Hands-On Practice on Sustainable Simulators in the Context of Training for Rural and Remote Practice Through a Fundamental Skills Workshop

Abstract

Simulation-based education (SBE) is a sustainable method to allow healthcare professionals to develop competencies in clinical skills that can be difficult to maintain in rural and remote settings. Simulation-based skills training is necessary for healthcare professionals that experience difficulties accessing skills development and maintenance courses to address the needs of rural communities. However, simulators, a key element of simulation, are often prohibitively expensive and follow a "one-size-fits-all" approach. Using additive manufacturing (AM) techniques, more specifically three-dimensional (3D) printing, to produce inexpensive yet functional and customizable simulators is an ideal solution for learners to practice and improve their procedural skills anywhere and anytime. AM allows for the customization of simulators to fit any context while reducing costs and is an economic solution that moves away from the use of animal products to a more ethical, sustainable method for training. This technical report describes the delivery of a fundamental skills workshop to provide hands-on training to rural and remote healthcare professionals using 3D-printed simulators purposefully designed following design-to-cost principles. The workshop was delivered at a three-hour session hosted at a rural and remote medicine course in Ottawa, Canada. The workshop consisted of four technical skills: suturing, cricothyrotomy, episiotomy, and intraosseous infusion (tibial) (IO) and used a blended learning approach to train healthcare professionals and trainees who practice in rural and remote areas. In addition, the learners were granted access to a custom-designed learning management system, which provided a repository of instructional materials, and enabled them to record and upload personal practice sessions, review other learners' practice sessions, collaborate, and provide feedback to other learners. The feedback collected from participants, instructors, and observations on the delivery of the workshop will help improve the structure and training provided to learners. The delivery of this workshop annually is an ideal solution to ensure parsimonious delivery of simulation training for rural and remote healthcare professionals.

Keywords: 3d printing; additive manufacturing; clinical skills; hands-on practice; healthcare professionals; physicians; rural and remote; simulation-based education; simulator; training.

Figure 1. A web page on GEN showing an instructional video for participants to view before practicing on the simulator.

Figure 2. Equipment setup of the suturing station for an individual participant.

Figure 3. Instructor demonstrating one of the suturing skills for participants.

Figure 4. The cricothyroidotomy simulator that participants used to practice the skill.

Figure 5. Instructor demonstrating the cricothyroidotomy skill for participants using the simulator.

Figure 6. Equipment setup of the episiotomy station for an individual participant.

Figure 7. Participants practicing the episiotomy technique on the simulator.

Figure 8. Equipment setup of the intraosseous infusion station for an individual participant.

Figure 9. Instructor training participants on the IO technique using the simulator.

Figure 10. A participant viewing a simulator at the display station guided by one of the research team members.