490 - Adaptive Approaches to Overcome Simulation-Based Training Challenges in Northern Ghana

Poster Number: 490
Publication Number: 490.111

Background: Simulation-based training is an effective tool to enhance clinical skills, improve patient outcomes, and build capacity. However, implementation in low-resource settings can be challenging due to constraints in funding, infrastructure, and access to state-of-the-art equipment. Effective adaptation to address these challenges is critical to sustainable and ongoing capacity building.

Objective: To describe the adaptive approaches implemented over two iterations to address challenges in a pediatric simulation training in northern Ghana, with close attention to specific training needs, local relevance, and sustainable knowledge transfer.

Design/Methods: Leveraging an international, academic partnership known as AMPATH Ghana, stakeholders collaborated to identify priority training needs and implement PedSim, a simulation training for pediatric intern-level House Officers (HOs). Collaborators co-created contextualized simulation cases and used an adaptive implementation approach to ensure local relevance and long-term sustainability.

Results: 50 HOs and 8 Medical Officers (MOs) participated in the first PedSim pilot, which was co-led by United States (US) and Ghanian faculty. Following the pilot, a subsequent iteration of the training program was introduced, entirely led by Ghanian faculty and MOs which trained an additional 43 HOs. Context-specific challenges were identified through stakeholder debrief, and these were iteratively addressed and refined (Table 1). Feedback from the participants revealed a marked increase in confidence managing acute pediatric conditions, including septic shock, acute respiratory distress, severe acute malnutrition, and status epilepticus. Subsequent trainings will be delivered every six months, now integrated as part of a new HO training orientation.

Conclusion(s): PedSim serves as a model for how contextualized, low-fidelity training can improve clinical confidence and skills in resource-limited settings. An adaptive approach to contextualize simulation cases with a lens towards sustainable knowledge transfer is crucial for success and sustainability. Future studies may evaluate the fidelity of simulation cases and the long-term impact of low-fidelity, high-yield simulation on patient outcomes and its replicability in similar settings.