Building and sustaining a laparoscopic simulation curriculum in Dar es Salaam, Tanzania

Abstract

PurposeAlthough laparoscopy has transformed surgical care in high-income countries, access remains limited in Africa. This calls for tailored laparoscopic education in such contexts to enable the training necessary to expand laparoscopic surgery. We aimed to describe the implementation, evaluation, and sustainability of a laparoscopic simulation lab in Dar es Salaam, Tanzania.MethodsWe founded a laparoscopic simulation lab at Muhimbili University of Health and Allied Sciences (MUHAS) and implemented a simulation curriculum. We conducted a prospective curricular evaluation focusing on both process and outcome metrics.ResultsWe established laparoscopic simulation training at MUHAS. This entailed securing a dedicated space, equipping the laboratory, and training a lab manager to be a simulation educator. Fifty-one participants completed 1,909 h of laparoscopic training at the simulation lab and received 3,940 individual pieces of online feedback. Analysis of task completion times and performance showed improvement in all tasks in pre-test task videos compared to final task videos. Nine of 20 graduates responding to a questionnaire (45%) actively performed laparoscopic surgery within their institutions. Among these respondents, all felt that participating in LAPP was very helpful or essential to their practice.ConclusionsWe implemented a laparoscopic curriculum at a new simulation lab in Tanzania. Residents, fellows, and faculty from across Tanzania dedicated substantial time and effort over more than 18 months to complete the curriculum, improve their laparoscopic skills, and change their operative practices. This report may serve as a blueprint for those looking to implement, evaluate, and sustain curricula in similar settings.