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Article ; Online: Assessing Healthcare Simulation Facilitation: A Scoping Review of Available Tools, Validity Evidence, and Context Suitability for Faculty Development in Low-Resource Settings.

Mossenson, Adam I / Livingston, Patricia L / Tuyishime, Eugene / Brown, Janie A

Simulation in healthcare : journal of the Society for Simulation in Healthcare

2024

Abstract: Summary statement: Assessment tools support simulation facilitation skill development by guiding practice, structuring feedback, and promoting reflective learning among educators. This scoping review followed a systematic process to identify ... ...

Abstract	Summary statement: Assessment tools support simulation facilitation skill development by guiding practice, structuring feedback, and promoting reflective learning among educators. This scoping review followed a systematic process to identify facilitation assessment tools used in postlicensure healthcare simulation. Secondary objectives included mapping of the validity evidence to support their use and a critical appraisal of their suitability for simulation faculty development in low-resource settings. Database searching, gray literature searching, and stakeholder engagement identified 11,568 sources for screening, of which 72 met criteria for full text review. Thirty sources met inclusion; 16 unique tools were identified. Tools exclusively originated from simulation practice in high-resource settings and predominantly focused on debriefing. Many tools have limited validity evidence supporting their use. In particular, the validity evidence supporting the extrapolation and implications of assessment is lacking. No current tool has high context suitability for use in low-resource settings.
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2223429-9
ISSN	1559-713X ; 1559-2332
ISSN (online)	1559-713X
ISSN	1559-2332
DOI	10.1097/SIH.0000000000000796
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Regional anaesthesia practice in public hospitals in Botswana: A cross-sectional study.

Kassa, Mamo / Madzimbamuto, Farai / Kediegite, Gaone / Tuyishime, Eugene

PloS one

2023 Volume 18, Issue 12, Page(s) e0295932

Abstract: Introduction: Little is known about the regional anesthesia practice in low resources settings (LRS). The aim of this study was to describe the regional anesthesia capacity, characteristics of regional anesthesia practice, and challenges and solutions ... ...

Abstract	Introduction: Little is known about the regional anesthesia practice in low resources settings (LRS). The aim of this study was to describe the regional anesthesia capacity, characteristics of regional anesthesia practice, and challenges and solutions of practicing safe regional anesthesia in public hospitals in Botswana. Methods: This was a cross-sectional survey of anesthesia providers working in public hospitals in Botswana. A purposive sampling method of public hospitals was used to achieve representation of different hospital levels across Botswana. Paper-based questionnaires were sent to anesthesia providers from selected hospitals. Descriptive statistics were used for analysis. Results: Questionnaires were distributed to 47 selected anesthesia providers from selected hospitals; 38 (80.9%) were returned. Most participants were nurse anesthetists and medical officers (57.8%). All hospitals perform spinal anesthesia; however, other regional techniques were performed by a small number of participants in one referral hospital. Most hospitals had adequate regional anesthesia drugs and sedation medications, however, most hospitals (except one referral hospital) lacked ultrasound machine and the regional anesthesia kit. The common challenges reported were lack of knowledge and skills, lack of equipment and supplies, and lack of hospital engagement and support. Some solutions were proposed such as regional anesthesia training and engaging the hospital management to get resources. Conclusions: The results of this study suggest that spinal anesthesia is the most common regional anesthesia technique performed by anesthesia providers working in public hospitals in Botswana followed by few upper limb blocks. However, most public hospitals lack enough training capacity, equipment, and supplies for regional anesthesia. More engagement of the hospital management, investment in regional anesthesia resources, and training are needed in order to improve the regional anesthesia capacity and provide safe surgery and anesthesia in Botswana.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Botswana ; Hospitals, Public ; Anesthesiology/education ; Anesthesia, Conduction
Language	English
Publishing date	2023-12-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0295932
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Article ; Online: Factors Influencing the Choice of Anesthesia as a Career by Undergraduates of the University of Rwanda.

Tuyishime, Eugene

Anesthesia and analgesia

2017

Language	English
Publishing date	2017-09-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000002481
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Article ; Online: Emergency airway management in the prone position: an observational mannequin-based simulation study.

Rajaleelan, Wesley / Tuyishime, Eugene / Plitman, Eric / Unger, Zoe / Venkataraghavan, Lakshmi / Dinsmore, Michael

Advances in simulation (London, England)

2024 Volume 9, Issue 1, Page(s) 14

Abstract: Introduction: Accidental extubation during prone position can be a life-threatening emergency requiring rapid establishment of the airway. However, there is limited evidence of the best airway rescue method for this potentially catastrophic emergency. ... ...

