The “empty Chairs” Approach to Learning: Simulation-Based Train the Trainer Program in Mzuzu, Malawi

Abstract

Together, a group of Canadian colleagues from St. John's, Newfoundland, Calgary, Alberta (some via Doha) and London, Ontario introduced the first Train the Trainer in Simulation-Based Learning (TTT-SBL) program in Mzuzu Central Hospital and Mzuzu University in Malawi. The team led by Elaine Sigalet (Doha) and consisting of Ian Wishart (Calgary), Faizal Haji (London) and Adam Dubrowski (St. John's) was invited to Malawi by Norman Lufesi to conduct a two-day TTT-SBL course for facilitators who teach an Emergency Triage, Assessment and Treatment (ETAT) plus Trauma course. The following technical report describes this course. All trainees-facilitators who took part in the first iteration of the TTT-SBL course were asked to participate in teaching an ETAT course and modify it to include elements of simulation. The new format of ETAT resulted in a reduction of time necessary to conduct the course from four days (based on historical data) to 2.5 days.

A Simulation Scenario Focused on Resuscitation of a Young Infant (Neonate) for Nurses and Midwives in Malawi, a Limited Resource Country

“…The technical report described here is a direct outcome of a larger initiative looking at the development of simulation expertise in developing countries described in our earlier paper [ 7 ]. The long-term aim of our initiative is to decrease morbidity and mortality through the introduction of a context-specific faculty development program focused on pedagogy and the administration of SBL programs.…”

“…The long-term aim of our initiative is to decrease morbidity and mortality through the introduction of a context-specific faculty development program focused on pedagogy and the administration of SBL programs. In this regard, we have successfully developed and implemented several train-the-trainer courses described earlier [ 7 ]. We hypothesized that the knowledge developed through these courses will cascade in a few directions – from new courses being offered across Malawi in health institutions to individual educators taking initiative and writing technical reports describing locally relevant simulation scenarios [ 9 ].…”

“…The introduction to the scenario will start with a pre-brief, which will take between five and 10 minutes. This is important as it helps create a safe learning environment, familiarizing the learners with expectations and the simulated clinical context [ 7 ]. The learners will be oriented to the setting and equipment that will be used in the scenario.…”

“…Three methods of giving feedback can be used for the scenario, and the choice of the method will depend on the learners’ and facilitators’ experiences with simulation [ 7 ]. These include:…”

Optimizing Perimortem Cesarean Section Outcomes Using Simulation: A Technical Report

“…This was of particular importance to this simulation, as the tragic nature of PMCS can be emotionally challenging. The debrief then proceeded to a more formal solicitation of discussion around experiences, and the dual identification of any relative gaps in performance, applying Sigalet’s LEARN framework: Learning objectives; Emotions; Actions and Reflection; and Next steps [ 13 ]. This involved reviewing the three learning objectives of the simulation (knowledge acquisition, skill acquisition, professionalism, as detailed below), on which trainees were prompted for personal reflection on performance relative to stated objectives and any perceived gaps.…”