Academic Global Surgery Curricula: Current Status and a Call for a More Equitable Approach

Jayaram, Anusha; Pawlak, Natalie; Kahanu, Alexis; Fallah, Parisa; Chung, Haniee; Valencia-Rojas, Nancy; Rodas, Edgar B.; Abbaslou, Ahmadreza; Alseidi, Adnan; Ameh, Emmanuel A.; Bekele, Abebe; Casey, Kathleen; Chu, Kathryn; Dempsey, Robert J.; Dodgion, Christopher; Jawa, Randeep S.; Jiménez, María Fernanda; Johnson, Walt; Krishnaswami, Sanjay; Kwakye, Gifty; Lane, Robert H.; Lakhoo, Kokila; Long, Kristin L.; Madani, Katayoun; Nwariaku, Fiemu E.; Nwomeh, Benedict C.; Price, Raymond R.; Roser, Steven M.; Rees, Andrew B.; Roy, Nobhojit; Ruzgar, Nensi; Sacoto, Hernan; Sifri, Ziad C.; Starr, Nicole; Swaroop, Mamta; Tarpley, Margaret J.; Tarpley, John L.; Terfera, Girma; Weiser, Thomas; Lipnick, Michael S; Nabukenya, Mary; Ozgediz, Doruk; Jayaraman, Sudha

doi:10.1016/j.jss.2021.03.061

Cited by 26 publications

(29 citation statements)

References 54 publications

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“…A quality surgical curriculum is an essential component of effective surgical training programs, 20,21 increasingly recognized as necessary to developing surgical education in LMICs. [8][9][10] Online curricula are an integral part of surgical training in high-income countries, 22 and blended learning instructional designs like the flipped classroom have been shown to improve trainee performance. 23 Covering a large, heterogeneous area and involving nearly 300 trainees in 17 countries, the results of this study demonstrate that an online, modular surgical curriculum can be successfully implemented in sub-Saharan Africa, as indicated by the high utilization of the curriculum.…”

Section: Discussionmentioning

confidence: 99%

“…3 Tailored curricular activities have been determined to be a necessary part of improving surgical education in LMICs like those in East, Central, and Southern Africa (ECSA). [5][6][7][8][9][10] Despite this recognition, there has been a lack of standardized surgical curricula for training programs in this region. 6,11 Standardized medical and surgical curricula have previously been shown to increase uniformity of knowledge, 12 ensure necessary content is covered without solely relying on case-and patient-based experiences within training, 13 and increase in-training examination scores.…”

Section: Introductionmentioning

confidence: 99%

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An Online, Modular Curriculum Enhances Surgical Education and Improves Learning Outcomes in East, Central, and Southern Africa: A Mixed-Methods Study

Parker

Steffes

Hill

et al. 2022

Annals of Surgery Open

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scale curriculum development project, there are several important contributors. All authors have given final approval of the version to be submitted. A.S.P. made substantial contributions to the conception and design of this study, the collection, analysis, and interpretation of data, and to writing the manuscript. B.C.S. made substantial contributions to the acquisition of data related to the examination scores and assessment of module-and non-module-related questions and has critically revised the manuscript. K.H. made substantial contributions to the conception and design this study, specifically relating to the acquisition of user feedback. She was instrumental in the analysis and interpretation of data and has critically revised the manuscript. D.M. and N.B. made substantial contributions to the acquisition of data relating to trainee engagement and tracking of learner participation and have critically revised the manuscript. M.M. and A.B., as membersObjective: We aimed to determine the impact of a standardized curriculum on learning outcomes for surgical trainees in East, Central, and Southern Africa (ECSA). Background: As surgical education expands throughout ECSA, there is a recognized need for a standardized curriculum. We previously described the design of a novel, large-scale, flipped-classroom, surgical curriculum for trainees in ECSA. Methods: In January 2020, the first year of curricular content for trainees of the College of Surgeons of ECSA was released, containing 11 monthly thematic topics, each with 2 to 5 weekly modular subtopics. We aimed to evaluate 3 outcomes utilizing data sources incorporated into the curriculum structure. Learner engagement was assessed by the number of trainees completing curriculum topics. User experience was evaluated using quantitative and qualitative feedback responses to embedded surveys for each content week. Curriculum impact on trainee examination performance was assessed by comparing certification examination scores stratified by the number of curricular topics each trainee completed. Results: Two hundred seventy-one trainees (96%) in 17 countries accessed at least 1 weekly module. Trainees completed a median of 9 topics (interquartile range: 6-10). The feedback survey response rate was 92% (5742/6233). Quantitative and qualitative responses were positive in overall module value (93.7% + 2.6%), amount of learning experienced (97.9% + 1.4%), confidence in achieving learning objectives (97.1% + 2.4%), and ease of use of the module (77.6% + 5.98%). Topic-related certification examination performance improved significantly with increased completion of thematic topics. Conclusions: A standardized surgical curriculum in ECSA demonstrated excellent trainee usage, positive feedback, and improved examination scores.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Online, Modular Curriculum Enhances Surgical Education and Improves Learning Outcomes in East, Central, and Southern Africa: A Mixed-Methods Study