Abstract	Introduction: Accidental extubation during prone position can be a life-threatening emergency requiring rapid establishment of the airway. However, there is limited evidence of the best airway rescue method for this potentially catastrophic emergency. The aim of this study was to determine the most effective method to recover the airway in case of accidental extubation during prone positioning by comparing three techniques (supraglottic airway, video laryngoscopy, and fiber-optic bronchoscopy) in a simulated environment. Methods: Eleven anesthesiologists and 12 anesthesia fellows performed the simulated airway management using 3 different techniques on a mannequin positioned prone in head pins. Time required for definitive airway management and the success rates were measured. Results: The success rates of airway rescue were 100% with the supraglottic airway device (SAD), 69.6% with the video laryngoscope (CMAC), and 91.3% with the FOB. The mean (SD) time to insertion was 18.1 (4.8) s for the supraglottic airway, 78.3 (32.0) s for the CMAC, and 57.3 (24.6) s for the FOB. There were significant differences in the time required for definitive airway management between the SAD and FOB (t = 5.79, p < 0.001, 95% CI = 25.92-52.38), the SAD and CMAC (t = 8.90, p < 0.001, 95% CI = 46.93-73.40), and the FOB and CMAC (t = 3.11, p = 0.003, 95% CI = 7.78-34.25). Conclusion: The results of this simulation-based study suggest that the SAD I-gel is the best technique to manage accidental extubation during prone position by establishing a temporary airway with excellent success rate and shorter procedure time. When comparing techniques for securing a definitive airway, the FOB was more successful than the CMAC.
Language	English
Publishing date	2024-04-06
Publishing country	England
Document type	Journal Article
ISSN	2059-0628
ISSN (online)	2059-0628
DOI	10.1186/s41077-024-00285-4
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Article ; Online: Resuscitation team training in Rwanda: A mixed method study exploring the combination of the VAST course with Advanced Cardiac Life Support training.

Tuyishime, Eugene / Mossenson, Adam / Livingston, Patricia / Irakoze, Alain / Seneza, Celestin / Ndekezi, Jackson Kwizera / Skelton, Teresa

Resuscitation plus

2023 Volume 15, Page(s) 100415

Abstract: Introduction: The influence of non-technical skills training on resuscitation performance in low-resource settings is unknown. This study investigates combining the Vital Anaesthesia Simulation Training Course with Advanced Cardiac Life Support training ...

Abstract	Introduction: The influence of non-technical skills training on resuscitation performance in low-resource settings is unknown. This study investigates combining the Vital Anaesthesia Simulation Training Course with Advanced Cardiac Life Support training on resuscitation performance in Rwanda. Methods: Participants in this mixed method study are members of resuscitation teams in three district hospitals in Rwanda. The intervention was participation in a 2-day Advanced Cardiac Life Support course followed by the 3-day Vital Anaesthesia Simulation Training Course. Quantitative primary endpoints were time to initiation of cardiopulmonary resuscitation, time to epinephrine administration, and time to defibrillation. Qualitative data on workplace implementation were gathered during focus groups held 3-months post-intervention. Results: Forty-seven participants were recruited. Quantitative data showed a statistically significant decrease in time to cardiopulmonary resuscitation, epinephrine administration, and defibrillation from pre- to post-Advanced Cardiac Life Support, with times of [43.3 (49.7) seconds] versus [16.5 (20) sec], Conclusion: A modified 2-day Advanced Cardiac Life Support course improved resuscitation time indicators with retention 3-months later. Combining the Vital Anaesthesia Simulation Training Course and Advanced Cardiac Life Support led to better team coordination, empowerment to act, and advocacy for system improvement. This pairing of courses has promise for improving Advanced Cardiac Life Support skills amongst healthcare workers in low-resource settings.
Language	English
Publishing date	2023-06-16
Publishing country	Netherlands
Document type	Journal Article
ISSN	2666-5204
ISSN (online)	2666-5204
DOI	10.1016/j.resplu.2023.100415
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Article ; Online: The initiative for medical equity and global health (IMEGH) resuscitation training program: A model for resuscitation training courses in Africa.

Tuyishime, Eugene / Irakoze, Alain / Seneza, Celestin / Fan, Bernice / Mvukiyehe, Jean Paul / Kwizera, Jackson / Rosenberg, Noah / Evans, Faye M

African journal of emergency medicine : Revue africaine de la medecine d'urgence

2023 Volume 14, Issue 1, Page(s) 33–37

Abstract: In high-income countries, outcomes following in hospital cardiac arrest have improved over the last two decades due to the introduction of rapid response teams, cardiac arrest teams, and advanced resuscitation training. However, in low-income countries, ... ...

