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Simulation capacity building in rural Indian hospitals : A 1-year follow-up qualitative analysis

Sheshadri, Veena ; Wasserman, Isaac ; Peters, Alexander W. ; Santhirapala, Vatshalan ; Mitra, Shivani ; Sandler, Simone ; Svensson, Emma LU orcid ; Ljungman, David ; George, Regi and Ambepu, Arundhathi , et al. (2021) In BMJ Simulation and Technology Enhanced Learning 7(3). p.140-145
Abstract

Introduction: The benefits of simulation-based medical training are well described. The most effective way to plant and scale simulation training in rural locations remains undescribed. We sought to plant simulation training programmes for anaesthesia emergencies in two rural Indian hospitals. Methods: Two Indian consultant anaesthetists without experience in medical simulation underwent a 3-day course at the Boston Children's Hospital's (BCH) Simulator Program. They returned to their institutions and launched simulation programmes with an airway manikin and mock patient monitor. The 1-year experience was evaluated using individual, in-depth interviews of simulation facilitators. Three staff members (responsible for facilitating medical... (More)

Introduction: The benefits of simulation-based medical training are well described. The most effective way to plant and scale simulation training in rural locations remains undescribed. We sought to plant simulation training programmes for anaesthesia emergencies in two rural Indian hospitals. Methods: Two Indian consultant anaesthetists without experience in medical simulation underwent a 3-day course at the Boston Children's Hospital's (BCH) Simulator Program. They returned to their institutions and launched simulation programmes with an airway manikin and mock patient monitor. The 1-year experience was evaluated using individual, in-depth interviews of simulation facilitators. Three staff members (responsible for facilitating medical simulations over the prior year) at two rural hospitals in India were interviewed. None attended the BCH training; instead, they received on-the-job training from the BCH-trained, consultant anaesthetist colleagues. Results: Successes included organisational adoption of simulation training with exercises 1 year after the initial BCH-training, increased interdisciplinary teamwork and improved clinical competency in managing emergencies. Barriers to effective, local implementation of simulation programmes fell into three categories: time required to run simulations, fixed and rigid roles, and variable resources. Thematic improvement requests were for standardised resources to help train simulation facilitators and demonstrate to participants a well-run simulation, in addition to context-sensitive scenarios. Conclusion: An in-person training of simulation facilitators to promote medical simulation programmes in rural hospitals produced ongoing simulation programmes 1 year later. In order to make these programmes sustainable, however, increased investment in developing simulation facilitators is required. In particular, simulation facilitators must be prepared to formally train other simulation facilitators, too.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute Care, Anesthesia, Assessment Of Crisis Management Skills, Assessment/Credentialling, Simulation-Based Training
in
BMJ Simulation and Technology Enhanced Learning
volume
7
issue
3
article number
000577
pages
6 pages
publisher
BMJ Publishing Group
external identifiers
  • pmid:35518561
  • scopus:85095606040
ISSN
2056-6697
DOI
10.1136/bmjstel-2019-000577
language
English
LU publication?
yes
id
fb164f17-0b8b-474e-98f1-cbbb2c72456b
date added to LUP
2021-01-08 11:53:18
date last changed
2025-01-24 03:30:31
@article{fb164f17-0b8b-474e-98f1-cbbb2c72456b,
  abstract     = {{<p>Introduction: The benefits of simulation-based medical training are well described. The most effective way to plant and scale simulation training in rural locations remains undescribed. We sought to plant simulation training programmes for anaesthesia emergencies in two rural Indian hospitals. Methods: Two Indian consultant anaesthetists without experience in medical simulation underwent a 3-day course at the Boston Children's Hospital's (BCH) Simulator Program. They returned to their institutions and launched simulation programmes with an airway manikin and mock patient monitor. The 1-year experience was evaluated using individual, in-depth interviews of simulation facilitators. Three staff members (responsible for facilitating medical simulations over the prior year) at two rural hospitals in India were interviewed. None attended the BCH training; instead, they received on-the-job training from the BCH-trained, consultant anaesthetist colleagues. Results: Successes included organisational adoption of simulation training with exercises 1 year after the initial BCH-training, increased interdisciplinary teamwork and improved clinical competency in managing emergencies. Barriers to effective, local implementation of simulation programmes fell into three categories: time required to run simulations, fixed and rigid roles, and variable resources. Thematic improvement requests were for standardised resources to help train simulation facilitators and demonstrate to participants a well-run simulation, in addition to context-sensitive scenarios. Conclusion: An in-person training of simulation facilitators to promote medical simulation programmes in rural hospitals produced ongoing simulation programmes 1 year later. In order to make these programmes sustainable, however, increased investment in developing simulation facilitators is required. In particular, simulation facilitators must be prepared to formally train other simulation facilitators, too.</p>}},
  author       = {{Sheshadri, Veena and Wasserman, Isaac and Peters, Alexander W. and Santhirapala, Vatshalan and Mitra, Shivani and Sandler, Simone and Svensson, Emma and Ljungman, David and George, Regi and Ambepu, Arundhathi and Krishnan, Jithendranath and Kataria, Raman and Afshar, Salim and Meara, John G. and Galea, Jerome T. and Weinstock, Peter and Roussin, Christopher and Taylor, Matthew and Menon, Nandakumar and McClain, Craig D.}},
  issn         = {{2056-6697}},
  keywords     = {{Acute Care; Anesthesia; Assessment Of Crisis Management Skills; Assessment/Credentialling; Simulation-Based Training}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{3}},
  pages        = {{140--145}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Simulation and Technology Enhanced Learning}},
  title        = {{Simulation capacity building in rural Indian hospitals : A 1-year follow-up qualitative analysis}},
  url          = {{http://dx.doi.org/10.1136/bmjstel-2019-000577}},
  doi          = {{10.1136/bmjstel-2019-000577}},
  volume       = {{7}},
  year         = {{2021}},
}