Promoting anaesthetisia providers' non-technical skills through the Vital Anaesthesia Simulation Training (VAST) course in a low-resource setting

Br J Anaesth. 2020 Feb;124(2):206-213. doi: 10.1016/j.bja.2019.10.022. Epub 2019 Dec 12.


Background: Short educational programmes are important in building global anaesthesia workforce capacity. The Vital Anaesthesia Simulation Training (VAST) course is a 3-day immersive simulation-based programme concentrating on core clinical challenges and non-technical skills required by anaesthesia providers in low-resource settings.

Methods: This mixed methods study prospectively evaluated the impact of VAST in Rwanda. Anaesthetists' Non-Technical Skills (ANTS) scores were quantitatively assessed for 30 course participants at three time points (pre-, post-, and 4 months after VAST). Qualitative data were gathered during focus groups (4 months after VAST) to learn of participants' experiences implementing new knowledge into clinical practice.

Results: The ANTS total scores improved from pre- (11.0 [2.3]) (mean [standard deviation]) to post-test (14.0 [1.6]), and improvements were maintained at retention (14.2 [1.7]). A similar pattern was observed when data were analysed using the four ANTS categories (all P<0.001). The key theme that emerged during focus group discussions was that the use of cognitive aids and clinical algorithms, repeated and reinforced across simulated scenarios, encouraged a systematic approach to patient care. The participants attributed the systematic approach to improving their problem-solving skills and confidence, particularly during emergencies. They found value in well-functioning teams and shared decision-making. After VAST, the participants described empowerment to advocate for better patient care and system improvement.

Conclusions: VAST offers a simulation-based training to anaesthesia providers working in low-resource settings. Skills retention and self-reported application of learning into the workplace reflect the scope of impact of this training.

Keywords: anaesthesia; global health; low-resource countries; non-technical skills; simulation; training.

MeSH terms

  • Anesthesiology / education*
  • Anesthetists
  • Clinical Competence / statistics & numerical data*
  • Developing Countries
  • Follow-Up Studies
  • Humans
  • Program Evaluation / methods*
  • Prospective Studies
  • Rwanda
  • Simulation Training / methods*