Application of Simulation in a Transition Economy Country

Background: Simulation-based teaching and learning has evolved as an important component of medical and surgical education and has been shown to be effective in teaching technical and nontechnical skills (1). Despite potential benefits to low- and middle-income countries, and transition economy countries like Myanmar, simulation training is predominantly used in high-income settings (2). Aims: To utilise various modalities of simulation-based teaching and learning in order to address learning needs relating to paediatric surgery in Myanmar, a transition economy country. Methods: 5 courses covering major aspects of paediatric surgery were designed. This included neonatal conditions, paediatric burns and trauma, paediatric urology, intussusception, and basic and advanced laparoscopic skills. A simulation-based focus was taken to meet learning needs of participants. Specific modalities of simulation included immersive scenario-based simulation, manakin-based simulation, role play, laparoscopic box trainers, part task trainers, and in-situ simulation. A flipped classroom approach was taken to deliver some content prior to arrival to country. Results: Over the course of 2 years, a multidisciplinary team consisting of paediatric surgical consultants, fellows, and trainees as well as experts in simulation and medical and surgical education ran 5 courses at Yangon’s Children Hospital in Myanmar. A total of 170 participants attended the 5 courses. All modalities of simulation used were shown to meet each courses’ learning objectives as assessed with pre- and post-course questionnaires. All modalities of simulation used were shown to be valued and enjoyed by participants and able to be adaptable by local faculty for ongoing utilisation. Conclusion: Simulation-based teaching can be used to meet essential learning objectives of local staff in a transition economy country. Through various modalities, it offers a reliable, proven and affordable means of teaching multiple aspects of paediatric surgical clinical practice. By employing innovative simulation-based solutions it can be adapted by local faculty to continue meeting ongoing learning needs.