Systematic Review of Procedural Skill Simulation in Health Care in Low- and Middle-Income Countries

Area of Science:

• Medical Education
• Health Systems Research
• Simulation Technology

Background:

• Procedural skill simulation is increasingly adopted in low- and middle-income countries (LMICs).
• Research on simulation in resource-constrained settings is expanding.
• Understanding the current landscape of simulation research in LMICs is crucial.

Purpose of the Study:

• To summarize procedural skill simulation research in LMICs.
• To analyze methodology, clinical focus, outcomes, cost, cost-effectiveness, and sustainability.
• To identify gaps and guide future research directions.

Main Methods:

• Comprehensive literature review of original articles on procedural skill simulation in LMICs.
• Screened 5371 articles, including 262 in the final review.
• Data extracted from inception until April 2022.

Main Results:

• Most studies were observational cohort studies (72.9%) and focused on obstetrics and neonatal medicine (32.4%).
• Task performance was the most common outcome measured (56.5%).
• Cost and sustainability were mentioned, but few studies provided monetary cost data or assessed cost-effectiveness.

Conclusions:

• Future research in LMICs should emphasize more rigorous methodologies.
• There is a need for detailed cost assessments and cost-effectiveness analyses.
• Research should expand to less-studied clinical areas to broaden simulation impact.