Parker

Steffes

Hill

et al. 2022

Annals of Surgery Open

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“…Nonetheless, some of the momentum may be excessively originating in highincome countries (HICs) rather than low-and-middle-income countries (LMICs). We urge programs not only to re-evaluate their own curricula and objectives but also to ensure that this process is primarily driven by LMICs -even for something as simple as revisiting the definition of a term like "global surgery" (Jayaram et al, 2021).…”

Section: Barriers To Educationmentioning

confidence: 99%

Decolonizing the decolonization movement in global health: A perspective from global surgery

Bua

Sahi

2022

Front. Educ.

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There has been a recent increase in dialogs around decolonization in global health. We present a perspective from global surgery emphasizing personal experiences around equity in barriers to education and surgical missions, citing specific personal challenges and local perceptions that we have experienced as well as potential solutions. We also cite fundamental challenges to the movement to decolonize global surgery, including donor-directed priorities and the creation of partnerships based in genuine bilateral exchange. We cite several models of current programs aiming to address some of these challenges.

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“…A recently published literature review of the status of academic global surgery curricula concluded there are no universally established competencies for the fundamentals of academic global surgery and that most of the existing literature has been published by high-income countries (HICs) for HIC healthcare providers. 20 Further, Sbaiti et al raise the question "Whose voices should shape global health education?," which is a particularly relevant question given the dearth of available resources. 21 In the limited literature that exists, there are a broad range of options of preparation resources.…”

Section: Cultural Sensitivity Trainingmentioning

confidence: 99%

Cultural Sensitivity and Ethical Considerations

Bobel

Hinai

Roslani

2022

Clin Colon Rectal Surg

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Global surgery is a burgeoning area of global health. Surgeons can engage in one–or many–of the facets of global healthcare delivery: clinical care, capacity building, education, research, etc. Working in an increasingly global community, surgeons must be aware of the richness of cultural diversity at home and around the world such that they can provide culturally sensitive care. This chapter focuses on the most common way in which surgeons engage in global surgery: surgical short-term experiences in global health (STEGHs). Surgical STEGHs pose an intricate set of ethical dilemmas. As team leaders, surgeons must understand the community they intend to serve on these trips. Further, they should confirm that everyone who joins them is prepared to deliver care in a culturally sensitive and competent manner. Finally, surgeons must consider potential ethical dilemmas that may arise before, during, and after surgical STEGHs and have strategies to navigate them.

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Academic Global Surgery Curricula: Current Status and a Call for a More Equitable Approach

Cited by 26 publications

References 54 publications

An Online, Modular Curriculum Enhances Surgical Education and Improves Learning Outcomes in East, Central, and Southern Africa: A Mixed-Methods Study

An Online, Modular Curriculum Enhances Surgical Education and Improves Learning Outcomes in East, Central, and Southern Africa: A Mixed-Methods Study

Decolonizing the decolonization movement in global health: A perspective from global surgery

Cultural Sensitivity and Ethical Considerations

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