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. 2025 Jan 3:11:23779608241309447.
doi: 10.1177/23779608241309447. eCollection 2025 Jan-Dec.

Practice, Experiences, and Facilitators of Simulation-Based Training During One Year of Implementation in 30 Hospitals in Tanzania

Benjamin A Kamala  1   2 , Robert Moshiro  1   2 , Florence S Kalabamu  2   3 , Torgeirsen Kjetil  4   5 , Godfrey Guga  1 , Beatrice Githiri  1 , Justine Samson  1 , Philimon Chavala  1 , Grace Qorro  2 , Damas Kayera  6 , Ivony Kamala  1 , Catherine Massay  1 , Paschal Mdoe  1 , Vickfarajaeli Daudi  1 , Esto Mduma  1 , Shally Mwashemele  7 , Felix Bundala  8 , Hege Ersdal  4   9 , Sara Rivenes Lafontan  10
Affiliations

Practice, Experiences, and Facilitators of Simulation-Based Training During One Year of Implementation in 30 Hospitals in Tanzania

Benjamin A Kamala et al. SAGE Open Nurs. .

Abstract

Introduction: Enhancing the proficiency of healthcare workers (HCWs) in handling birth-related complications is crucial for reducing maternal and newborn morbidity and mortality. To achieve this, the Safer Births Bundle of Care offers a comprehensive set of innovative, simulation-based training interventions designed to strengthen the skills and competencies of HCWs working as skilled birth attendants.

Objective: To describe the use of in-situ low-dose, high-frequency simulation-based training, and the experiences of this usage among HCWs and stakeholders at facilities in Tanzania.

Methods: This mixed-methods study included quantitative and qualitative data collected between July 2021 and July 2022 across 30 health facilities in five regions of Tanzania. NeoNatalie Live (NNL) simulators were installed for independent skills and scenario training, and in-situ facilitator-led team simulations were introduced. The training frequency was analyzed using descriptive and analytical statistics, and mentorship and supervision reports were analyzed using qualitative content analysis.

Results: A large and sustained number of in-situ NNL skill-training sessions (n = 35,101) and facilitator-led team simulations (n = 266) were conducted during the first year. Clinical burden per HCW did not affect the frequency of NNL skills training at the health facility level (r = -0.16, p = .40) nor facilitator-led team simulations. There was a positive but weak correlation between the frequency of facilitator-led team simulations and NNL skills training (r = 0.34, p = .05). Qualitative data showed a high degree of motivation and participation among all stakeholders, and active use of hospital data, both clinical indicators and training data, was perceived as a success factor.

Conclusion: Facilitator-led in-situ simulation training was more likely to occur where individual skills-training sessions were recorded. Training sessions took place regardless of the increased workload.

Keywords: facilitator-led team simulations; high frequency; innovation; low dose; safer births; simulation-based training; skills training.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SRL was employed an independent qualitative research consultant with Laerdal Medical and Laerdal Global Health from 2022-2023. Laerdal Medical and Laerdal Global Health provided the simulation equipment used in this study. Laerdal Medical and Laerdal Global Health played no part in the design or performance of the study nor in the analysis or interpretation of results. The other authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Periods for Interventions in the different regions (wedges) and health facilities (clusters) during the roll-out of the study.
Figure 2.
Figure 2.
Integrating the innovative Safer Births Bundle of Care (SBBC) tools for clinical care, data collection and training to facilitate continuous quality improvement efforts. LDHF = low-dose, high-frequency.
Figure 3.
Figure 3.
Illustration of the planned training cascade and implementation strategy.
Figure 4.
Figure 4.
An excerpt from the NeoNatalie Live training progress board providing feedback to healthcare workers.
Figure 5.
Figure 5.
Average number of skills-training sessions using NeoNatalie Live and facilitator-led in-situ simulation training by facility.
Figure 6.
Figure 6.
Average number of training sessions per month versus the average number of births per healthcare worker (HCW) per month, by region and facility.
See this image and copyright information in PMC

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