A Pilot Comparison of Standardized Online Surgical Curricula for Use in Low- and Middle-Income Countries

Goldstein, Seth D.; Papandria, Dominic; Linden, Allison F.; Azzie, Georges; Borgstein, Eric; Calland, J. Forrest; Finlayson, Samuel R.G.; Jani, Pankaj; Klingensmith, Mary E.; Labib, Mohamed A.; Lewis, Frank; Malangoni, Mark A.; O’Flynn, Eric; Ogendo, Stephen; Riviello, Robert

doi:10.1001/jamasurg.2013.4830

Cited by 31 publications

(17 citation statements)

References 24 publications

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“…Twenty-five (13.7%) studies reported limitations to telemedicine for surgical care in LMICs. These included Internet bandwidth, network instability and coverage [ 69 , 78 , 82 , 122 – 124 ], high costs of technology set-up [ 55 , 125 ], and safety, privacy and confidentiality concerns [ 117 , 118 , 126 ]. Poor image quality for asynchronous (where information transmission and response do not take place in real-time) telemedicine [ 127 ], inability to confirm delivery of information by SMS recipients [ 128 , 129 ], and time zone differences for international collaborations and mentoring [ 31 ] were additional limitations that were reported.…”

Section: Resultsmentioning

confidence: 99%

Telemedicine in Surgical Care in Low‐ and Middle‐Income Countries: A Scoping Review

et al. 2022

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Background Access to timely and quality surgical care is limited in low- and middle-income countries (LMICs). Telemedicine, defined as the remote provision of health care using information, communication and telecommunication platforms have the potential to address some of the barriers to surgical care. However, synthesis of evidence on telemedicine use in surgical care in LMICs is lacking. Aim To describe the current state of evidence on the use and distribution of telemedicine for surgical care in LMICs. Methods This was a scoping review of published and relevant grey literature on telemedicine use for surgical care in LMICs, following the PRISMA extension for scoping reviews guideline. PubMed-Medline, Web of Science, Scopus and African Journals Online databases were searched using a comprehensive search strategy from 1 January 2010 to 28 February 2021. Results A total of 178 articles from 53 (38.7%) LMICs across 11 surgical specialties were included. The number of published articles increased from 2 in 2010 to 44 in 2020. The highest number of studies was from the World Health Organization Western Pacific region ( n = 73; 41.0%) and of these, most were from China ( n = 69; 94.5%). The most common telemedicine platforms used were telephone call ( n = 71, 39.9%), video chat ( n = 42, 23.6%) and WhatsApp/WeChat ( n = 31, 17.4%). Telemedicine was mostly used for post-operative follow-up ( n = 71, 39.9%), patient education ( n = 32, 18.0%), provider training ( n = 28, 15.7%) and provider-provider consultation ( n = 16, 9.0%). Less than a third ( n = 51, 29.1%) of the studies used a randomised controlled trial design, and only 23 (12.9%) reported effects on clinical outcomes. Conclusion Telemedicine use for surgical care is emerging in LMICs, especially for post-operative visits. Basic platforms such as telephone calls and 2-way texting were successfully used for post-operative follow-up and education. In addition, file sharing and video chatting options were added when a physical assessment was required. Telephone calls and 2-way texting platforms should be leveraged to reduce loss to follow-up of surgical patients in LMICs and their use for pre-operative visits should be further explored. Despite these telemedicine potentials, there remains an uneven adoption across several LMICs. Also, up to two-thirds of the studies were of low-to-moderate quality with only a few focusing on clinical effectiveness. There is a need to further adopt, develop, and validate telemedicine use for surgical care in LMICs, particularly its impact on clinical outcomes. Supplementary Information The online version co...

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Section: Resultsmentioning

confidence: 99%

Telemedicine in Surgical Care in Low‐ and Middle‐Income Countries: A Scoping Review

et al. 2022

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“…Residents are still encouraged to register with COSECSA to allow them the benefit from additional training opportunities that are not available through UR such as the School for Surgeons 21 . Comparison between the SCORE curriculum and School for Surgeons did not find significant differences between the two platforms although one was designed for US surgical postgraduates and the other for sub-Saharan African surgical providers 22 .…”

Section: Cosecsa/asea Publication -East and Central African Journal Omentioning

confidence: 91%

Utilizing the American Board of Surgery in-training exam in a Rwandan surgical residency program: Alignment of exam topics with the University of Rwanda general surgery curriculum

Rickard¹,

Ntirenganya²,

Kyamanywa³

et al. 2016

East. Cent. Afr. J. Surg.

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Background: University of Rwanda (UR) increased postgraduate surgery training and assessment strategies are needed. We compared American Board of Surgery In-Training Exam (ABSITE) topics with UR surgery curriculum to determine the applicability of ABSITE in Rwanda. Methods: Topics are outlined in the Surgical Council on Resident Education (SCORE) curriculum whereas the UR utilizes a modular system. Diseases and conditions in SCORE were compared with UR surgery module content. Operation and procedures in SCORE were compared with operative procedures in UR surgery curriculum. Results: Overall, 72% of diseases and conditions from SCORE were covered in UR curriculum. Of this, 76% of medical knowledge and 71% of patient care content was covered in UR curriculum. 41% of operations and procedures from SCORE were identified in UR curriculum. 55% of core operations and 16% of advanced operations from SCORE were included in UR general surgery curriculum. Content identified in UR curriculum and not SCORE included infectious and tropical diseases, orthopedics, urology and neurosurgery. Conclusions: There is alignment between ABSITE topics and UR general surgery curriculum suggesting that the ABSITE can be used as an in-training examination for Rwandan residents. Understanding the limitations of the ABSITE exam can help utilization of this examination.

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“…Virtual international meetings have been held successfully prior to the pandemic in response to environmental concerns and financial limitations. 6 - 10 …”

Section: To the Editormentioning

confidence: 99%

Lessons learned from organizing and evaluating international virtual training for healthcare professionals

et al. 2022

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A Pilot Comparison of Standardized Online Surgical Curricula for Use in Low- and Middle-Income Countries

Cited by 31 publications

References 24 publications

Telemedicine in Surgical Care in Low‐ and Middle‐Income Countries: A Scoping Review

Telemedicine in Surgical Care in Low‐ and Middle‐Income Countries: A Scoping Review

Utilizing the American Board of Surgery in-training exam in a Rwandan surgical residency program: Alignment of exam topics with the University of Rwanda general surgery curriculum

Lessons learned from organizing and evaluating international virtual training for healthcare professionals

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