Low-cost simulation models for soft-tissue procedures for medical student education in Rwanda.

BACKGROUND

Simulation-based training (SBT) enhances medical education but is often limited in low-resource settings. This study aimed to describe the development, use, and cost implication of three low-cost models of soft tissue lesions for SBT of medical students in Rwanda as part of their general surgery clerkship. We also aimed to evaluate perceptions and knowledge gained from the course.

METHODS

Surgical educators and healthcare providers from Rwanda and the United States partnered to design and implement SBT for soft tissue procedures. We prioritized three common procedures based on operative log reviews and a Delphi process: abscess drainage with/without ultrasound guidance; excision of a subcutaneous nodule; and wound debridement. Materials for the SBT models were locally sourced. Data was collected as a prospective cohort study assessing the participants pre- and post-course knowledge using the Kirkpatrick level one and two questions. Students’ self-reported confidence and course feedback was also collected.

RESULTS

Cost was <$1.20 per model and each took ≤ 5 min of active time to construct. Sixty-two students participated over 3 iterations of the soft tissue SBT. Few students had previously observed nodule excision (8.3%), abscess drainage (10.0%), or wound debridement (27.1%). On a five-point Likert scale, student perception of confidence in performing soft tissue procedures improved by + 1.7 (p < 0.001) for nodule excision, + 1.4 (p < 0.001) for abscess drainage, and + 1.7 (p < 0.001) for wound debridement. Confidence scores were greater than or equal to 3.9 out of 5 for all procedures post-session.

CONCLUSIONS

SBT for management of soft-tissue lesions using low-cost, locally-sourced models was well-received, and increased students’ perceived confidence in three common procedures. These models may be adaptable to other procedural settings and learning levels.