Simulation, Reflection, and the Reality of Quality: Exploring Transformative Learning in the Fellow of Health Facility Accreditation Agency (FIHFAA) Program

Abstract

In the evolving landscape of healthcare governance, accreditation is increasingly recognized not merely as a regulatory requirement but as a dynamic tool for quality improvement and systemic learning. This study explores the transformative learning experiences of participants in the Fellowship of Health Facility Accreditation Agency (FIHFAA) program—a capacity-building initiative designed to cultivate competent and reflective accreditation surveyors in Indonesia. Employing a qualitative-narrative approach with an exploratory-reflective design, this research draws from 32 narrative responses submitted by FIHFAA participants, from which 10–15 rich, contextually detailed narratives were purposively selected. Thematic analysis following Braun and Clarke’s (2006) framework was used to identify key themes such as professional identity transformation, ethical dilemmas in simulation, and the negotiation between standard compliance and contextual realities. Participants reported that simulations, case discussions, and mentorship sessions triggered deep reflection and critical awareness beyond technical competencies. Moreover, they highlighted the need for more inclusive learning environments—suggesting language adaptation, field simulation in primary care settings, and post-training alumni communities. This study contributes not only to the evaluation of FIHFAA but also to the global discourse on accreditation education by emphasizing the human, reflective, and contextual dimensions of surveyor training. The findings call for a pedagogical shift in accreditation training—towards programs that prioritize transformative, experience-based, and ethically grounded learning frameworks.