Supporting occupational therapy students from culturally and linguistically diverse backgrounds in simulation-based learning: Student and educator perspectives

Abstract

Introduction: Students from culturally and linguistically diverse (CALD) backgrounds represent a substantial and growing proportion of enrolments in Australian health professional programs, including occupational therapy, where simulation-based learning (SBL) has become integral to clinical skill development. However, students from CALD backgrounds have been shown to experience distinctive challenges in SBL. Although the need for culturally responsive education has been widely recognised, limited research has examined the specific mechanisms that support occupational therapy students from CALD backgrounds to participate in high-fidelity SBL. To address this gap, this study explored the perceptions of occupational therapy students from CALD backgrounds and occupational therapy educators regarding mechanisms that support these students’ participation in high-fidelity SBL. Methods: A qualitative descriptive design was employed. Fifteen occupational therapy students from CALD backgrounds and 18 occupational therapy educators from entry-level programs across Australia participated in individual semi-structured interviews. Data were analysed using reflexive thematic analysis. Results: Four key themes were generated: (1) student agency and self-advocacy in SBL, (2) educator facilitation strategies and their tensions in SBL, (3) creating cultural inclusion and psychological safety in SBL and (4) programmatic supports and systemic constraints. Conclusions: Effective support for occupational therapy students from CALD backgrounds in SBL involves recognising student agency alongside calibrated educator scaffolding and sustained institutional commitment. The findings also highlight important differences between student and educator perspectives, indicating the value of transcultural and strengths-based approaches. This study has implications for culturally responsive simulation design and faculty development.