Surgical Simulation Training for Medical Students: Strategies and Implications in Botswana

Abstract

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.

Exploring the Impact of Pre-course High-Fidelity Simulation on Professional Socialization of Medical Students in Emergency Medicine Internship Rotation—A Qualitative Approach

“…Simulation-based medical education (SBME) has emerged as a way to help students' maximize their block clinical learning and development experiences ( 8 , 24 ). A literature review of the role of SBME indicates that it enhances medical students' skills acquisition and scaffolds medical student's professional development, through affording students with a variety of practice opportunities ( 21 , 25 ). SBME can also prompt medical student's clinical reasoning and enhances their clinical judgment skills through reflective thinking ( 23 ).…”

“…Previous studies indicate that students who participated in pre-clerkship and pre-internship simulation-based education improved their knowledge, technical skills, confidence, were more satisfied with their learning experiences and likely to be trusted by their supervisors and patients ( 26 – 28 ). Based on this, scholars propose that simulation increases trainees' opportunities to participate in the clinical setting ( 8 ), thus could potentially help with the process of transitioning into workplace ( 27 ) and transitioning into internship, especially under constrained resources ( 25 , 28 ).…”

“…Despite the wide acknowledgment of the importance of simulation in supporting medical students' learning process, there is paucity of literature on the effectiveness of simulation in shaping the transition and socialization process of medical students in short-term rotation ( 8 , 25 ). Additionally, the current research on students' learning experiences during their EM internship rotation is also limited ( 4 ).…”

“…Additionally, the current research on students' learning experiences during their EM internship rotation is also limited ( 4 ). The role of simulation in enhancing interns' transition into the EM internship remains to be explored ( 25 ). Based on this, it is imperative that we conduct a study to explore the nuances of interns' workplace learning experiences in the EM setting.…”

Práxis educativa inovadora na anatomia e na cirurgia: relato de experiência

“…Os próprios estudantes são capazes de relatar melhora da confiança de suas habilidades, tanto na preparação para auxiliar em uma cirurgia, quanto para realização de procedimentos (ALVARENGA et al, 2021). Este ensino simulando em vivos Técnicas Cirúrgicas é capaz de ser conduzido efetivamente por pares e colegas próximos, podendo ser relevante em locais onde tempo e recursos são limitados ou poucos professores para a quantidade de alunos (BEDADA et al, 2022).…”