Introduction of a portable and affordable surgical simulator at a low-resource training programme: A pilot study in western Kenya

Background: Surgical simulation is increasingly recognized as an important adjunct to surgical education. However, high-fidelity models are often unrealistic to replicate in limited-resource settings. The GlobalSurgBox was developed as a portable and modular training platform with the specific goal of creating a low-cost simulator that is adaptable to varying skill sets and training levels. This pilot study aimed to evaluate the initial application and perceptions of the GlobalSurgBox by surgical trainees at a low-resource training programme. Methods: The usefulness and feasibility of the GlobalSurgBox were assessed following distribution to medical students, junior doctors, surgical trainees, and cardiothoracic surgery fellows at Tenwek Hospital in Bomet, Kenya. Participants were coached on how to perform a variety of common surgical manoeuvres using the GlobalSurgBox and allowed to practise ad libitum for 1 week. Participants were then administered an anonymized, electronic survey. Results: Twenty-six participants were included. All participants agreed that surgical simulation is an important adjunct to training; however, only 50.0% (n=13) reported access to surgical simulator resources. While 76.9% of participants (n=10 of 13) reported barriers to using currently available simulators, including lack of time and lack of convenient access, only 42.3% of all participants (n=11) cited obstacles to routinely using the GlobalSurgBox. The majority of participants (96.2%) reported that the GlobalSurgBox better prepared them to practise similar skills in the operating theatre. Conclusions: The GlobalSurgBox represents an important global health equity initiative that provides a novel resource for surgical trainees of all levels and from all types of training environments to supplement their surgical education and operating experience.