Bajwa Maria, Najeeb Fizza, Alnazzawi Haneen, Ayub Ayesha, Bell Jessica G, Sadiq Fouzia
Health Professions Education, Massachusetts General Hospital (MGH) Institute of Health Professions, Boston, USA.
The Center for Interprofessional Education and Practice (CIPEP), Nova Southeastern University, Fort Lauderdale, USA.
Cureus. 2024 Dec 27;16(12):e76485. doi: 10.7759/cureus.76485. eCollection 2024 Dec.
Healthcare simulation has gained global recognition in health professions education, yet its adoption in Pakistan, a lower-middle-income country (LMIC), remains limited. This scoping review aimed to explore how simulation is integrated into healthcare education in Pakistan, highlighting challenges and opportunities to inform similar LMICs. Pakistan serves as a critical case study for LMICs due to its unique challenges, including uneven access to simulation technologies and limited faculty training, which are shared by many similar resource-constrained settings. Using the Arksey and O'Malley framework, a systematic review of 693 publications identified 145 studies that met inclusion criteria. The findings revealed diverse simulation modalities primarily focused on skills training and clinical decision-making. Notable innovations included low-cost simulation solutions, effectively addressing resource constraints. However, significant gaps emerged, including an urban-centric focus with limited rural representation, insufficient evaluation of long-term impacts, and the absence of standardized terminology and training protocols. These challenges hinder broader integration and equitable access to simulation-based learning. Addressing these gaps through strategic collaborations, capacity-building initiatives, and innovative, cost-effective solutions, such as low-cost simulators crafted from readily available materials, could enhance simulation adoption in Pakistan and similar LMICs. This review highlights the importance of adopting evidence-based practices, increasing funding, and conducting comprehensive research on simulation's long-term impact to ensure effective implementation and improved healthcare education and outcomes globally.
医疗模拟在卫生专业教育中已获得全球认可，但在巴基斯坦这个中低收入国家，其应用仍然有限。本范围综述旨在探讨模拟如何融入巴基斯坦的医疗教育，突出挑战与机遇，以为类似的中低收入国家提供参考。由于巴基斯坦面临独特挑战，包括模拟技术获取不均衡和师资培训有限，而许多类似资源受限环境也存在这些问题，因此巴基斯坦是中低收入国家的关键案例研究对象。采用阿克西和奥马利框架，对693篇出版物进行系统综述，确定了145项符合纳入标准的研究。研究结果显示，模拟方式多样，主要集中在技能培训和临床决策方面。显著的创新包括低成本模拟解决方案，有效解决了资源限制问题。然而，也出现了重大差距，包括以城市为中心，农村代表性有限，对长期影响评估不足，以及缺乏标准化术语和培训方案。这些挑战阻碍了模拟学习的更广泛整合和公平获取。通过战略合作、能力建设举措以及创新的低成本解决方案（如用现成材料制作的低成本模拟器）来弥补这些差距，可提高巴基斯坦及类似中低收入国家对模拟的采用率。本综述强调了采用循证实践、增加资金投入以及对模拟的长期影响进行全面研究的重要性，以确保在全球有效实施并改善医疗教育及成果。
