TY - JOUR
T1 - Creation, Implementation, and Assessment of a General Thoracic Surgery Simulation Course in Rwanda
AU - Ramirez, Adriana G.
AU - Nuradin, Nebil
AU - Byiringiro, Fidele
AU - Ssebuufu, Robinson
AU - Stukenborg, George J.
AU - Ntakiyiruta, Georges
AU - Daniel, Thomas M.
N1 - Funding Information:
The authors extend special appreciation to Dr John Hanks for his supervisory role during field collection, Drs Christian Ngarambe, Ahmed Kiswezi, and Didace Mugisa for their assistance as ancillary teaching staff, and Florence Mukakabano for technical support and use of the simulation center at University Teaching Hospital of Kigali. The authors also recognize the Rwanda Human Resources for Health Program (T.M.D.) for its initial investment in facilitating collaborative education and cultivating the development of educational simulation experiences. This work was supported by grant T32-HL-007849 (A.G.R.) from the National Heart, Lung, and Blood Institute of the National Institutes of Health. Institutional support from the UVA Center for Global Health (A.G.R. and N.N.) and the UVA Medical School Foundation Surgery Education Project in Rwanda (T.M.D.) provided financial support to cover the cost of the simulation models and travel expenses to Rwanda for the United States–based researchers.
Publisher Copyright:
© 2018 The Society of Thoracic Surgeons
PY - 2018/6
Y1 - 2018/6
N2 - Background: The primary objective was to provide proof of concept of conducting thoracic surgical simulation in a low-middle income country. Secondary objectives were to accelerate general thoracic surgery skills acquisition by general surgery residents and sustain simulation surgery teaching through a website, simulation models, and teaching of local faculty. Methods: Five training models were created for use in a low-middle income country setting and implemented during on-site courses with Rwandan general surgery residents. A website was created as a supplement to the on-site teaching. All participants completed a course knowledge assessment before and after the simulation and feedback/confidence surveys. Descriptive and univariate analyses were performed on participants’ responses. Results: Twenty-three participants completed the simulation course. Eight (35%) had previous training with the course models. All training levels were represented. Participants reported higher rates of meaningful confidence, defined as moderate to complete on a Likert scale, for all simulated thoracic procedures (p < 0.05). The overall mean knowledge assessment score improved from 42.5% presimulation to 78.6% postsimulation, (p < 0.0001). When stratified by procedure, the mean scores for each simulated procedure showed statistically significant improvement, except for ruptured diaphragm repair (p = 0.45). Conclusions: General thoracic surgery simulation provides a practical, inexpensive, and expedited learning experience in settings lacking experienced faculty and fellowship training opportunities. Resident feedback showed enhanced confidence and knowledge of thoracic procedures suggesting simulation surgery could be an effective tool in expanding the resident knowledge base and preparedness for performing clinically needed thoracic procedures. Repeated skills exposure remains a challenge for achieving sustainable progress.
AB - Background: The primary objective was to provide proof of concept of conducting thoracic surgical simulation in a low-middle income country. Secondary objectives were to accelerate general thoracic surgery skills acquisition by general surgery residents and sustain simulation surgery teaching through a website, simulation models, and teaching of local faculty. Methods: Five training models were created for use in a low-middle income country setting and implemented during on-site courses with Rwandan general surgery residents. A website was created as a supplement to the on-site teaching. All participants completed a course knowledge assessment before and after the simulation and feedback/confidence surveys. Descriptive and univariate analyses were performed on participants’ responses. Results: Twenty-three participants completed the simulation course. Eight (35%) had previous training with the course models. All training levels were represented. Participants reported higher rates of meaningful confidence, defined as moderate to complete on a Likert scale, for all simulated thoracic procedures (p < 0.05). The overall mean knowledge assessment score improved from 42.5% presimulation to 78.6% postsimulation, (p < 0.0001). When stratified by procedure, the mean scores for each simulated procedure showed statistically significant improvement, except for ruptured diaphragm repair (p = 0.45). Conclusions: General thoracic surgery simulation provides a practical, inexpensive, and expedited learning experience in settings lacking experienced faculty and fellowship training opportunities. Resident feedback showed enhanced confidence and knowledge of thoracic procedures suggesting simulation surgery could be an effective tool in expanding the resident knowledge base and preparedness for performing clinically needed thoracic procedures. Repeated skills exposure remains a challenge for achieving sustainable progress.
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U2 - 10.1016/j.athoracsur.2018.01.043
DO - 10.1016/j.athoracsur.2018.01.043
M3 - Article
C2 - 29476717
AN - SCOPUS:85046780788
SN - 0003-4975
VL - 105
SP - 1842
EP - 1849
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -