Building Confidence and Competence through Simulation-based Trainings

Dr Binisha Gongal, a third-year resident at the National Academy of Medical Sciences (NAMS), feels more confident to tend to critically ill patients after recently participating in a simulation-based training on anesthesia.

“The training helped me to ace important techniques such as performing venous access and high-quality cardiopulmonary resuscitation (CPR), effectively communicating during case management, and managing diagnosis and treatment in various healthcare settings," she says. "Being able to enact real-life situations with the aid of necessary equipment such as mannequins was instrumental in helping me gain essential life-saving skills."  

Hundreds of healthcare professionals like Dr Gongal have benefitted from the hands-on trainings being provided at the National Simulation Lab inside Bir Hospital. With access to equipment including pediatric and adult mannequins, intubation kits, defibrillator, ECG machine, patient monitor, and tracheal tubes, health workers are able to train and practice their skills in a safe and controlled environment at the Simulation Lab.

“From adopting early and systematic approaches to ensure immediate recognition of emergencies and carry triage accordingly, to checking the WHO surgical safety standards to avoid safety errors, to enhancing decision-making and communication skills, the training has equipped me with all the essential skills required to deliver effective care," says Dr Suyog Aryal, who also attended the simulation-based training on anesthesia.

A joint initiative of the National Health Training Center (NHTC) and Bir Hospital, the Skills Lab was set up in March 2022 with support from WHO and ECHO, with the objective to create a space for health workers to receive practical trainings using simulation-based learning. As part of the project, WHO also facilitated the refurbishment of the auditorium hall with support from the US Department of State.

Since then, several important trainings on critical care, management of acute respiratory distress syndrome (ARDS), advanced cardiovascular life support, simulation-based learning in anesthesia, have been held at the lab. As of May 2023, more than 1000 healthcare workers have participated in trainings.

“The trainings conducted at the Simulation Lab have helped trainees improve their skills and decision-making abilities, making them more confident in dealing with real-life medical scenarios, ultimately benefitting patient safety,” says Dr Yadu Chandra Ghimire, Director, NHTC.

Ms Sapana Shrestha, an ICU nurse at Bir Hospital, says she gained in-depth knowledge on topics such as managing airway paths, properly using mechanical ventilators and Automated External Defibrillators, and various medications and their dosage during the Essential Critical Care Training held on June 2022.

“These skills, knowledge, and attitude - key pillars to prevent negative situations – are crucial for us nurses, who are most present with patients and their loved ones," says Ms Shrestha.

Prof. Dr. Ravi Ram Shrestha, Chief Consultant Anesthesiologist, Bir hospital, who also serves as the Lab focal person says the new lab and hall has provided a conducive environment for hosting trainings.

"Earlier we lacked space and equipment for conducting trainings. The establishment of a dedicated space and a well-quipped lab at the same venue has enabled us to host important trainings and do so in an effective manner," he says.

“The trainings conducted on ARDS and Infection Prevention and Control, were particularly crucial and much needed at a time when healthcare workers were facing unprecedented situations in managing patient emergencies," he adds.

“The establishment of the National Simulation Lab must be commended as it will and is already contributing to developing skilled health workers. The next step would be to prioritize establishing a network of such labs across the country to improve the clinical skills of healthcare workers nationwide and improve patient safety,” says Dr Rajesh Sambhajirao Pandav, WHO Representative to Nepal.