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Strengthening and scaling up medical simulation-based interventions to save lives in Africa

Neonatal and maternal mortality remain major challenges in sub-Saharan Africa. A skilled health workforce is an important component of preventing maternal and neonatal deaths. Medical simulation plays a central role in the training and re-training of health professionals and in the retention of critical lifesaving skills.

Although the benefits of simulation training are well-documented, the challenges and transformative potential of medical simulation as a teaching and learning tool in sub-Saharan Africa remains inadequately researched. Mbarara University of Science and Technology (MUST) in Uganda, together with the Stavanger Acute Medicine Foundation for Education and Research in Norway and the University of Calgary established a medical simulation centre at MUST through the Simulation for Life initiative (Sim for Life). The program has grown into a nationally recognized centre of excellence for skills enhancement as a teaching facility for medical and nursing students and for in-service health professionals in East Africa.

Building on the success of Sim for Life in Uganda, this project aims to incorporate and test innovative approaches to simulation-based learning among medical and nursing students and frontline health providers. It will also measure the impact of these approaches on maternal and newborn survival. The project seeks to expand simulation-based learning in East and West Africa through partnerships with medical and nursing education programs in northern and eastern Uganda, Tanzania, and Nigeria. It will also support equitable inter-professional collaboration through innovative simulation and peer-led training that addresses gender and social inequities in clinical care.

An implementation research approach will help identify what prevents and facilitates the adoption, uptake, and effective use of simulation-based learning across five African settings. This will generate evidence and context-specific adaptations to better inform policy and practice with respect to skills retention and capacity building among health professionals, and decrease facility-specific maternal and neonatal mortality.

Project ID
109013
Project Status
Active
Duration
42 months
IDRC Officer
Marie-Gloriose Ingabire
Total Funding
CA$ 850,000.00
Location
Democratic Republic of the Congo
Ethiopia
Kenya
Nigeria
Tanzania
Uganda
Programs
Global Health
Maternal and Child Health
Global Health
Institution Country
Uganda
Project Leader
Dr. Santorino Data
Institution
Mbarara University of Science and Technology

Outputs

Understanding the barriers and enablers for postgraduate medical trainees becoming simulation educators : a qualitative study

Understanding the barriers and enablers for postgraduate medical trainees becoming simulation educators : a qualitative study

Article

Introduction: There is increasing evidence that Simulation-based learning (SBL) is an effective teaching method for healthcare professionals. However, SBL requires a large number of faculty to facilitate small group sessions. Like many other African contexts, Mbarara University of Science and Technology (MUST) in Uganda has large numbers of medical students, but limited resources, including limited simulation trained teaching faculty. Postgraduate medical trainees (PGs) are often involved in clinical teaching of undergraduates. To establish sustainable SBL in undergraduate medical education (UME), the support of PGs is crucial, making it critical to understand the enablers and barriers of PGs to become simulation educators. Methods We used purposive sampling and conducted in-depth interviews (IDIs) with the PGs, key informant interviews (KIIs) with university staff, and focus group discussions (FGDs) with the PGs in groups of 5–10 participants. Data collection tools were developed using the Consolidated framework for implementation research (CFIR) tool. Data were analyzed using the rigorous and accelerated data reduction (RADaR) technique. Results We conducted seven IDIs, seven KIIs and four focus group discussions. The barriers identified included: competing time demands, negative attitude towards transferability of simulation learning, inadequacy of medical simulation equipment, and that medical simulation facilitation is not integrated in the PGs curriculum. The enablers included: perceived benefits of medical simulation to medical students plus PGs and in-practice health personnel, favorable departmental attitude, enthusiasm of PGs to be simulation educators, and improved awareness of the duties of a simulation educator. Participants recommended sensitization of key stakeholders to simulation, training and motivation of PG educators, and evaluation of the impact of a medical simulation program that involves PGs as educators. Conclusion In the context of a low resource setting with large undergraduate classes and limited faculty members, SBL can assist in clinical skill acquisition. Training of PGs as simulation educators should address perceived barriers and integration of SBL into UME. Involvement of departmental leadership and obtaining their approval is critical in the involvement of PGs as simulation educators.

Author(s): Muhumuza, Albert, Najjuma, Josephine Nambi, MacIntosh, Heather, Sharma, Nishan, Singhal, Nalini

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Language: English