The investigators will use a multi-methods approach, including both qualitative and quantitative methods. In the quantitative methodology, the investigators will use a before and after approach to compare medical student grades/scores before and after the integration of Simulation based learning (SBL) in the curriculum. The hypothesis is that SBL will generally increase knowledge and skills and hence improve the scores from the theory (MCQ) and clinical (OSCE) examinations conducted outside simulated settings in the clinical departments.

Simulation faculty development will be measured by retention and engagement in simulation sessions. The investigators will use survival analysis methods and plot Kaplan Meier curves to calculate probability of retention and determine the factors that are associated with retention as derived from participant in-depth interviews and departmental meetings. A faculty member will be considered disengaged if they do not participate in simulation session for at least 6 months post training, despite reminders and opportunities for participation. Reasons for potential disengagement will be explored qualitatively.

In the qualitative approach, the investigators will conduct in-depth key informant interviews (45 minutes to 1 hour) with administrators at the institution, namely Academic Registrar, Deans of Medical School, heads of Departments and Simulation facilitators (the post-graduate student trainers). The investigators will conduct focus group discussions (1 hour) with postgraduate simulation facilitators, the medical and nursing students before, during and after their enrollment in SBL. The interviews and focus group discussions will be audio-recorded and transcribed.

Inclusion Criteria:

• Medical (Medicine and Nursing) students
• Enrolled in the Faculty of medicine at Mbarara University of Science and Technology
• Currently attending clinical years

Exclusion Criteria:

• Non clinical student years in the Faculty of Medicine
• not enrolled in Medicine or Nursing programs at Mbarara University of Science and Technology

Data will share with permission from the research ethics committee and Mbarara University Academic Registrar's authorization

No masking applicable