Board 104 - Program Innovations Abstract Expanding Simulation-Based Medical Education to Ecuador (Submission #1031)

Abstract

Introduction/Background Recently, there has been a shift in attitudes to recognize the need for formalized faculty development courses and innovative teaching methodologies to improve medical education worldwide.1 In response to such a demand, the use of simulation-based medical education (SBME) has increased dramatically. Research on SBME has shown that there is a core set of best practices required to produce optimal results, requiring detailed curriculum design and trained instructors.2 General practitioners in Ecuador have expressed the need for a simulation-based training program to improve current knowledge, skills and attitudes related to advancements in educational technologies, novel educational methods and improved healthcare practices. To date, there is not an active dedicated simulation center or simulation-based educational curriculum in Ecuador. We propose a novel simulation-based, blended learning curriculum geared towards General Practitioners and healthcare educators in Ecuador. The goal of our project is to introduce low-cost, high-quality teaching principles and strategies that are both 1) tailored to a specific cultural and contextual setting and 2) sustainable for continued curricular implementation. Methods Effectively deploying a simulations-based curriculum to a new institution and nation requires a multi-tiered approach regarding institutional design, faculty development and simulation-based educational curricula. In partnership with the Andean Health and Development organization, we initiated the first phase of our project by traveling to Ecuador to perform a targeted needs assessment 3, where we anonymously surveyed a random cohort of physicians, nurses and paramedics (n=18). The survey asked questions regarding current educational practices in medical education, as well as current perceived needs and challenges for medical education in Ecuador. Qualitative data was analyzed for descriptive purposes. In addition, we piloted a two-day "Introduction to Simulation" course in one of the largest rural hospitals in Santo Domingo, Ecuador. The introductory course offered a blend of didactics and simulations-based hands-on application in the areas of educational theory, the basics of simulation, case design, instructor debriefing, as well as the technological and logistical aspects of designing a simulation center. We held the course in Ecuador’s soon to be first dedicated simulation center, in Santo Domingo and had healthcare professionals and academic leaders from various parts of the country attend. Our preliminary data illustrate that currently, in Ecuador, the majority of teaching in medical schools is still mostly classroom based (50%), followed by clinical teaching (44%). However, 80% of our population surveyed state they learn best through hands-on practice, not an ideal method for either classroom settings or actual patient care. The majority of the participants stated that the biggest need in medical education in Ecuador was the following, (in descending order); the need for technological advancement and utilization, a simulation center, new methods of learning including hands-on practice methodologies, environments for application of skill, improved quality of trained academic educators and improved relationships between students and professors. The feedback from our two day pilot course yielded positive reviews and invitations for future partnerships and collaborations for similar simulations-based courses and curricula in other parts of the country. Conclusion In Ecuador, a gap exists between methods of educational delivery and knowledge/skill acquisition, which can improve through the implementation of a SBME curriculum. This project will result in improved systems based healthcare education, through the engagement of faculty development opportunities and implementation of a resource sensitive, culturally aware simulation-based program for both urban and rural Ecuador. Additional factors to consider in the future include financial and resource barriers, as well as other requirements to support the sustainability of the proposed curricula. After implementation of the simulation-based curriculum, our next steps are to validate our approach and ultimately demonstrate improvement in healthcare practices and systems-based approaches to healthcare delivery in Ecuador.