Low-Cost ENT Simulation for Medical Student Education in Rwanda

Wednesday, October 4, 2023

9:51 AM - 9:57 AM East Coast USA Time

Location: 204

Presenting Author(s)

SN

Sarah R. Nuss, BS

Medical Student
Warren Alpert School of Medicine at Brown University
Providence, RI, United States

Senior Author(s)

Mary Jue Xu, MD

Clinical Instructor
University of California San Francisco
San Francisco, California, United States

Co-Author(s)

RW

Rachel E. Wittenberg, BS

Harvard Medical School, USA
VS

Valerie E. Salano, MBChB, MMed

Otolaryngologist
Nyahururu County Hospital,County Government of Laikipia
Nairobi, Kenya
NS

Natnael Shimelash, MD, MSc

Simulation and Skills Center, University of Global Health Equity, Butaro, Rwanda, USA
OM

Ornella Masimbi, MD, MGHD

Manager, Simulation and Skills Center
Simulation and Skills Center, University of Global Health Equity, Butaro, Rwanda
Burera, Kigali, Rwanda
GT

Gratien Tuyishimire, MD

Department of Otolaryngology, MCB Hospital
Kigali, RWA

Disclosure(s):

Sarah R. Nuss, BS: No relevant relationships to disclose.

Mary Jue Xu, MD: No relevant relationships to disclose.

Introduction: The objective of this study was to investigate the feasibility and effectiveness of low-cost otolaryngology simulation for medical students in Rwanda. Otolaryngology is an important field of study for medical students, but access to hands-on training and equipment is often limited in low-and middle-income countries. Confidence in performing basic otolaryngology skills is essential for all medical students, especially those who will practice in rural or remote settings where access to specialty care is limited. In this study, we designed and implemented a low-cost otolaryngology simulation program for medical students in Rwanda, using a combination of inexpensive materials and high-fidelity mannikins.

Methods: The simulation program consisted of three main components 1) a low-cost cricothyrotomy model 2) a low-cost ear model for foreign body and cerumen removal 3) a high-fidelity mannikin used for skills sessions of epistaxis management and nasal foreign body removal. The students were evaluated using both pre-and post-test assessments gauging content knowledge, experience, perceived skill, and confidence in performing the procedure, as well as a survey to gather feedback on the program.

Results: A total of 30 medical students participated in the simulation program, which was incorporated into a 1-week long otolaryngology “bootcamp” week prior to beginning a 3-week otolaryngology clerkship rotation. The total cost of the low-cost simulations were $1.02 and $0.20 for the cricothyrotomy and foreign body models, respectively. Time to construct was less than 5 minutes per model. Knowledge and perceived confidence increased across all three simulations. 100% of students found the simulations useful, enjoyable, and anticipated using the skill in future training.

Conclusions: Low-cost otolaryngology simulation was well-received, and increased knowledge, interest, and confidence in performing basic otolaryngology skills across all simulations. Simulation offers a way to augment traditional didactic curriculums in otolaryngology, and implementation is feasible in lower-resource settings.