Lauren Zolpys is a 4th year anesthesia resident at Dalhousie University in Halfiax, Nova Scotia. In addition to being the resident representative for the CAS International Education Foundation (CASIEF), she has worked closely with CASIEF’s program in Rwanda to teach their anesthesia residents.
How did you first hear about this experience?
I first heard about the program when I was applying to anesthesia at Dal! Dalhousie has a very close affiliation with the CASIEF program in Rwanda, and it is well known among the department members and residents here. Our department generally has around 3 staff people going each year and they usually take residents from the program with them.
Was it easy to organize? Did you feel support from your program?
It was very easy to organize. Our department has an excellent office of global health that helped me coordinate everything. I felt very supported by my program – the experience is actually an established elective with its own set of goals and objectives.
How did you fund it?
Our department has set aside funding for three residents to go each year, so they were a huge help in covering my costs (airfare, visa, etc). The National University of Rwanda (NUR) covers the accomodations and I paid for my own food, weekend trips, etc.
How long did you go for?
I was fortunate to have the opportunity to go twice – the first was for a month in January 2012, and then I returned for three weeks in October 2012 to work on a research project.
What were your duties?
On my first trip, I was there with an educational role. I prepared talks for the residents’ academic day and helped to facilitate their learning both in the classroom and the OR. I also helped to organize a journal club for the residents. My resident research project was based in Rwanda so I also did some data collection while I was there, which mainly involved intervieweing Rwandan anesthesia providers.
The second time, I went to run low-fidelity simulation sessions with some of the anesthesia residents and technicians, as part of a different research study, on non-technical skills. Thanks in large part to the efforts of one of our anesthesiologists, Dr. Patty Livingston, who was able to secure a grant to help with funding, developments are currently underway to open a simulation and skills centre in Rwanda. Part of my time in Rwanda was therefore spent doing some logistical work for the centre.
Was there preparation beforehand?
I went to Uganda during medical school for an elective so I already had some idea of what to expect. There is an excellent volunteer handbook that has been developed for this project which gave me a lot of information on the project and how to prepare ahead of time. I was also fortunate to go with someone who had been to Rwanda several times before, as we had many discussions before hand which helped me prepare. One of my research projects also involved interviewing previous volunteers about their experiences, which gave me a good sense of the project.
What is one experience or case that had an impact on you?
Running the simulation sessions, especially with the anesthesia technicians, had a huge impact on me. It was the first time that they had been through a simulation, and was also one of the few opportunities they get for continuing medical education. I was so impressed by their desire to learn and their whole-hearted enthusiasm with the project. They jumped right in, weren’t afraid to embarass themselves, and picked up really quickly on the things we talked about. I could see a huge improvement after just one session, and they just seemed so appreciative to have the opportunity to learn. It was just really inspiring to work with them and see the effort they put in everyday to try and improve the care they provide for their patients, under very difficult conditions.
Outside of work – what did you get to do?
Every weekend, we had the opportunity to discover a different part of Rwanda. On the first weekend, we went to the Nyungwe National Park and did an amazing hike through the rainforest to a beautiful waterfall. On another weekend, we had a chance to see the mountain gorillas, which involved an 8 hour hike to see those magnificent creatures. Another trip was spent cycling through small villages along Lake Kivu, in the Western part of the country. It was incredible to see how beautfiul and colourful Rwanda is. During the week, we also would go to the local market to pick up food and gorgeous fabrics, and we found a great place to go swimming and unwind at the end of a long day.
Did you get a chance to debrief when you came back?
Yes, my supervisor and I got together frequently upon our return, to debrief and reflect on our trip.
Will this experience change your overall career plans?
I’m not sure that it will change my plans as I have always wanted global health to be a part of them. It definitely solidified my desire to do more work in the future like this. I think that it also made me realize the value of educational projects. While service-based projects have their role, it’s incredible to see what kind of difference this kind of project can make, and how sustainable it really is.
Can you tell us about your research project?
There are two research projects that I have been involved in in Rwanda. The first is a qualitative ethnographic study, using interviews and observations to assess non-technical skills in Rwanda. The second is sort of a follow up to the first project. It is an RCT looking at the use of low-fidelity simulation to teach non-technical skills to anesthesia residents and technicians in Rwanda. We don’t have all the results yet but so far it looks promising!