A Comprehensive Framework to Optimize Short-Term Experiences in Global Health (STEGH)

Shah, Shivani; Lin, Henry C.; Loh, Lawrence C.

doi:10.1186/s12992-019-0469-7

Cited by 37 publications

(55 citation statements)

References 31 publications

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“…The endgame of such programs would be to empower local physicians to care for their communities and wean reliance of LMICs on foreign surgeons; such initiatives have been shown to maximize quality of patient care. [1][2][3]9 While we concede that such proposals may seem like Herculean tasks, especially in the most impoverished locations where modern technology/internet infrastructure is lacking, SGHPs should strive to improve communication channels and education platforms through whatever means possible.…”

mentioning

confidence: 99%

“…The surgical needs of LMICs remain unmet by the existing medley of federal agencies and NGOs. 2,3,5,9 The COVID-19 contagion will likely exacerbate health disparities and the need for surgical care in LMICs. With evidence-based information lacking, otolaryngologistshead and neck surgeons, facial plastic surgeons, and plastic surgeons have a remarkable opportunity to work together to be at the forefront of revolutionizing global surgical outreach for the better.…”

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confidence: 99%

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Effect of Coronavirus Disease 2019 and Pandemics on Global Surgical Outreach

Azizzadeh¹,

Hamdan

Salehi

2020

JAMA Otolaryngol Head Neck Surg

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The ongoing coronavirus disease 2019 (COVID-19) pandemic has led to a health care crisis, changing billions of lives worldwide. The ramifications of the contagion will likely be felt for the foreseeable future and will undoubtedly have a momentous effect on health care. While recent publications have focused on optimizing health care delivery, patient care, and physician safety in the setting of COVID-19, not much has been discussed regarding the effect on surgical global health programs (SGHPs). Prior to the novel coronavirus outbreak from Wuhan, China, SGHPs played an important role in delivering care to low-and middle-income countries (LMICs). Such mission trips have long been a staple for facial plastic surgeons, plastic surgeons, and otolaryngologists-head and neck surgeons. 1 Humanitarian organizations perform more than 250 000 procedures globally per year. 2 Despite the volume of care provided, LMICs continue to demonstrate significant unmet surgical needs. 1,3 While one-third of the global population inhabits LMICs, only 3% to 6% of operations occur there. 1,3 From a global health perspective, access to surgical services have been cited as integral to minimizing patient morbidity and mortality. 1,3 Economically, it is estimated that lack of access to surgical services in LMICs may contribute to cumulative losses of $20.7 trillion to the global economy from 2015 to 2030. 1 During this uncertain time, SGHPs ought to consider how they may aid in the ongoing crisis and to consider the short-and long-term effects on global surgical outreach. Surgical global health programs face several obstacles in the coming months. In efforts to flatten the curve and minimize the use of personal protective equipment, surgical societies (including facial plastic surgeon, plastic surgeon, and otolaryngologists-head and neck surgeon societies) have called for the suspension of elective and nonessential services for the immediate future. 4 When such cases will resume remains unknown. Moreover, many health care systems and academic centers have prohibited international travel for the time being, not to mention recently enforced global travel restrictions. In the longer term, SGHPs may face difficulties securing funding. The cost of surgical mission trips has been estimated to be more than $3.7 billion annually. 5 Even when the severity of the COVID-19 outbreak declines, governmental and nongovernmental organizations (NGOs) will likely need to triage spending to address the economic and health care fallout from the pandemic. Concerns for a looming recession may complicate securing donations and physician selffunding of global surgical outreach. The pandemic may instill fear among health care workers regarding international travel for years to come. With stories of overworked and burned out health care

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confidence: 99%

mentioning

confidence: 99%

Effect of Coronavirus Disease 2019 and Pandemics on Global Surgical Outreach

Azizzadeh¹,

Hamdan

Salehi

2020

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

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“…STEGHs are characterized by the travel of students from high-income countries to low-and middle-income countries (LMICs) to gain work experience, volunteer, teach, or conduct research [10]. These experiences can vary widely in terms of length, location, and scope of work, but at the core of the STEGH is immersion in an international setting [11].…”

