A Scoping Review of Surgical Simulation Training for Undergraduate Medical Students in Low- and Midd

Aim: This scoping review aimed to explore the surgical simulations for undergraduate medical students in LMICs, focusing on modalities used, reported outcomes, barriers to implementation, and evidence gaps. Methods: The scoping review followed JBI guidelines for methodology and PRISMA-ScR guidelines for reporting. The inclusion criteria were defined based on the Population, Concept, Context (PCC) framework. The protocol for this scoping review was registered in OSF (reg. r4btv). The systematic search using specific strings /and Boolean operators was performed in PubMed, ERIC, WHO Global Index Medicus, and Google Scholar. The review process involved title and abstract screening followed by full-text assessment, after which data extraction and charting were performed. The results were then presented in a narrative format for studies involving surgical simulations among undergraduate medical students in LMIC settings. Results: Out of the total 861 relevant search results, 28 full texts were finally used in data synthesis. The majority of the studies were from South Asia and sub-Saharan Africa regions. Low-fidelity bench models (13/28), skills lab manikins (7/28), and laparoscopic simulators (4/28) were the most commonly used modalities. Improved OSCE scores (12/28), enhanced knowledge retention (10/28), and increased student confidence (8/28) were the outcomes noted. The implementation was challenged by budget limitations, insufficient faculty resources, and inadequate infrastructure. Sufficient evidence exploring the sustainability of skill retention, transferability into real clinical scenarios, and integration into curricula is lacking. Conclusion: Low-cost and low-fidelity models have been shown to enhance short-term learning and confidence in surgical skills for undergraduate students in LMICs. However, more investigation is needed to map the sustainability of skills, their transferability, and curricula integration