Table 5

Participant identified ‘facilitators’ and ‘inhibitors’ to personal and organisational change

  • Participants themselves and others seeing the benefit to patients (in the Mercy Ships hospital) as opposed to just being told about a new technique or new practice

  • Being trained as part of a team, ie, not just on your own but with someone else from your institution—ideally a surgeon and a nurse

  • Supportive leadership (from a surgeon or hospital director)

  • Courage to persist and keep going

  • Credibility as being trained by Mercy Ships as an external organisation

  • Resistance to change from colleagues due to lack of belief in/understanding of new techniques and practices

  • Lack of materials

  • Lack of staff

  • Lack of support from ‘superiors’

  • Changing long-standing habits and attitudes is hard work