From the Mbarara University of Science and Technology (S.D., F.B., C.K., N.N.J., C.M., L.A., T.N., M.T.), Mbarara, Uganda; KidSIM Simulation Program (M.D., T.R., I.W., A.C.), Alberta Children's Hospital; and Department of Pediatrics (J.L.B., N.S., I.W., A.C.), and Global Health and International Partnerships (H.M.), Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Simul Healthc. 2021 Dec 1;16(6):e100-e108. doi: 10.1097/SIH.0000000000000531.
Many deaths in Sub-Saharan Africa are preventable with provision of skilled healthcare. Unfortunately, skills decay after training. We determined the feasibility of implementing an interprofessional (IP) simulation-based educational curriculum in Uganda and evaluated the possible impact of this curriculum on teamwork, clinical skills (CSs), and knowledge among undergraduate medical and nursing students.
We conducted a prospective cohort study over 10 months. Students were divided into 4 cohorts based on clinical rotations and exposed to rotation-specific simulation scenarios at baseline, 1 month, and 10 months. We measured clinical teamwork scores (CTSs) at baseline and 10 months; CSs at baseline and 10 months, and knowledge scores (KSs) at baseline, 1 month, and 10 months. We used paired t tests to compare mean CTSs and KSs, as well as Wilcoxon rank sum test to compare group CS scores.
One hundred five students (21 teams) participated in standardized simulation scenarios. We successfully implemented the IP, simulation-based curriculum. Teamwork skills improved from baseline to 10 months when participants were exposed to: (a) similar scenario to baseline {baseline mean CTS = 55.9% [standard deviation (SD) = 14.4]; 10-month mean CTS = 88.6%; SD = 8.5, P = 0.001}, and (b) a different scenario to baseline [baseline mean CTS = 55.9% (SD = 14.4); 10-month CTS = 77.8% (SD = 20.1), P = 0.01]. All scenario-specific CS scores showed no improvement at 10 months compared with baseline. Knowledge was retained in all scenarios at 10 months.
An IP, simulation-based undergraduate curriculum is feasible to implement in a low-resource setting and may contribute to gains in knowledge and teamwork skills.
在撒哈拉以南非洲，提供熟练的医疗保健可以预防许多死亡。不幸的是，培训后技能会下降。我们确定了在乌干达实施跨专业（IP）基于模拟的教育课程的可行性，并评估了该课程对本科医学和护理学生团队合作、临床技能（CSs）和知识的可能影响。
我们进行了为期 10 个月的前瞻性队列研究。学生根据临床轮转分为 4 个队列，并在基线、1 个月和 10 个月时接受轮转特定的模拟情景。我们在基线和 10 个月时测量临床团队协作评分（CTSs）；在基线和 10 个月时测量 CSs；在基线、1 个月和 10 个月时测量知识评分（KSs）。我们使用配对 t 检验比较平均 CTSs 和 KSs，以及 Wilcoxon 秩和检验比较组 CS 评分。
105 名学生（21 个团队）参加了标准化模拟情景。我们成功实施了跨专业、基于模拟的课程。当参与者接触到：（a）与基线相似的情景{基线平均 CTS = 55.9%（标准差[SD] = 14.4）；10 个月平均 CTS = 88.6%；SD = 8.5，P = 0.001}和（b）与基线不同的情景[基线平均 CTS = 55.9%（SD = 14.4）；10 个月 CTS = 77.8%（SD = 20.1），P = 0.01]时，团队合作技能从基线到 10 个月有所提高。与基线相比，所有特定于情景的 CS 评分在 10 个月时均未提高。在所有情景中，知识在 10 个月时都得到保留。
在资源匮乏的环境中实施跨专业、基于模拟的本科课程是可行的，并可能有助于知识和团队合作技能的提高。
