Simulation-Based Education for Otolaryngology, Head and Neck Surgery Emergency Procedures in the South Pacific: A...

The South Pacific faces challenges in delivering timely Otolaryngology, Head and Neck Surgery (OHNS) emergency care due to specialist scarcity, geographic isolation, and resource constraints. Simulation-based education (SBE) provides safe, reproducible opportunities to practise time-critical procedures. This pilot education study evaluated the impact of a regional simulation course on surgeon and trainee confidence in managing common OHNS emergencies.

A one-day simulation course was conducted during the South Pacific Legacy Program in Fiji in August 2023. Five scenarios were taught including rigid bronchoscopy, flexible bronchoscopy, adult tracheostomy, paediatric tracheostomy and cortical mastoidectomy. Participants ( $n=20$ ) completed questionnaires at baseline, immediately post-course and at 6 months to assess confidence and skill retention using 5-point Likert scales.

Confidence increased significantly across all procedures immediately post-course (all $p\le 0.006$ ; $r=0.64-0.82$ ) and remained significantly above baseline at 6 months (all $p\le 0.016$ ; $r=0.63-0.78$ ). Sustained improvements were greatest for adult and paediatric tracheostomy. Surgeons reported higher confidence than trainees in selected scenarios. After 6 months, 67% of participants reported using skills in clinical practice and all expressed interest in further SBE.

A regional, low-resource simulation course significantly improved and sustained confidence in managing otolaryngology emergencies. This feasible and well-received model may support capacity building across geographically dispersed, low-resource health systems.