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Table 3 Arguments for perceived difficulty in NTS observation

From: Observation of behavioural skills by medical simulation facilitators: a cross-sectional analysis of self-reported importance, difficulties, observation strategies and expertise development

Theme

Quotes

1. Not everything can be observed

The availability of NTS to be observed is influenced by the -scripted- training scenario and the degree of (non)verbal expression by the participants. E.g. certain NTS cannot be observed directly as they are mental processes of the participants.

Translated: ā€œObservation is what you see, without knowing what the intentions and thoughts of the observed [participants] areā€ [R6]

ā€œSome people are more introvert ā€¦ and do not think/talk out [loud] in the room. Also some have vague mimics and gestures.ā€ [R126]

Translated: ā€œDepending on the scenario (complexity, length, roles), some NTS are not addressed.ā€ [R24]

Translated: ā€œDuration of the scenarios is sometimes too short.ā€ [R70]

2. Not everything is observed

Even when NTS are expressed, not everything is actually seen or heard by the facilitator. Many variables influence facilitatorsā€™ opportunity and capability of NTS observation, hence NTS aspects can be missed easily.

Translated: ā€œEspecially in larger teams (over 3 persons) it is difficult to capture all NTS. Most of the (non-verbal) communication happens simultaneously between team members. I therefore focus especially on the team leader.ā€ [R4]

ā€œSimulation situations are many times very loud and it is difficult to hear all the communication which occurs.ā€ [R124]

Translated: ā€œMore subtle variants [of NTS] that do influence the interaction between people, can be missed.ā€ [R40]

Translated: ā€œIt [observation of NTS] is very strenuous, at the end of a training day you sometimes miss things.ā€ [R16]

3. Interpretation of the observed NTS is difficult

Whenever NTS are actually expressed and observed by the facilitator, interpretation and analysis is difficult and subjective to personal influences

Translated: ā€œObservations are often subjective and influenced by your own frame of reference and experience.ā€ [R9]

ā€œThey [certain NTS] are more difficult to observe because you cannot have a list of unique behavioural markers. There may be more ways to achieve a good goal.ā€ [R123]

Translated: ā€œMany NTS items are interlinked and influence each other, which makes them hard to unravel.ā€ [R43]

Translated: ā€œBecause [the training] takes place in a simulation center, people may (re)act different compared to the authentic work-place setting.ā€ [R23]