A randomized cross-over trial focused on breast core needle biopsy skill acquisition and confidence using high fidelity versus low fidelity simulation models in Rwanda

INTERVENTION: A one‐day, five‐hour BCNB educational training course for surgical residents was implemented after baseline assessment. Similar sessions were conducted for OB/GYN residents on different days. During the first course for surgical residents, instructors included two fellowship trained Rwandan and United States (USA) breast surgeons, one radiologist, and one emergency department physician with fellowship training in ultrasound. The OB/GYN training sessions were identical in lecture and evaluation content except only one USA fellowship trained breast surgeon and one USA trained radiologist were available as instructors and evaluators. Residents performed a baseline BCNB exam prior to any educational intervention on the model to which they were randomized (Exam 1). After the baseline exam, participants listened to a four‐hour lecture session. Subsequently they had 60 minutes of hands‐on training by an attending physician with the simulator model to which they were originally randomized. After the lectures and hands‐on simulation practice, participants took a second BCNB exam (Exam 2) and then participated in a third BCNB exam where they crossed over to the other model (Exam 3). At the end of the course, participants took a confidence survey. Prior to the course, the instructors were trained on how to evaluate participants in a similar manner using the US guided BCNB evaluation tool. CONDITION: Benign or malignant breast disease ; Cancer PRIMARY OUTCOME: The mean difference in BCNB exam scores between HF and LF groups, measured on the day the education intervention was implemented (exam 1, 2 and 3) SECONDARY OUTCOME: 1. Provider level traits that may affect mean difference in exam scores; 2. Participant confidence assessed using survey at the end of the course INCLUSION CRITERIA: Residents training in either surgery or obstetrics and gynecology (OB/GYN) in any postgraduate year (PGY) at the University of Rwanda, rotating at CHUK hospital in Kigali, Rwanda