Capacity-building partnerships for surgical post-graduate training in low- and middle-income countries: a scoping review of the literature with exploratory thematic synthesis

Abstract

In recent years, international surgical programmes have moved away from vertical service delivery and towards collaborative, capacity-building partnerships. The aim of this review was to provide a map of the current literature on international surgical training partnerships together with an exploration of factors influencing their implementation. Three bibliographic databases were searched for peer-reviewed reports of surgical training partnerships between organizations in high- and low or middle-income countries to July 2018. Reports were sorted in an iterative fashion into groups of similar programmes, and data were extracted to record the intervention strategies, context, financing, reported results and themes around implementation. Eighty-six reports were grouped into five types of programme: full residency training, bi-institutional twinning partnerships, diagonal/sub-specialist programmes, focused interventions or courses and programmes using remote support. Few articles were written from the perspective of the low-middle income partner. Full residency programmes and some diagonal/sub-specialist programmes report numbers trained while twinning partnerships and focused interventions tend to focus on process, partners’ reactions to the programme and learning metrics. Two thematic networks emerged from the thematic synthesis. The first made explicit the mechanisms by which partnerships are expected to contribute to improved access to surgical care and a second identified the importance of in-country leadership in determining programme results. Training partnerships are assumed to improve access to surgical care by a number of routes. A candidate programme theory is proposed together with some more focused theories that could inform future research. Supporting the development of the surgical leadership in low- and middle-income countries is key.

Strategies for Digital Clinical Teaching During the COVID Pandemic: A Scoping Review

“…A scoping review [ 3 ] with an additional thematic synthesis [ 4 ] was used. Scoping reviews are part of the family of methods used for the systematic review of “messy” bodies of literature.…”

“…They use standardized data extraction tables to map out evidence, and they are particularly valuable for describing the types of evidence found in a defined research field, examining key concepts, and identifying research gaps [ 3 , 5 ]. However, document sets may also contain rich data about themes that were not defined a priori in the data extraction table, and an additional exploratory thematic synthesis [ 6 ] may be used to identify and organize themes relevant to the review question as they emerge from the data [ 4 ].…”