# Advancing Global Health Education: Preparing Emergency Medicine Trainees for Low-Resource Settings Through Simulation-Based Training

## TL;DR

A simulation-based training course for emergency medicine trainees improves their confidence and preparedness for working in low-resource global health settings.

## Contribution

An EM-specific simulation curriculum tailored to low-resource global health experiences, with demonstrated confidence improvements in critical conditions.

## Key findings

- 80% of participants supported annual inclusion of the simulation-based training in the residency curriculum.
- Participants showed increased confidence in managing postpartum hemorrhage and organophosphate poisoning.
- The course was effective in preparing emergency medicine trainees for high-acuity conditions in low-resource settings.

## Abstract

Global health experiences (GHEs) are increasingly popular among medical trainees. Predeparture training is crucial in preparing learners for the challenges of working in low- and middle-income countries (LMICs). However, few resources are tailored to training level or specialty. This simulation-based course was designed to enhance emergency medicine (EM) trainees’ preparedness for GHEs in LMICs.

A 4-hour course consisting of 5 small-group simulations followed by a large-group summative lecture designed to reinforce case scenarios was presented to EM residents and medical students. Topics were chosen to represent common, high-acuity conditions in LMICs (e.g., multiple blunt-force trauma, postpartum hemorrhage, pericardial tamponade secondary to tuberculosis, cerebral malaria, intentional organophosphate poisoning). To mirror resource-constrained environments, learners managed each simulated case using limited equipment, diagnostic tools, and medications. A critical action checklist ensured that simulation educational objectives were achieved, and a postcourse survey assessed perceived relevance, realism, and impact on confidence.

Sixteen EM residents and 4 medical students participated. While most learners had previous experience managing postpartum hemorrhage and tension pneumothorax (each 75%), fewer had experience managing pulmonary tuberculosis (25%), malaria (25%), or organophosphate poisoning (15%). Following training, 80% supported inclusion in the residency curriculum annually. Most participants strongly agreed that the training increased confidence in practicing EM in LMICs. Confidence improved in handling all conditions, with the highest increases in confidently managing postpartum hemorrhage and organophosphate poisoning.

This EM-specific, simulation-based global health course was well-received and effectively enhanced participants’ confidence and preparedness for GHEs.