Abstract	In high-income countries, outcomes following in hospital cardiac arrest have improved over the last two decades due to the introduction of rapid response teams, cardiac arrest teams, and advanced resuscitation training. However, in low-income countries, such as Rwanda, outcomes are still poor. This is due to multiple factors including lack of adequate resuscitation training, few trainers, and lack of equipment. To address this issue, the Initiative for Medical Equity and Global Health Equity (IMEGH), a training organization founded in 2018 by 5 local anesthesiologists has regularly taught resuscitation courses such as Basic Life Support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support in hospitals throughout Rwanda. The aims of the organization include developing a sustainable model to offer context relevant resuscitation training courses, building a cadre of local instructors to teach on the courses, as well as engaging funding partners to help support the effort. From October 2018 until September 2022, 31 courses were run in 11 hospitals across Rwanda training 1,060 healthcare providers (mainly of non-physician anesthetists, nurses, midwives, and general practitioners). Ongoing challenges include lack of local protocols, inability to tracking resuscitation outcomes, and continued inaccessibility by many healthcare providers. Despite these challenges, the IMEGH program is an example of a successful context-relevant model and has potential to inform the design of resuscitation programs in other similar settings. This article describes the development of the IMEGH program, accomplishments as well as lessons learned, challenges, and next steps for expansion.
Language	English
Publishing date	2023-12-30
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-4203
ISSN (online)	2211-4203
DOI	10.1016/j.afjem.2023.12.003
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Article ; Online: The Rwanda Anesthesia Residency Program: A Model for GME in Low- and Middle-Income Countries.

Tuyishime, Eugene / Durieux, Marcel / Banguti, Paulin Ruhato

Journal of graduate medical education

2019 Volume 11, Issue 4 Suppl, Page(s) 20–21

MeSH term(s)	Anesthesiology/education ; Education, Medical, Graduate/organization & administration ; Faculty, Medical ; Humans ; Internship and Residency/methods ; Internship and Residency/organization & administration ; Mentoring ; Rwanda
Language	English
Publishing date	2019-08-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2578612-X
ISSN	1949-8357 ; 1949-8349
ISSN (online)	1949-8357
ISSN	1949-8349
DOI	10.4300/JGME-D-18-01031
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Article ; Online: Case Report of Ogilvie's Syndrome Following Emergency Haemostatic Subtotal Abdominal Hysterectomy at University Teaching Hospital of Butare, Rwanda.

Tuyishime, Eugene / Mutuyimana, Marie Grace / Zigiranyirazo, Evariste / Twagirumugabe, Theogene

The East African health research journal

2020 Volume 4, Issue 1, Page(s) 17–19

Abstract: Background: Acute colonic pseudo-obstruction or Ogilvie's syndrome is a rare condition that usually develops due to a dysregulated autonomic nervous system following a medical or surgical condition. With delayed diagnosis, it may lead to bowel ischemia ... ...

Abstract	Background: Acute colonic pseudo-obstruction or Ogilvie's syndrome is a rare condition that usually develops due to a dysregulated autonomic nervous system following a medical or surgical condition. With delayed diagnosis, it may lead to bowel ischemia and perforation with poor prognosis. Case: We report a case of a 33 years old female, Gravida 1, Para1, who developed severe abdominal distension following abdominal haemostatic hysterectomy due to a severe postpartum haemorrhage and shock requiring epinephrine infusion after a spontaneous vaginal delivery. The postpartum haemorrhage was due to both atony and posterior cervical tear. Two initial administrations of neostigmine 2 mg mixed with atropine 0.5 mg were unsuccessful, but an insertion of a flexible recto-sigmoid cannula allowed a slight decompression. A subsequent third dose of neostigmine 2 mg mixed with atropine 0.5 mg was followed with a remarkable flatus evacuation and complete decompression. Conclusion: Prompt diagnosis and management of Ogilvie's syndrome is crucial in order to avoid subsequent complications. In case of postoperative cecal and colonic distension without mechanical obstruction, Ogilvie's syndrome should be suspected as this will ensure timely and adequate management of patients at risk including obstetric patients.
Language	English
Publishing date	2020-06-26
Publishing country	Burundi
Document type	Journal Article
ISSN	2520-5285
ISSN (online)	2520-5285
DOI	10.24248/eahrj.v4i1.629
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Article ; Online: Burnout Syndrome Among Anesthesia Providers Working in Public Hospitals in Rwanda: A Cross-Sectional Survey.

