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Hands On Learning: Simulated Medical Care from Utah to Tanzania

Tanzanian NursesThe University of Utah’s College of Nursing partnered with the Pronto International program to bring 10 nurses from Tanzania to participate in a simulation facilitation training program from June 14 to June 19, 2015.

 The 10 nurses, who were working within the maternal and neonatal care program at Dixie State University for six weeks prior, were participating in an exchange program with the Tanzanian Nurses Association.

 The University of Utah invited the non-profit organization Pronto International, to help facilitate the simulation training.

“This training is focused on teaching simulation facilitation,” said Susanna Cohen, co-founder of Pronto International, and associate professor in the University of Utah’s College of Nursing. “We started out with the nurses experiencing a simulation to see how it worked and what they could learn from it. Over the week they have been acquiring the skills to set, up, run and debrief their own simulations.”

Pronto International is a non-profit organization that provides simulation and team training to low resource settings around the world.  The program has offered training to more than 2,400 people across seven countries.

The program offers what is referred to as “low cost, high fidelity” simulation exercises that allows participants to actively engage in realistic simulations of childbirth scenarios, and potential complications.

“Our goal is to bring simulation to places where they can’t afford a fancy simulation center or high tech simulators, while encouraging healthcare providers to give quality care to mothers and babies during the time of birth,” Cohen said. 

Each simulation is recorded, so that after the emergency scenario has played out, the participants and observers are able to go back through self-guided analysis of the simulation. They are able to directly observe what worked, what didn’t and discuss where improvements could be made.

Cohen explained that the program offers a number of benefits to the participants, not only by immersing them in simulations that they can use to learn additional skills, but also in teaching them how to create and run simulations of their own.

 “I think as participants in a simulation they learn how to manage emergencies within the context in which they happen, utilizing the resources and team they have,” Cohen said. “And as simulation facilitators, they are learning how to facilitate groups and how to create a safe learning environment.”

Stanley Kajuna, was one of the nurses participating in the exchange training, and works as a nurse at one of the regional referral hospitals in Tanzania.

Kajuna found that much of what the simulation courses offered was valuable, especially in regards to the debriefings that followed each of the simulation scenarios.

“Within a simulation, you can see a situation from a realistic perspective,” Kajuna said. “So in doing a simulation, when you get to the debriefing, it is helpful to go back and discuss mistakes and what corrections were made to resolve the situation. It helps to present things as more than just a theory, but in a practical way, which has been very beneficial.”

Not only did the nurses who participated in the simulation training gain valuable insight that will help them to teach simulation techniques back in Tanzania, but Pronto International also worked to provide them with the necessary tools to do so.

“In addition to the training we are receiving, we will also be provided with kits that we can take home which I am sure we will use to teach other nurses in our country,” Kajuna said. “These kits are great because they are simple and can be used in many different areas, not just among healthcare providers, but out into the community where we can provide much more help.”

That simplicity is one of the keys to the success of the Pronto training. Not all countries where these simulations will be used have access to the resources we have in hospitals within the United States.

The “Pronto Pack” kits provided to the nurses to take back to Tanzania are designed in such a way, as to allow the facilitation of realistic simulations even in rural, or low-tech environments, making them ideal for disseminating the information throughout communities.

Utah State Senator Steve Urquhart gathered the private funding that allowed the nurses to participate in the training at both Dixie State University and the University of Utah.