Navigating cultural collision: onboarding and adaptation of western healthcare professionals as self-initiated expatriates in Qatar and Saudi Arabia

The purpose of this study is to find and evaluate ways of mitigating the range of cultural-collision challenges faced by new Western expatriate employees adapting to a new working life in Middle Eastern organisations in the healthcare sector. The study also addresses a recognised gap in the literature concerning expatriation, highlighted by Guðmundsdóttir and Lundbergsdóttir (2016) and Chhinzer and Jinuk (2021), namely that which relates to the self-initiated expatriate (SIE). The majority of studies to date have been about in-company expatriates sent abroad on behalf of their company. However, the SIE joining both a new organisational culture and a new national environment is challenged by a range of practical, psychological and cultural issues amounting to what Guðmundsdóttir and Lundbergsdóttir (2016) describe as a ‘stark adaptive challenge’, and a ‘vast disruption to their social support network, and career’ (p 515). This was experienced in reality by the researcher as an SIE himself, and his roles in the HR departments of two different Middle Eastern organisations provided an excellent opportunity to address the following research question:

‘What factors lead to the effective optimisation of newcomer onboarding within a culturally complex, multinational healthcare organisation, and how can the process be improved by additional interventions?’

The study begins by surveying the literature and available models for describing the onboarding process, analysing organisational cultures and contrasting national cultures. From these several propositions are developed concerning the matching of the research findings with predictions arising from these chapters.

The research employed a subjective ontology and constructivist epistemology and itself follows a model of Pragmatic Action Research, appropriate for an embedded researcher. It included four phases of a Cycle – namely, Diagnosis, Action Planning, Implementation, and Evaluation. The research methods employed adopted participant observation, 1:1 interviews, focus groups, and questionnaires. Using a sample of 47 expatriates, divided into Cohort One (35 participants from Qatar) and Cohort Two (12 participants from Saudi Arabia), led to thirteen identifiable factors contributing to what the study calls cultural collision. These were grouped under three main thematic headings, namely: Leadership and Organisational Culture; Management of HR Processes; and Self-Management. The first two phases of the Action Research were done in the first organisation in Qatar. The resulting Actions could not be implemented there due to a career change for the researcher, but he was later given the opportunity to carry them out and evaluate their effectiveness four years later in the second organisation, which was in the same healthcare sector but in the culturally similar Kingdom of Saudi Arabia (KSA). Before doing so, the initial diagnosis was confirmed using a briefer approach with Cohort Two.

The diagnostic conclusions led to an Action Plan of four specific interventions which could be managed in the timescale available. That timescale meant that the factors to do with Leadership and Organisational Culture had to be treated as a given. Two of the interventions related to the HR processes surrounding Onboarding and two to Self-Management and the development of Cultural Intelligence (CQ) and personal resilience and adaptability. Each was thoroughly evaluated for its effectiveness in easing the onboarding journey. This demonstrated a significant positive impact on SIEs’ socialisation and cultural adaptation, with success in all the interventions made.

The focus on Self-Management proved particularly effective and led to the development of a process given the name of the Pathway Method, which provides a disciplined and personalised approach to cultural adaptation. Time did not permit moving into a second research cycle, and whereas some small improvements might be made to the interventions already undertaken, some longer-term and more complex changes could be envisaged. These are discussed at the end of the thesis.

Of the five propositions proposed, the theoretical models of organisational and international cultures were generally of value, but did not account for all the findings. Three others related to the interventions and were confirmed as correct.

The thesis concludes with a chapter reflecting on the methods and tools, and the value of the study. It does contribute to the sparseness of studies on the SIE coming fresh into both a new organisation and a new culture at the same time, and has potential value to other organisational practitioners in different cultures and sectors.

The study was limited by the sample size (35 participants in Qatar and 12 in KSA) and the timescale for making changes. Future research should test the interventions longitudinally, expand to other sectors, and refine the framework for wider use.

However its strengths lie in its focus on a neglected category of expatriate that experiences both cultural and organisational “collisions” and in its novel use of Action Research. The flexible research design demonstrated agility in responding to disruptions, highlighting the methodology’s robustness. The findings provide HR professionals and organisations with practical support and help build resilience for self-management. This enhances cultural intelligence (CQ), a valuable asset for future use and assisting others.