nothing”.

Finally, participants are asked for any additional comments. Some examples of the responses are shown below:

“Brilliant session. So thought provoking and held engagement throughout. Compassionate delivery”.

 “This should be mandatory training for all NHS staff, Band 1-9”.

 “Thank you. It was so helpful to be able to reflect on allyship and think about how to help others”.

Conclusion:

Key points from this case study are:

• Authentic scenarios developed in collaboration with specialist inclusivity and diversity leads ensured accuracy.
• By the end of the workshop 100% of participants were able to reflect on how to navigate the journey of allyship.
• All participates highlighted the value of role-play and in-person scenarios.

The simulation-based workshop, “Cultural Allyship,” delivered to healthcare staff significantly aided participants in developing their understanding of allyship as a concept and its role within proving equitable and patient-centred care.