A Reflection Of The Challenges And Lessons Learned From My Experience Of Conducting Low-fidelity Simulation Training For Anaesthesia Residents At A University Hospital In Ethiopia

A Reflection Of The Challenges And Lessons Learned From My Experience Of Conducting Low-fidelity Simulation Training For Anaesthesia Residents At A University Hospital In Ethiopia

Matthew Tang
St George’s University Hospitals NHS Foundation Trust, London, United Kingdom

Between November 2024 and April 2025, I delivered weekly to biweekly simulation teaching to fourteen first-year anaesthesia residents at Black Lion Specialized Hospital in Addis Ababa, Ethiopia. The simulation curriculum was specifically designed for low-resource settings (Morgan et al., 2025) and the scenarios broadly included common emergencies relating to airway, obstetric, paediatric and trauma anaesthesia.

Reflecting on this experience, several key themes emerged and prompted a series of self-examining questions: (1) How to encourage participants to be honest, reflect and share during debrief and can they ever be in the system that they are in? (2) What do ‘good’ non-technical skills look like to them and is their vision similar to ours? (3) Facilitating the tricky scenarios, for example maternal collapse and postmortem Caesarean section, what are the ethical, legal and cultural considerations? (4) Which debriefing models do they respond to more positively? (5) Teaching a technical skill that you are unable to supervise in the medium and long-term, and whose responsibility is it?

In this review, I retrospectively analyse the personal and systemic challenges I faced and critique the adaptive techniques I developed in the way I facilitated simulation and debrief, in the hopes that the lessons I share may inform future educators conducting simulation in low-resource settings overseas.

Keywords: Anaesthesia, simulation, education, low-resource