Bulamba Fred, Sendagire Cornelius, Kintu Andrew, Hewitt-Smith Adam, Musana Fred, Lilaonitkul Maytinee, Ayebale Emmanuel T, Law Tyler, Dubowitz Gerald, Kituuka Olivia, Lipnick Michael S
From the Department of Anesthesia (F.B., A.H.S., F.M.), Faculty of Health Sciences, Busitema University, Tororo; Department of Anesthesia and intensive care (C.S.), Uganda Heart Institute; Department of Anesthesia (A.K., E.T.A.), College of Health Sciences, Makerere University, Kampala, Uganda; Department of Anesthesia and Perioperative Care (M.L., M.S.L., T.L., G.D.), University of California at San Francisco, San Francisco, California; and Department of Surgery (O.K.), College of Health Sciences, Makerere University, Kampala, Uganda.
Simul Healthc. 2019 Apr;14(2):113-120. doi: 10.1097/SIH.0000000000000345.
Simulation is relatively new in many low-income countries. We describe the challenges encountered, solutions deployed, and the costs incurred while establishing two simulation centers in Uganda. The challenges we experienced included equipment costs, difficulty in procurement, lack of context-appropriate curricula, unreliable power, limited local teaching capacity, and lack of coordination among user groups. Solutions we deployed included improvisation of equipment, customization of low-cost simulation software, creation of context-specific curricula, local administrative support, and creation of a simulation fellowship opportunity for local instructors. Total costs for simulation setups ranged from US $165 to $17,000. For centers in low-income countries trying to establish simulation programs, our experience suggests that careful selection of context-appropriate equipment and curricula, engagement with local and international collaborators, and early emphasis to increase local teaching capacity are essential. Further studies are needed to identify the most cost-effective levels of technological complexity for simulation in similar resource-constrained settings.
模拟技术在许多低收入国家相对较新。我们描述了在乌干达建立两个模拟中心时遇到的挑战、采取的解决方案以及产生的成本。我们遇到的挑战包括设备成本、采购困难、缺乏适合当地情况的课程、电力供应不可靠、当地教学能力有限以及用户群体之间缺乏协调。我们采取的解决方案包括设备的临时拼凑、低成本模拟软件的定制、针对特定情况的课程创建、当地行政支持以及为当地教师创造模拟研究员机会。模拟设施的总成本在165美元至17000美元之间。对于试图建立模拟项目的低收入国家的中心来说，我们的经验表明，仔细选择适合当地情况的设备和课程、与当地和国际合作者合作以及尽早重视提高当地教学能力至关重要。需要进一步研究以确定在类似资源受限环境中模拟的最具成本效益的技术复杂程度。