Section: Role Of Global Health Electives In Trainingmentioning

confidence: 99%

“…When designing remote applied learning programs, it is important to maintain certain foundational activities that are characteristic of immersive applied learning programs. Even though the physical immersion aspects of a program may not be possible, there are activities in the preparatory, practicum, and post-practicum phases [10] of the learning program experience that can be preserved. We believe there exist innovative pedagogical solutions that can be incorporated or enhanced to achieve this goal.…”

Section: Strategies To Strengthen Practicum Designmentioning

confidence: 99%

Practical and Ethical Solutions for Remote Applied Learning Experiences in Global Health

Kalbarczyk

Harrison

Sanguineti

et al. 2020

Annals of Global Health

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Global health trainees rely on immersive experiences to apply their classroom knowledge in real-world settings. However, during the COVID-19 pandemic travel has come to a halt and short-term experiences are no longer available in their current form. As with didactic material, global health programs have an opportunity to innovate the delivery of applied learning, providing trainees with robust, mentored experiences that promote the acquisition of core global health competencies. We provide a series of practical solutions for remote applied learning including case-based learning, pathfinder pedagogy, virtual reality simulations, and twinning. We further describe the role of these approaches in addressing common criticisms of short-term experiences and their potential for creating new win-win dynamics between institutions and trainees.

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“…2 However, there is a body of international concern over the potential negative impacts on hosting communities. 3 This is especially the case with surgical specialties, where the potential for harm is most obvious.…”

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confidence: 99%

Going together: ethical considerations for trainees in global surgery

Doe

Bua

2020

Trop Doct

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Links between healthcare teams in high-income (HIC) and low-and middle-income countries (LMIC) have long provided a vehicle for medical training and equipment supply. Every link has its own approach, with mixed results-some form an excellent model for development, others less so. 1 Ethical considerations are inevitably a focus of these relationships, especially with specialty trainees. Shortterm placements involving trainees in HICs travelling to LMIC settings are increasingly popular. 2 However, there is a body of international concern over the potential negative impacts on hosting communities. 3 This is especially the case with surgical specialties, where the potential for harm is most obvious. These concerns come at a time when the unmet need in global surgery is most evident. In 2015, the Lancet Commission in Global Surgery reported that nine of ten people in LMICs cannot access basic surgical care and that 'to meet present and projected population demands, urgent investment in human and physical resources for surgical and anaesthesia care is needed'. 4 Experienced independent clinicians in HICs may offer more to personnel-limited LMIC settings than their trainees. However, time and enthusiasm for placements in LMICs is invariably greater earlier in one's career and HIC training programmes are easier to take a break from than substantive consultant posts. Inevitably, the later a LMIC placement is left in life, the less likely it is to happen. So how can trainees respond to the Lancet Commission's rallying cry? First, keep the fire burning. Trainees should engage with, but not be put off by, the ethical considerations of placements in LMICs. These inevitably come with risk, but there is also the huge potential to be a blessing to the hospital and community one serves. The skilled, sensible trainee always has something to offer. Second, pick well. It is more appropriate for a trainee to join a larger more established surgical service than lead a rural team in their first overseas experience. Equally, trainees would do well to select a location where they are truly needed to help meet a personnel shortage, rather than tread on the toes of local trainees. Third, enlist support from home. The financial implications of an extended unpaid placement abroad

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A Comprehensive Framework to Optimize Short-Term Experiences in Global Health (STEGH)

Cited by 37 publications

References 31 publications

Effect of Coronavirus Disease 2019 and Pandemics on Global Surgical Outreach

Effect of Coronavirus Disease 2019 and Pandemics on Global Surgical Outreach

Practical and Ethical Solutions for Remote Applied Learning Experiences in Global Health

Going together: ethical considerations for trainees in global surgery

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