Overview of a novel paediatric surgical simulation‐based medical education programme in Myanmar

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Global Surgery Education and Training Programmes—a Scoping Review and Taxonomy

“…Less commonly, exchanges involved LMIC surgical trainees travelling to HIC hospitals [ 43 , 59 ] or bi-directional exchanges [ 60 , 61 ], and in just one case a LMIC-LMIC trainee mobility programme [ 62 ]. HIC institutional support for surgical training in LMICS — either through support for the delivery an existing formal training programme [ 15 , 53 , 56 , 58 , 63 – 68 ], or additional training delivered to trainees enrolled in a formal training programme [ 17 , 18 , 48 , 69 – 71 ], or delivered outside of a formal training programme [ 16 , 19 – 21 , 61 , 72 – 77 ]. Provision of qualified HIC surgical care providers as trainers in LMICs [ 15 , 61 , 78 ], or the training of such HIC providers to work successfully in low resource environments [ 79 , 80 ].…”

“…HIC institutional support for surgical training in LMICS — either through support for the delivery an existing formal training programme [ 15 , 53 , 56 , 58 , 63 – 68 ], or additional training delivered to trainees enrolled in a formal training programme [ 17 , 18 , 48 , 69 – 71 ], or delivered outside of a formal training programme [ 16 , 19 – 21 , 61 , 72 – 77 ].…”

Long‐Term Impact of a Low‐Cost Paediatric Intussusception Air Enema Reduction Simulation‐Based Education Programme in a Low‐Middle Income Country

“…The AE technique was introduced using a novel validated specifically created simulator and a workshop including in situ simulation as part of a wider SBE programme [12, 14, 15]. Participants were recruited from tertiary paediatric surgery centres in Yangon, Myanmar.…”

RACS and its Fellows: a contribution to sustainable healthcare improvement in South East Asia

“…RACS has also provided modest assistance to a team from Monash University to support the development of paediatric surgical simulation‐based education programmes in Myanmar 12 …”