Development of an Interactive Global Surgery Course for Interdisciplinary Learners

Abstract

Introduction: Global surgical care is increasingly recognized in the global health agenda and requires multidisciplinary engagement. Despite high interest among medical students, residents and other learners, many surgical faculty and health experts remain uniformed about global surgical care. Methods:We have operated an interdisciplinary graduate-level course in Global Surgical Care based on didactics and interactive group learning. Students completed a pre-and post-course survey regarding their learning experiences and results were analyzed using the Wilcoxon signed-rank test.Results: Fourteen students completed the pre-course survey, and 11 completed the post-course survey. Eleven students (79%) were enrolled in a Master's degree program in global health, with eight students (57%) planning to attend medical school. The median ranking of surgery on the global health agenda was fifth at the beginning of the course and third at the conclusion (p = 0.11). Non-infectious disease priorities tended to stay the same or increase in rank from pre-to post-course. Infectious disease priorities tended to decrease in rank (HIV/AIDS, p = 0.07; malaria, p = 0.02; neglected infectious disease, p = 0.3). Students reported that their understanding of global health (p = 0.03), global surgery (p = 0.001) and challenges faced by the underserved (p = 0.03) improved during the course. When asked if surgery was an indispensable part of healthcare, before the course 64% of students strongly agreed, while after the course 91% of students strongly agreed (p = 0.3). Students reported that the interactive nature of the course strengthened their skills in collaborative problem-solving. Conclusions:We describe an interdisciplinary global surgery course that integrates didactics with team-based projects. Students appeared to learn core topics and held a different view of global surgery after the course. Similar courses in global surgery can educate clinicians and other stakeholders about strategies for building healthy surgical systems worldwide.

With equity in mind: Evaluating an interactive hybrid global surgery course for cross-site interdisciplinary learners

“…The course design was adapted from an existing semester-long graduate seminar in Global Surgical Care at the DGHI. Designed collaboratively by faculty in the Duke School of Medicine and the Duke Global Health Institute, the base course consisted of 12 topics built around the Lancet Commission on Global Surgery [ 17 ]. In-person class time was 2.5 hours weekly over 12–14 weeks, consisting of multiple learning methods.…”

“…Students organized themselves into groups of 3–4 learners, with team-based research focussed on a LMIC of their choice for the length of the course. Weekly assignments fed into a final project—the development of a National Surgical Obstetrics and Anaesthesia Plan (NSOAP) for their chosen LMIC [ 17 ].…”

“…The course design was carried out in a series of collaborative meetings over 6 months involving 7 UGHE and 5 DGHI participants (learners, educators, surgeons, and administrators). The contextualized course maintained the basic structure of team-based learning, flipped classroom approach, and final development of a NSOAP [ 17 ].…”

“…This paper describes the development of a hybrid, synchronous semester-long Global Surgical Care course between the University of Global Health Equity in Rwanda (UGHE) and Duke Global Health Institute (DGHI) targeted at multidisciplinary, cross-cultural learners from a variety of HIC and LMICs. We highlight key modifications to a historically in-person course to an international, blended cohort of remote and in-person learners [ 17 ]. In addition, we examine the ethics of collaboration and principles of equity between the partnering LMIC and HIC institutions, evaluate student cross-site group dynamics, and assess the educational outcomes and outputs of the program using the first and second Kirkpatrick framework [ 18 ].…”

Cultural Sensitivity and Ethical Considerations

“…On one end of the spectrum, surgical STEGH participants could enroll in a semester-long course such as the one that Duke University offers its medical students. 22 A course such as this offers the breadth and depth of material relevant to global surgery; however, it may not be a feasible time commitment for all STEGH participants. In contrast, there are some publicly available fact sheets and primers for just-in-time learning.…”