Implementation of the ENTRUST Platform for Global Undergraduate Surgical Education: Curriculum Integration at the University of Global Health Equity, Rwanda
Anam N. Ehsan, Anteneh Gadisa Belachew, Malerie Pratt, Edward Melcer, Jason Tsai, Yewon A. Son, Katherine Arnow, Martin Bronk, Tyler Wilson, Barnabas Alayande, Lye-Yeng Wong, Carlie Arbaugh, Jaclyn Wu, Fatyma Camacho, Thomas Weiser, Abebe Bekele, Dana T. Lin±, Cara A. Liebert± (± co-senior)
Introduction: Robust and accessible evidence-based tools are essential for advancing competency-based surgical education globally. ENTRUST Learning and Assessment Platform is an online case-based virtual patient simulation designed to teach and assess clinical decision-making. This study describes the longitudinal integration of ENTRUST into the undergraduate surgical clerkship at the University of Global Health Equity (UGHE), Rwanda.
Methods: An ENTRUST case-based curriculum was developed and integrated into the surgical clerkship at UGHE. ENTRUST cases were also utilized in Mid-Clerkship, End-of-Clerkship, and Medical School Exit Examinations. Curriculum effectiveness was assessed via student feedback, platform analytics, and comparisons with traditional assessment modalities, such as Objective Structured Clinical Examinations (OSCEs). Descriptive statistics and Spearman’s rank correlation were calculated.
Results: In 2023-2024, thirty senior clerkship students completed the ENTRUST curriculum (Figure). Mean age was 23.5 years (SD:1.7); 67% (n=20) were female. Most students had full English/bilingual proficiency (97%,n=29). Platform usability scores were high (mean:77.7,SD:14.3). Students completed an average of 17.6 cases (SD:5.9) and spent 210 minutes (SD:78.5) learning independently on ENTRUST. Median scores on ENTRUST (15.7,IQR:14.42–17) were comparable to OSCE performance (16.9,IQR:15.7–17.9) upon Exit Examination. ENTRUST performance correlated positively with OSCE scores for both End-of-Clerkship Assessment (r=0.45,p=0.01) and Medical School Exit Examination (r=0.37,p=0.04).
Conclusion: This study demonstrates the feasibility of integrating ENTRUST into undergraduate surgical education as both a learning and assessment tool. The platform exhibited strong usability, engagement, and student acceptance, with performance outcomes comparable to traditional examination modalities. ENTRUST has potential to serve as a scalable and effective tool for competency-based surgical education globally.