Implementation of an Intensive Surgical Simulation Week for Medical Students in Rwanda

Simulation-based training often fails to meet the needs of low- and middleincome countries with limited access to high-cost models. We built on an existing surgical simulation curriculum for medical students in Rwanda and assessed students’
experience.
Methods: Based on a contextual simulation-based education curriculum that was piloted in
2022, our team designed and delivered an intensive week-long surgical simulation course
for medical students. We increased interactive clinical scenarios using high-fidelity mannequins, improved and added benchtop models for training, and incorporated a new
postcourse assessment of students’ experiences using a survey on the first Kirkpatrick level
to determine sessions with the highest utility. Modules included informed consent, preoperative patient preparation, trauma simulations, and procedural skills. The final day
focused on integrating and applying skills learned throughout the week in an interactive
circuit.
Results: Thirty-six students participated in the 5-d simulation course and 24 completed an
end of course survey. When asked about their exposure to simulation prior to the course,
20/24 (83%) students reported “a lot” and 4/24 (17%) reported “a little”, 24/24 (100%) strongly
agreed that simulation is a valuable educational tool and 23/24 (96%) felt that the week
enhanced their knowledge and skills to “a great extent”. The modules with the highest self-rated level of engagement were the interactive trauma simulations, knot-tying and suturing practice and competition, and a model-based session on cutaneous lesions. The lowest ranked session was the interactive circuit on integrated skills.
Conclusions: Implementing a locally-informed and locally-sourced surgical simulation
curriculum is feasible and effectively engages medical students in low-income settings