Challenges and prospects of surgical simulation among final-year medical students in Enugu State, Nigeria

Abstract Background: Simulation has rapidly become the go-to method for skill practice and training in surgical practice, to reduce the use of patients. Objectives: To determine the current state of simulations in surgical education among final-year medical students in Enugu state, Nigeria, ascertain the challenges, and proffer realistic solutions to the provision of simulations for surgical education among the students. Materials and Methods: A cross-sectional survey of final-year medical students in two (2) medical schools in Enugu state, Nigeria. Data collection was done using a well-structured and validated online questionnaire distributed through online social media platforms (WhatsApp and Telegram). Descriptive and inferential data analysis was done with Statistical Package for the Social Sciences (SPSS) version 21. Chi-squares and Fischer’s exact values were calculated. Significance was set at P < 0.05. Consent was obtained from all participants. Results: 113 final-year medical students completed and submitted the questionnaires. The most commonly used virtual resource for simulation was Zoom lectures (39.8%), followed by recorded teachings (24.8%), and mannequin use (17.7%). The majority agreed that these resources caused less emotional (always = 31.0%; most times = 31.0%) and physical stress (always = 34.5%; most times = 41.6%) as well as aided better understanding of concepts (always = 22.1%; most times = 40.7%). More than half (62.8%) of respondents agreed that inadequate numbers of simulation devices was a very significant challenge, and 67.3% also recognised cost to be a very significant challenge. Among the suggested solutions, the majority agreed that curriculum restructuring was beneficial (67.3%; statistically significant with P = 0.05), increased funding (71.7%), training courses (48.7%) and increased awareness (62.8%) were still needed as solutions to the challenges. Conclusion: There is a need for larger-scale studies to determine the nationwide status of surgical simulation in medical schools. There is also a need to coordinate efforts towards establishing and incorporating simulator-based curricula in medical students’ surgical training in Nigeria.