Tuyishime, Eugene / McIsaac, Daniel I / Mumbwe, Mbangu C / Ruhato Banguti, Paulin / Mvukiyehe, Jean Paul / Nzarora, Josue / Bould, M Dylan

Anesthesia and analgesia

2022 Volume 135, Issue 4, Page(s) 820–828

Abstract: Background: Many studies address anesthesia provider burnout in high-income countries; however, there is a paucity of data on burnout for anesthesia providers in low-income countries (LICs). Our objectives were (1) to evaluate the prevalence of burnout ... ...

Abstract	Background: Many studies address anesthesia provider burnout in high-income countries; however, there is a paucity of data on burnout for anesthesia providers in low-income countries (LICs). Our objectives were (1) to evaluate the prevalence of burnout among anesthesia providers in Rwandan hospitals and (2) to determine factors associated with burnout among anesthesia providers in Rwandan hospitals. Methods: A questionnaire was sent to selected Rwandan anesthesia providers working in public hospitals. The questionnaire assessed burnout using the Maslach Burnout Inventory Human Services Survey, a validated 22-item survey used to measure burnout among health professionals. Sociodemographic and work-related factors found to be associated with burnout were also assessed using logistic regression in a Bayesian framework to estimate odds ratios (OR) and associated credible intervals (CrIs). Results: Surveys were distributed to 137 Rwandan anesthesia providers; 99 (72.3%) were returned. Sixty-six (67%) respondents were nonphysician anesthesia providers. Burnout was present in 26 of 99 (26.3%) participants (95% confidence interval [CI], 17.9-36.1). When considering weakly informative priors, we found a 99% probability that not having the right team (OR, 5.36%; 95 CrI, 1.34-23.53) and the frequency of seeing patients with negative outcomes such as death or permanent disability (OR, 9.62; 95% CrI, 2.48-42.84) were associated with burnout. Conclusions: In a cross-sectional survey of anesthesia providers in Rwanda, more than a quarter of respondents met the criteria for burnout. Lacking the right team and seeing negative outcomes were associated with higher burnout rate. These identified factors should be addressed to prevent the negative consequences of burnout, such as poor patient outcomes.
MeSH term(s)	Anesthesia ; Bayes Theorem ; Burnout, Professional/diagnosis ; Burnout, Professional/epidemiology ; Burnout, Psychological ; Cross-Sectional Studies ; Hospitals, Public ; Humans ; Rwanda/epidemiology ; Surveys and Questionnaires
Language	English
Publishing date	2022-09-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000006053
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Article ; Online: Surgical applications of ultrasound use in low- and middle-income countries: A systematic review.

Navarro, Sergio M / Shaikh, Hashim / Abdi, Hodan / Keil, Evan J / Odusanya, Simisola / Stewart, Kelsey A / Tuyishime, Eugene / Mazingi, Dennis / Tuttle, Todd M

Australasian journal of ultrasound in medicine

2022 Volume 25, Issue 2, Page(s) 80–97

Abstract: Background: Ultrasound is a portable technology able to deploy health care effectively in low resource settings. This study presents a systematic review to determine trends in the utility and applicability of this technology in low- and middle-income ... ...

Abstract	Background: Ultrasound is a portable technology able to deploy health care effectively in low resource settings. This study presents a systematic review to determine trends in the utility and applicability of this technology in low- and middle-income countries (LMIC), specifically for surgical applications. The review includes characterising and evaluating trends in the geographic and specialty-specific use of ultrasound pertaining to surgical disease. Methods: The databases such as Medline OVID, EMBASE and Cochrane were searched from 2010 through March 2019 for studies available in English, French and Spanish. Commentaries, opinion articles, reviews and book chapters were excluded. A categorical analysis of ultrasound use for surgical disease in LMICs was conducted. Results: A total of 6276 articles were identified, with 4563 studies included for the final review. A total of 221 studies were selected researching ultrasound use in LMICs to treat surgical disease. Most studies identified ultrasound usage focused on general surgery, acute care surgery and surgical ICU topics (52%, 115) followed by computed tomography surgery studies (20%, 44). Most studies were retrospective in nature, with 81% (180) of research studies generated in four countries (India, Pakistan, Nigeria and Egypt). Ultrasound proved to be a feasible technique for utility in pre-operative diagnosis, cost-effectiveness and prediction of surgical outcomes. Findings are limited by the limited number of randomised clinical trials reported. Conclusion and global health implications: Our systematic literature review of ultrasound use in LMICs demonstrates the growing utilisation of this relatively low-cost, portable imaging technology in low resource settings for surgical disease.
Language	English
Publishing date	2022-06-01
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2843953-3
ISSN	2205-0140 ; 1836-6864
ISSN (online)	2205-0140
ISSN	1836-6864
DOI	10.1002/ajum.12302
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