Launching Simulation Training in Tanzania to Develop a New Generation of Surgeons
For a long time, the technological revolution that advanced surgical techniques and devices at lightning speed, hadn’t reached surgical education with the same voracity. Almost all surgical workers were still being trained by reading books, attending lectures and clinical rotations.
But times are changing. As we seek to make learning more effective and distribute information globally, technology – such as simulations, tele-mentoring, and augmented reality software – is starting to reshape medical education. Nowhere is this transformation more critical than in low- and middle-income countries (LMICs) which suffer with severe shortages of surgical workers.
Many LMICs have less than 1 specialist surgeon, anaesthetist, or obstetrician (SAO) per 100,000 people – less than 70 times the number of SAOs in high-income countries. The Lancet Commission on Global Surgery recommends at least 20 SAOs per 100 000 population to ensure equal access to quality care for everyone. This means that by 2030 an additional 800,000 surgical providers will be needed in LMICs.
Developing the SAO workforce is critical to extending safe surgical care to the 5 billion people globally who currently cannot access surgery. Innovating in the ways we teach surgical workers and integrating technology will allow us to rapidly upskill the existing workforce, as well as develop the next generation of surgical workers more quickly and effectively.
This month, Safe Surgery 2020 and Digital Surgery launched their partnership to bring cutting-edge simulation training to LMICs. Digital Surgery’s Touch Surgery platform is an interactive and mobile-based cognitive task simulator and rehearsal tool for healthcare professionals. In the platform, operative decisions are mapped to a virtual 3D patient. The user progresses through the surgical procedure by interacting with the virtual patient. At the end of the simulation, an inbuilt assessment tool evaluates cognitive competence and maps an individual’s learning curve.
Assist International, Digital Surgery and local health facilities and hospitals, including Kijabe Hospital in Kenya, have been collaborating closely to develop a series of simulation trainings for the most common procedures provided by primary facilities in LMICs, such as C-sections and hysterectomies. The simulations are developed specifically for surgical teams operating in low-resource settings to ensure the procedure is achievable with basic instruments. The simulation integrates the WHO’s surgical safety checklist to reinforce the importance of following the checklist to improve patient outcomes.
We began rolling out the Touch Surgery simulation app in Tanzania this month, providing surgical teams in Safe Surgery 2020 facilities in the Lake Zone. The Safe Surgery 2020 hospitals will receive in-person and tele-mentoring training and education on the Touch Surgery app as well as practical tools such as tablets in each facility for continuous learning.
The Touch Surgery product has been validated as an effective mobile-based training tool by more than 15 independent, peer-reviewed publications. Through Safe Surgery 2020’s collaboration with Touch Surgery’s parent company, Digital Surgery, we will trial the effectiveness of on-demand simulation training to increase surgical teams’ knowledge and, ultimately, improve patient care in low-resource facilities in LMICs.
The future of surgical education will be driven by technological innovation. By ensuring innovations are co-created with leaders and surgical teams in LMICs and adapted to the realities on the ground, we can create a world where everyone can access life-transforming, life-saving surgery.