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Educational impact of a pilot paediatric simulation-based training course in Botswana
  1. Nicolaus W Glomb1,
  2. Manish I Shah2,
  3. Adeola A Kosoko3,
  4. Cara B Doughty2,
  5. Cafen Galapi4,
  6. Bushe Laba4,
  7. Marideth C Rus2
  1. 1Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco, California, USA
  2. 2Pediatric Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA
  3. 3Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, USA
  4. 4Emergency Medical Services, Republic of Botswana Ministry of Health, Gaborone, Botswana
  1. Correspondence to Dr Nicolaus W Glomb, Emergency Medicine, University of California San Francisco School of Medicine, San Francisco, CA 94143, USA; Nicolaus.glomb{at}


Background As emergency medical services (EMS) systems develop globally in resource-limited settings, equipping providers with paediatric training is essential. Low-fidelity simulation-based training is an effective modality for training healthcare workers, though limited data exist on the impact of such training programmes. The objective of this study was to evaluate the paediatric portion of a simulation-based curriculum for prehospital providers in Botswana.

Methods This was a prospective cohort study of EMS providers from more populated regions of Botswana, who attended a 2-day training that included didactic lectures, hands-on skills stations and low-fidelity simulation training. We collected data on participant self-efficacy with paediatric knowledge and skills and performance on both written and simulation-based tests. Self-efficacy and test data were analysed, and qualitative course feedback was summarised.

Results Thirty-one EMS providers participated in the training. Median self-efficacy levels increased for 13/15 (87%) variables queried. The most notable improvements were observed in airway management, newborn resuscitation and weight estimation. Mean written test scores increased by 10.6%, while mean simulation test scores increased by 21.5% (p<0.0001). One hundred per cent of the participants rated the course as extremely useful or very useful.

Discussion/Conclusion We have demonstrated that a low-fidelity simulation-based training course based on a rigorous needs assessment may enhance short-term paediatric knowledge and skills for providers in a developing EMS system in a limited-resource setting. Future studies should focus on studying larger groups of learners in similar settings, especially with respect to the impact of educational programmes like these on real-world patient outcomes.

  • simulation
  • emergency medical services
  • prehospital
  • education
  • Botswana
  • collaboration
  • resource limited
  • resuscitation
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  • Data/results from this manuscript have been previously presented in poster format at the InternationalPediatric Simulation Symposium and Workshop on 1–3 June 2017, Boston, MA, Glomb et al, Pediatric Simulation Training for Prehospital Providers in Botswana.

  • Contributors NWG, MIS, AAK, CBD, CG, BL and MCR made substantial contributions to the conception and the design of the project, participated in the drafting and revision of the work and the data analysis required to complete the project, and approved the final version of the manuscript and agrees to be accountable for all aspects of the work. NG was the principal investigator for this study and MCR served as the senior author of the manuscript.

  • Funding All funding for this training program was provided by a Texas Children’s Hospital and Baylor College of Medicine, Department of Pediatrics Educational Award.

  • Competing interests None declared.

  • Ethics approval This study was approved by the institutional review boards of Baylor College of Medicine (Houston, Texas, USA), University of California, San Francisco, and the Republic of Botswana Ministry of Health and Wellness Research and Ethics Committee (Gaborone, Botswana). Written consent was obtained from all participants.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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