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Health Worker Focused Distributed Simulation for Improving Capability of Health Systems in Liberia

Gale, Thomas C. E. BM, BS, MEd; Chatterjee, Arunangsu PhD; Mellor, Nicholas E. MSc; Allan, Richard J. MSc

doi: 10.1097/SIH.0000000000000156
Highly Communicable Disease Management Theme Issue

Introduction The main goal of this study was to produce an adaptable learning platform using virtual learning and distributed simulation, which can be used to train health care workers, across a wide geographical area, key safety messages regarding infection prevention control (IPC).

Methods A situationally responsive agile methodology, Scrum, was used to develop a distributed simulation module using short 1-week iterations and continuous synchronous plus asynchronous communication including end users and IPC experts. The module contained content related to standard IPC precautions (including handwashing techniques) and was structured into 3 distinct sections related to donning, doffing, and hazard perception training.

Outcome Using Scrum methodology, we were able to link concepts applied to best practices in simulation-based medical education (deliberate practice, continuous feedback, self-assessment, and exposure to uncommon events), pedagogic principles related to adult learning (clear goals, contextual awareness, motivational features), and key learning outcomes regarding IPC, as a rapid response initiative to the Ebola outbreak in West Africa. Gamification approach has been used to map learning mechanics to enhance user engagement.

Conclusions The developed IPC module demonstrates how high-frequency, low-fidelity simulations can be rapidly designed using scrum-based agile methodology. Analytics incorporated into the tool can help demonstrate improved confidence and competence of health care workers who are treating patients within an Ebola virus disease outbreak region. These concepts could be used in a range of evolving disasters where rapid development and communication of key learning messages are required.

Supplemental digital content is available in the text.

From the Collaboration for the Advancement of Medical Education Research and Assessment, Plymouth University Peninsula Schools of Medicine and Dentistry (T.C. E.G., A.C.), Plymouth, UK; Masanga Mentor Ebola Initiative (N.E.M.); and The MENTOR Initiative (R.J.A.), Monrovia, Liberia.

Reprints: Thomas C. E. Gale, BM, BS, MEd, Collaboration for the Advancement of Medical Education Research and Assessment, Plymouth University Peninsula Schools of Medicine and Dentistry, John Bull Bldg, Plymouth Science Park, Research Way, Plymouth PL6 8BU, United Kingdom (e-mail:

The authors declare no conflict of interest. Funding for this work was received from the Daily Telegraph Christmas Charity Appeal, United Kingdom.

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© 2016 Society for Simulation in Healthcare