A preparation guide for surgical resident and student rotations to underserved regions

Leow, Jeffrey J.; Groen, Reinou S.; Kingham, T. Peter; Casey, Kathleen; Hardy, Mark A.; Kushner, Adam L.

doi:10.1016/j.surg.2012.03.002

Cited by 22 publications

(10 citation statements)

References 15 publications

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“…Despite extensive literature devoted to the development of resident "guides" or recipes for success 14,[54][55][56] , HIC residents believed and LMIC hosts agreed that HIC residents were underprepared for their LMIC rotations and required increased supervision, often because of poor patient-surgeon communication or surgeon-surgeon communication. In addition, HIC residents of all training levels often assumed authority and the ability to teach or provide training where perhaps they should not.…”

Section: Discussionmentioning

confidence: 99%

Clinical Observership Opportunities in North America for International Orthopaedic Surgeons

Carrillo

Segarra

Sabharwal

2020

Journal of Bone and Joint Surgery

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Introduction: Interest in clinical rotations in low-and middle-income countries (LMICs) has grown among high-income country (HIC) orthopaedic residents. This study addresses the following questions: (1) What motivates HIC surgical residents to rotate in LMICs? (2) What is the impact of rotations on HIC residents? (3) What are the LMIC partner perceptions of HIC collaboration? Materials and Methods: A search strategy of multiple databases returned 3,740 unique articles pertaining to HIC surgical resident motivations for participating in rotations in LMICs or the LMIC host perspective. Data extraction was dually performed using meta-ethnography, the qualitative equivalent of meta-analysis. Results: Twenty-one studies were included in the final analysis. HIC residents were primarily motivated to rotate in LMICs by altruistic intent, with greatest impact on professional development. LMIC partners mostly valued HIC sustained investment and educational opportunities for LMIC partners. From LMIC's perspective, potential harm from collaboration arose from system-level and individual-level discordance between HIC and LMIC expectations and priorities. HIC priorities included the following: (1) adequate operative time, (2) exposure to varied pathology, and (3) mentorship. LMIC priorities included the following: (1) avoiding competition with HIC residents for surgical cases, (2) that HIC groups not undermine LMIC internal authority, (3) that HIC initiatives address local LMIC needs, and (4) that LMIC partners be included as authors on HIC research initiatives. Both HIC and LMIC partners raised ethical concerns regarding collaboration and perceived HIC residents to be underprepared for their LMIC rotation. Discussion: This study synthesizes the available literature on HIC surgical resident motivations for and impact of rotating in LMICs and the LMIC host perception of collaboration. Three improvement categories emerged: that residents (1) receive site-specific preparation before departure, (2) remain in country long enough to develop site-specific skills, and (3) cultivate flexibility and cultural humility. Specific suggestions based on synthesized data are offered for each concept and can serve as a foundation for mutually beneficial international electives in LMICs for HIC orthopaedic trainees.

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Section: Discussionmentioning

confidence: 99%

Clinical Observership Opportunities in North America for International Orthopaedic Surgeons

Carrillo

Segarra

Sabharwal

2020

Journal of Bone and Joint Surgery

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“…These findings underscore the need for general surgeons or obstetricians/gynecologists to be able to train across the 2 specialties to optimally address the disparities that exist in surgical care. Many articles in this review discussed strategies to provide this type of training, including rotations for medical students in rural or low-income areas [ [77] , [78] , [79] ], residency tracts for rural or global surgery [ 23 , 28 , [80] , [81] , [82] , [83] , [84] , [85] , [86] , [87] , [88] , [89] , [90] , [91] , [92] , [93] , [94] , [95] , [96] , [97] , [98] , [99] , [100] , [101] , [102] , [103] ], and training courses for general surgeons to enhance their obstetrical skills if they desire to practice in an underserved location locally or abroad [ 13 , 60 , 115 , [121] , [122] , [123] , [124] , [125] , [126] , [127] , [128] , [129] , [130] , [131] , [132] , [133] , [134] , [135] ]. Although it is challenging to provide this broad-based surgical training, sustainable models have been created when continued support is provided to those recruited locally to the area in need [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of valued obstetric and gynecologic (OB/GYN) procedures in resource-poor areas

Blears

Pham

Bauer³

2020

Surgery Open Science

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Background Obstetric and gynecologic procedures are valuable in rural settings. Data identifying common procedures may better prepare surgeons to meet patient needs in remote settings. Materials and methods A literature review using key MeSH terms was performed according to methods described by the Cochrane Collaboration and PRISMA on studies that described obstetric and gynecologic surgery in rural high-income countries or any setting in middle- to low-income countries. Meta-analysis was performed using random effects modeling for odds ratios of cesarean delivery and hysterectomy as proportions of total surgical volume. Results A total of 195 studies were included for qualitative synthesis and 22 for quantitative analysis. Obstetric and gynecologic procedures made up a 19% of all surgical cases. As compared to other obstetric and gynecologic surgical procedures, cesarean delivery was the most common procedure with odds ratio of 2.39 (95% confidence interval 1.48–3.86), and hysterectomy was the second most common procedure with odds ratio of 1.60 (1.57–1.64). However, heterogeneity between the studies was extremely high and risk of bias was high, limiting quality of findings. Conclusion Greater provision of surgical care can be enhanced by defining which procedures are most needed, which include many obstetric and gynecologic procedures, most commonly cesarean delivery and hysterectomy.

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“…For example, in the Pharmobility Program programs funded by the partners in the Funds for the Improvement of Post-Secondary Education (FIPSE) have a priority in exchange activities; but, when a site was available, FIPSE entertained applications from other pharmacy programs. 47 In this case, the sharing of good or bad experiences helped each partner. Policies and procedures adopted by pharmacy programs offering G/I APPEs, such as educational outcomes, curriculum, scope of practice for students, assessment tools, and other related materials, could be shared with other programs to improve consistency and assist with the development and evaluation of other G/I APPEs.…”

Section: 43mentioning

confidence: 98%

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

Alsharif

Dakkuri

Abrons

et al. 2016

American Journal of Pharmaceutical Education

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International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs) with specific recommendations for home/host country and host site/institution. The paper is based on a literature review (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014) in databases and Internet searches with specific keywords or terms. Educational documents such as syllabi and memoranda of understanding (MoUs) from pharmacy programs were also examined. In addition, a preliminary draft was developed and the findings and recommendations were reviewed in a 90-minute roundtable discussion at the 2014 American Association of Colleges of Pharmacy Annual Meeting. Recommendations for the host country include travel considerations (eg, passport, visa, air travel), safety, housing, transportation, travel alerts and warnings, health issues, and financial considerations. For the home country, considerations for establishment of G/I APPE site (eg, vetting process, MoU, site expectations) are described. The paper is a resource for development of new G/I APPEs and provides guidance for continuous quality improvement of partnerships focusing on G/I pharmacy education.

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A preparation guide for surgical resident and student rotations to underserved regions

Cited by 22 publications

References 15 publications

Clinical Observership Opportunities in North America for International Orthopaedic Surgeons

Clinical Observership Opportunities in North America for International Orthopaedic Surgeons

A systematic review and meta-analysis of valued obstetric and gynecologic (OB/GYN) procedures in resource-poor areas

Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

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