SUGAR stands for Simulation Use for Global Away Rotations and was initially developed as a simulation-based curriculum used to prepare medical providers for common challenges (both practical and emotional) faced when working in resource-limited settings. Given the success of the simulation-based curriculum, we have expanded SUGAR to include procedures (PEARLS), a comprehensive pre-departure preparatory course (S-PACK), and a comprehensive immigrant health curriculum (I-PACK). This SUGAR Suite of products fall under the umbrella of SUGARPREP. For more information, click here.


SUGARPREP was co-created by two pediatric global health educators, Sabrina Butteris and Mike Pitt and initially piloted at the seven institutions that make up the Midwest Consortium of Global Child Health Educators. The curriculum was rolled-out nationally in 2014 and is now being used institutions, training programs and providers across the globe. SUGARPREP is most commonly used by global health educators who use the materials to help them prepare trainees for global health experiences. In addition to being used by those preparing medical providers, SUGARPREP, particularly PEARLS, has been used by providers caring for patients in resource-limited settings.

How can I learn to facilitate the SUGAR Suite?

Each part of the SUGAR Suite has its own landing page on the website. On the main landing pages you will find links to facilitator training materials. These materials will walk you through everything you need to know to facilitate all parts of the SUGAR Suite and provide you with any necessary materials (handouts, PowerPoint slides, etc). If you are interested in hosting one of the SUGARPREP leads at your institution for an in person training workshop, send us an email.

Is it just for pediatrics?

No. While the pilot of SUGAR was carried out at seven pediatric institutions, it is now being used for preparation in multiple specialties. The content can easily be adapted for a number of settings and audiences.

How much does it cost?

We feel that proper preparation for global health experiences abroad is critical and should be universally available. As a result there is no cost to receive the training or materials to facilitate SUGAR at your institution. We have received some grant support to help offset the cost of disseminating this curriculum.

How do I get involved with SUGARPREP or contribute to the curriculum?

While the original curriculum was developed in partnership with the Midwest Consortium of Global Child Health Educators, we have collaborators and contributors from a wide range of disciplines and geographic areas. Contact us if you are interested in getting involved.

SUGAR Sim Cases

Do I need to have simulation experience to facilitate the cases?

No. SUGAR Sim Cases have been successfully used by facilitators without any prior simulation experience. We encourage all facilitators to utilize the Debriefing Script that is paired with each case; this provides an easy to use guide for debriefing, one of the most important components of simulation education.

Do I need access to a simulation center/mannequin?

No. As the SUGAR Sim Cases are intended to mimic settings with limited resources, it is not essential to have high-fidelity equipment, a simulation center, or mannequins. Even when performed in simulation centers, we advise against using monitors, crash carts, etc as these are not typically available in the settings most providers will be practicing in. Many SUGAR facilitators lead the scenarios with inflatable mannequins or dolls in conference rooms or living rooms.

What supplies do I need?

The supplies needed vary based on the case being led and a list of suggested supplies is provided in each case handout. Most supplies will fit in a shoebox. For an example of supplies needed, watch this short tutorial:


Are the procedures just for pediatrics?

We have begun the series with a set of ten commonly performed procedures with a focus in pediatrics, but most of the skills discussed are used for adults and children. We anticipate the creation of more videos, relevant to a variety of disciplines, over time.

Can I use these procedures with the simulation cases?

Yes! One of the modular components of S-PACK does just that.

Can I download the videos to view later or in a place that I don’t have access to the internet?

Yes. Each of the videos in SUGAR PEARLS can be downloaded and viewed at a later date (without an internet connection).

Want to develop a SUGAR PEARLS video? Have an idea for a procedure that would be helpful to include in the series?

Submit your idea here:


Do I need to do all of the activities in S-PACK?

S-PACK was originally designed to be used as a one-day, comprehensive course that included all of the activities. However, each of the activities has it’s own landing page for those who are just looking for a particular type of activity to supplement their existing curriculum.

Does S-PACK include Sim Cases and PEARLS?

Yes. S-PACK includes a limited number of Sim Cases and PEARLS as well as a pairing of the 2 curricula. However, we would highly suggest doing more Sim Cases and PEARLS if possible. You may also want to consider a 2-day course with one day dedicated to just simulation and procedures. We have found that these hands-on activities are extremely valuable.


Where can I find more information about global health education?

We would highly suggest visiting the Association of Pediatric Program Directors Global Health Learning Community website. This website is maintained by global health educators and includes a wealth of resources. The website also houses a link to the Program Directors Guide for Global Health Education developed by the American Board of Pediatrics Global Health Task Force. The guide is a comprehensive, practical resource for incorporating global health education into residency and fellowship training programs. While developed for pediatric training programs, the content is widely applicable.

What other resources might be valuable to me?

There are many wonderful resources available. You may find videos that provide a nice supplement to the SUGARPREP curriculum here: These videos, created by the Global Health Media Project are designed to teach health workers and communities in resource-limited settings life saving skills. This is a must-view series before heading abroad.

What if my question about SUGAR wasn’t answered here?

Email us with questions at

Want to get involved in expanding or adapting the curriculum or leading a research project involving SUGARPREP? Submit your ideas here