Causal study of low stakeholder engagement in healthcare simulation projects

Stakeholder engagement plays a fundamental role in the success of ‘operational research’ initiatives including simulation projects. However, there is little empirical evidence of real engagement in the context of healthcare simulation. This paper principally examines this issue and aims to provide insights into the possible causes. The paper reports on the results of a literature review and 10 field studies within the UK healthcare settings, supplemented with the authors’ experience in order to arrive at an initial list of the causes, which will then be tested through a survey of expert opinions. Twelve primary and 26 secondary causal factors, which received statistically significant level of agreement from the experts, are presented in a fish-bone diagram. The findings indicate that communication gap between simulation and stakeholder groups is the top primary factor contributing the most to the poor stakeholder engagement in healthcare simulation projects, followed by ‘poor management support’, ‘clinician’s high workload’ and ‘failure in producing tangible and quick results’.