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Background The role of simulation in teaching technical skills to medical students is not yet well defined. Strategies for its use may be especially relevant where teachers, time, and resources are limited, especially in low-middleincome countries. Methods Sixty-seven third-year and 67 fifth-year medical students at the University of Botswana were taught surgical skills by a trained peer medical student, a medical officer with no specialty training or a staff surgeon. Preand post-intervention performance of two basic tasks (simple interrupted suture (SIS) and laparoscopic peg transfer (LPT)) and one complex task (laparoscopic intracorporeal suture (LIS)) were assessed. Subjective measures of selfperceived performance, preparedness for internship, and interest in surgery were also measured. Results The simulation program decreased the time to complete the two basic tasks and improved the objective score for the complex task. Performance of the basic skills improved regardless of the seniority of the instructor while performance of the advanced skill improved more when taught by a staff surgeon. All students had similar improvements in their self-reported confidence to perform the skills, preparedness to assist in an operation and preparedness for internship, regardless of the seniority of their instructor. Students taught by a staff surgeon felt better prepared to assist in laparoscopic procedures. Conclusion Simulation-based teaching of defined surgical skills can be effectively conducted by peers and nearpeers. The implications are widespread and may be most relevant where time and resources are limited, and where experienced teachers are scarce.

Introduction: The role of mortality and morbidity conferences (M&MC) in surgical departments is to provide education and improve patient care. However, evidence in the literature that M&MCs reduce preventable deaths is sparse. Therefore, this study aimed to assess the impact of routine M&MC on the preventable death rate over four years. Methodology: This study used a quantitative research methodology. In this retrospective audit of the M&MC data, we collected all mortality data from the date the database started, July 2016, to December 2019, for the surgery department. The department adopted and adapted the criteria and definitions of preventability based on WHO guidelines for trauma quality improvement programs. We used the Pearson correlation statistic to evaluate the correlation between the time (years) since the start of routine M&MC and the preventable death rate. We secured ethical approval. Results: There were 4660 registered admissions from July 2016 to December 2019. Of these, 267 deaths were recorded, resulting in a crude mortality rate of 6%. Overall, the department considered 23% (61/267) of the deaths as preventable. A strong linear correlation (R2 = 0.982, p = 0.009) between the preventable death rate and time(years) since the commencement of routine M&MC was found. Trauma was the leading cause of preventable deaths (27.0%, 17/61). Conclusion: Our findings suggest that routine M&MCs have the desired effect of reducing preventable death rates. Further studies are required to investigate this observed effect.