Background : Increasingly residents are participating in global health (GH) electives where they encounter difficult medical and emotional challenges. Educators often struggle to find innovative ways to prepare learners for these challenges. Simulation Use for Global Away Rotations (SUGAR) is a free online curriculum designed to prepare providers for common challenges experienced when working in resource-limited settings (sugarprep.org). We created a pre-departure course that integrates SUGAR cases with traditional teaching methods to prepare residents for GH electives.
Purpose/Objective : Common themes reported from residents during GH electives include frustration in lack of resources, floundering when faced with new or unfamiliar diseases, failure when practicing in a new environment, and a feeling of futility when limited-resources combine with overwhelming need. The SUGAR curriculum is a standardized set of simulated cases from several disciplines including emergency medicine, obstetrics & gynecology, surgery, and pediatrics, which are meant to provoke these emotions and prepare learners for anticipated challenges.
Methods : We combined formal lectures and small-group discussions with interactive simulation cases from the SUGAR curriculum to create a pre-departure course targeted at a multidisciplinary group of emergency medicine, surgical and non-surgical post-graduate trainees. We implemented the SUGAR standardized debriefing tool to help guide residents to desired outcomes including increased adaptability, awareness of resources, adjustment and humility, and acknowledgement of limitations.
Outcomes : Post-graduate trainees (n=29), which included residents and fellows, were asked to complete an anonymous course evaluation after participation in our pre-departure course. All participants completed the evaluation. When asked about the course content, 90% of participants reported that the course was ‘useful in my preparation for a global health elective.’ 82% reported the simulations were helpful in ‘preparing to work in low-resource settings.’