Simulation based learning practice is limited in Sub-Saharan Africa. Experiences gained from our prior implementation in Phase I of this program show that simulation is feasible and significantly contributes to learning. However, the growth and sustainability of simulation methodologies in health training and service delivery institutions is subject to variability and institution specific factors. These factors may include but are not limited to ease of adoption of new technologies, human resources, space and institutional culture. These factors are likely to vary widely in Sub-Saharan Africa across countries and institutions.

It's not known how institutional factors will influence the introduction, adoption and sustainability of simulation methodologies in East and West African health training and service delivery institutions. We have partnered with four institutions in East and West Africa (in Uganda, Tanzania, and Nigeria) to learn about the process of introduction and scaling of simulation based learning in new frontiers.

The investigators in this proposal have partnered and propose to expand Simulation Based Learning to Lira University in northern Uganda, Busitema University in Eastern Uganda, the Catholic University of Health and Allied Sciences (CUHAS), Tanzania and University of Jos in Nigeria. All these health training and service institutions serve large rural and peri-urban populations with poor access to health care.

The investigators will engage the partners in the co-design of implementation plans to design solutions for the barriers to implementation that are anticipated, and ensure appropriate tailoring to the local context. The investigators will use a Train of trainers (ToT) Faculty development model and this will include web-based debrief mentorship using recorded debriefing sessions from real simulations at partner sites. These videos will be loaded onto a centralization server to facilitate peer-to-peer feedback using a quality of debriefing framework.

Based on the investigators' learning experience from Phase I of implementation, the team aims to develop two categories of simulation facilitators: 1) Simulation implementation faculty (SiF) and 2) Lead simulation faculty. Lead simulation faculty (LsF) will be trained at the Mbarara University of Science and Technology (MUST) simulation center of excellence and will receive support in assessing their sites' barriers and facilitators regarding the Sim intervention. The faculty trainees will undergo an intensive 1.5-day faculty development course followed by a 2-day placement at MUST sim center for mentored scenario execution practice.

Inclusion Criteria:

• Health professions Institutions in East and West Africa in the Sim for life program
• Institutional commitment to adopt simulation based learning Faculty at these health professions institutions

Exclusion Criteria: Institutions outside East and West Africa Sim for life program

-

Ethics approval is required