title: Simulation in Pre-departure Training for Residents Planning Clinical Work in a Low-Income Country.
abstract: BACKGROUND
  Increasingly, pediatric and emergency medicine (EM) residents are pursuing clinical rotations in low-income countries. Optimal pre-departure preparation for such rotations has not yet been established. High-fidelity simulation represents a potentially effective modality for such preparation. This study was designed to assess whether a pre-departure high-fidelity medical simulation curriculum is effective in helping to prepare residents for clinical rotations in a low-income country.
  
  
  METHODS
  43 pediatric and EM residents planning clinical rotations in Liberia, West Africa, participated in a simulation-based curriculum focused on severe pediatric malaria and malnutrition and were then assessed by survey at three time points: pre-simulation, post-simulation, and after returning from work abroad.
  
  
  RESULTS
  Prior to simulation, 1/43 (2%) participants reported they were comfortable with the diagnosis and management of severe malnutrition; this increased to 30/42 (71%) after simulation and 24/31 (77%) after working abroad. Prior to simulation, 1/43 (2%) of residents reported comfort with the diagnosis and management of severe malaria; this increased to 26/42 (62%) after simulation and 28/31 (90%) after working abroad; 36/42 (86%) of residents agreed that a simulation-based global health curriculum is more useful than a didactic curriculum alone, and 41/42 (98%) felt a simulator-based curriculum should be offered to all residents planning a clinical trip to a low-income country.
  
  
  CONCLUSIONS
  High-fidelity simulation is effective in increasing residents' self-rated comfort in management of pediatric malaria and malnutrition and a majority of participating residents feel it should be included as a component of pre-departure training for all residents rotating clinically to low-income countries.
authors.affiliation: Massachusetts General Hospital, Harvard Medical School, Department of Pediatrics and Department of Emergency Medicine, Boston, Massachusetts.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Schwartz
authors.affiliation: Baystate Medical Center, Tufts University School of Medicine, Department of Emergency Medicine, Springfield, Massachusetts.
authors.forename: Kimball A
authors.initials: KA
authors.lastname: Prentiss
mesh_terms: D002648:Child; D015362:Child Nutrition Disorders / Q000175:diagnosis / Q000628:therapy; D003198:Computer Simulation; D003479:Curriculum; D003906:Developing Countries; D004635:Emergency Medicine / Q000193:education*; D014943:Global Health; D006801:Humans; D007396:Internship and Residency; D008288:Malaria / Q000175:diagnosis / Q000628:therapy; D010372:Pediatrics / Q000193:education*; D000066908:Simulation Training; D011795:Surveys and Questionnaires; D014481:United States