Low-Cost Simulation to Teach Anesthetists’ Non-Technical Skills in Rwanda

Abstract

Rwandan anesthesia providers show improvement in ANTS practice during cesarean delivery after 1 teaching session using a low-cost high psychological fidelity simulation model with debriefing.

The effect of simulator fidelity on acquiring non-technical skills: a randomized non-inferiority trial

“…A recent study showed that a lowcost and low physical fidelity mannequin was effective in teaching NTS to Rwandan anesthesia providers. 25 Our study will hopefully provide useful information to help guide the development of future simulation scenarios intended to teach NTS in centres with limited financial resources.…”

Promoting anaesthesia providers' non-technical skills through the Vital Anaesthesia Simulation Training (VAST) course in a low-resource setting

“…Previous literature determining ANTS scores for anaesthesia trainees working in low-resource settings assessed during simulation showed that the average mean difference between scores was 2 and a standard deviation of the mean difference of 3.1 (SMD¼0.645). 13 Assuming a two-tailed test with a¼0.05, 90% power, an effect size of SMD¼0.645, 10% dropout, and a worst-case scenario for the parent distribution (i.e. minimum asymptotic relative efficiency), 32 participants were required.…”

“…These results are consistent with previous studies showing that targeted training can improve the participants' non-technical skills. 13,23 We investigated the impact of VAST soon after its development and implementation. It contributes new knowledge regarding simulation training and non-technical skills retention in low-resource settings.…”

“…11 Low-cost simulation is recognised as valid for learning non-technical skills in high-and low-income settings. 13,26 Education in low-resource settings requires 'contextually informed tools' to teach and assess non-technical skills. 10 The VAST course was designed de novo, stemming from a long-standing partnership between the University of Rwanda and Dalhousie University.…”

“…It has been validated for inter-rater reliability (IRR) with trained observers, 16 used widely in simulation research in high-resource countries 17e20 and found to be applicable in Rwanda. 12,13 The framework has four categories: task management, teamworking, situation awareness, and decision-making that are scored from a minimum of 1 to a maximum of 4. Our primary outcomes were the total ANTS score (the summation of all four categories, with a maximum score of 16 and a minimum of 4).…”