title: Simulation Use for Global Away Rotations (SUGAR): preparing residents for emotional challenges abroad--a multicenter study.
abstract: BACKGROUND
  Preparation for residents participating in global health (GH) experiences is critical. Active preparatory curricula allowing residents to experience and debrief emotional challenges they may encounter abroad are generally lacking. We sought to evaluate a novel simulation curriculum designed to prepare residents for emotions they may experience in response to challenges abroad.
  
  
  METHODS
  Pediatric GH educators from 7 institutions developed case vignettes incorporating common challenges residents experience abroad. Residents participating in a GH training track or planning to participate in a GH rotation from the 7 institutions were eligible to participate in the simulation curriculum. Participants and trained facilitators completed postsimulation evaluations that were analyzed using descriptive statistics and thematic analysis of written comments to assess the utility of the curriculum, emotions evoked, and changes residents anticipated making to their GH rotation preparation.
  
  
  RESULTS
  Fifty-one residents and 16 facilitators completed 160 and 52 evaluations, respectively. Overall, respondents found the simulations useful (mean [SD] resident score 4.49 [0.82] and facilitator score 4.85 [0.36] on a 5-point scale [1 = completely useless, 5 = very useful]). Residents reported strong emotions in 153 (98%) of 156 comments. After the sessions, 131 (96%) of 137 comments reflected anticipated changes to GH rotation preparation plans.
  
  
  CONCLUSIONS
  Active preparation for GH rotations using simulated cases appears to be a useful tool that can be implemented across a variety of sites with minimal facilitator training or simulation experience. The curriculum successfully elicited powerful emotions in residents and provided an opportunity to debrief these experiences before encountering them abroad.
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wis. Electronic address: sbutteris@pediatrics.wisc.edu.
authors.forename: Sabrina M
authors.initials: SM
authors.lastname: Butteris
authors.affiliation: Division of Global Pediatrics, University of Minnesota, Minneapolis, Minn.
authors.forename: Sophia P
authors.initials: SP
authors.lastname: Gladding
authors.affiliation: Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.
authors.forename: Walter
authors.initials: W
authors.lastname: Eppich
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wis.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Hagen
authors.affiliation: Division of Global Pediatrics, University of Minnesota, Minneapolis, Minn.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Pitt
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004644:Emotions; D014943:Global Health; D006801:Humans; D007396:Internship and Residency; D016544:Patient Simulation; D010372:Pediatrics / Q000193:education*; D010820:Physicians / Q000523:psychology*; D014195:Travel
keywords: curriculum; emotion; global health; preparation; resident; simulation