Abstract
Simulation-based medical education (SBME) is an integral part of undergraduate and postgraduate training in high-income countries (HICs). Despite potential benefits to low- and middle-income countries (LMICs), it has not been widely applied. Our aim was to use SBME to address some essential paediatric surgery learning needs in a LMIC. Eleven SBME courses were designed, implemented and evaluated over a 4-year period in partnership with local paediatric surgeons and the University of Medicine 1 in Yangon, Myanmar. All courses were simulation-based and different major SBME modalities were utilized. Evaluation included pre- and post-course questionnaires, other evaluation assessments including Likert scale self-rated confidence in different domains, as well as, mixed method evaluation and Kirkpatrick's hierarchy of evaluation. Over 4 years, a multidisciplinary team consisting of surgical consultants, fellows, and educational specialists delivered 11 courses at a tertiary LMIC paediatric surgical centre. Attendance varied between 23 and 50 healthcare professionals, with some participants attending all of the educational activities. SBME modalities were utilized to meet each courses' learning objectives. All educational courses scored highly and showed statistically significant differences in all the self-rated pre and post-course confidence Likert scale domains. SBME was accepted and embraced by local participants and faculty, and transition to local delivery of educational content has begun. Level 4 of Kirkpatrick's hierarchy of evaluation was demonstrated. SBME can be used to meet essential learning objectives of local staff in a LMIC. Through various modalities, it offers a reliable, proven and affordable means of teaching multiple aspects of paediatric surgical clinical practice. By employing innovative simulation-based solutions, it can be adapted by local faculty to continue meeting ongoing learning needs.
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