Frugal innovation: a sustainable approach to simulated clinical skills training.

Introduction Environmentally sustainable practice must be considered when developing training interventions. This is particularly important with skills simulation - a field that, traditionally has significant consumables. This article presents a replicable case study of a clinical skills course with minimal cost and plastic waste.Background A 'rotary instrument skills' course was developed as part of the Dundee School of Dentistry revised curriculum, focusing on instrument ergonomics through tasks involving shape cutting, distinct from specific clinical scenarios, instilling transferable skills rather than replicating.Development Core factors considered included safety, environmental sustainability, cost and pedagogy. Progressive cutting exercises were designed reusing typodont teeth from different courses. These were mounted in a novel jig created from popular building blocks allowing for pressure feedback and multiple reuses of each tooth.Impact The course has run continuously since 2022. Students have responded positively to the virtually limitless cutting practice. Each jig initially cost less than £3, proving cost effective. Total plastic expenditure is minimal.Discussion and conclusion This study demonstrates environmental sustainability in simulation. Alternatives like haptic simulators have no plastic expenditure after initial production, however, require significant infrastructure and cost. Frugal innovations provide potentially more equitable solutions for institutions with limited finances.