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Simulation-Based Education of Health Workers in Low- and Middle-Income Countries: A Systematic Review
Samuel J A Robinson1,2,3, Angus M A Ritchie1,2,3, Maurizio Pacilli1,2,3
1Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
Global Health, Science and Practice
|November 7, 2024
Summary
Simulation-based education (SBE) effectively improves health worker outcomes in low- and middle-income countries (LMICs). While widely applied, standardized reporting of SBE essential features is lacking, necessitating further research for context-specific effectiveness.
Area of Science:
- Medical Education
- Global Health
- Healthcare Simulation
Background:
- Simulation-based education (SBE) is a World Health Organization priority for improving clinician competency and patient care in low- and middle-income countries (LMICs).
- This review investigates the global distribution and effectiveness of SBE for health workers in LMICs.
- It also examines learning focus, simulation modalities, and evaluation methods in relevant studies.
Approach:
- A systematic review was conducted following PRISMA guidelines, searching major databases from 2002 to 2022.
- Included studies reported Level 4 Kirkpatrick outcomes; simulation-based assessment and validation studies were excluded.
- Narrative synthesis and descriptive statistics were employed for data analysis.
Key Points:
- 97 studies were included, with 56% in sub-Saharan Africa, focusing on neonatology (48%), obstetrics (30%), and acute care (16%).
- Common modalities included mannequins (51%) and scenario-based simulation (47%), often low-technology.
- 75% of studies demonstrated at least partial improvement in Level 4 outcomes.
Conclusions:
- SBE is broadly implemented in LMICs to enhance health outcomes, frequently using low-technology simulation methods.
- A significant gap exists in standardized reporting of SBE educational activities and essential features.
- Further research is crucial to identify effective SBE approaches tailored to specific contexts.
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