Abstract:introduction: The AAOS International Scholars Program was launched in 2002 with the goal of enhancing the knowledge and skills of orthopedic surgeons in underserved regions. The goals of this study were to (1) characterize the professional and practice profile of scholarship recipients, (2) assess the perceived impact of this short-term educational experience on their clinical practice, (3) if/how the knowledge and skills have been disseminated to students and/or colleagues, and (4) assess career development i… Show more
“…Currently, many North American (NA) academic centers and professional societies provide such teaching and training opportunities for international surgeons (ISs) from LMICs. [6][7][8] A recent webbased search found that orthopaedic trauma was one of the most prevalent subspecialties among orthopaedic observerships available in North America to ISs. [12] However, the perceived impact of trauma-focused observerships on the visiting LMIC surgeons in the context of their own clinical practice has not been well studied.…”
Section: Introductionmentioning
confidence: 99%
“…[3,4] The need for improving access to quality surgical care in medically underserved regions globally is well known to the orthopaedic community. [5–11]…”
International observerships are one of many efforts aimed at addressing disparities in orthopaedic trauma care globally. However, their impact on visiting surgeons and their home countries, as well as the challenges faced by participating surgeons, are not well-documented.Methods: A survey was distributed to overseas surgeons who participated in an orthopaedic trauma observership from 2009 to 2020. Surgeons were identified through North American institutions previously recognized by the authors as having hosted international observerships. Information gathered included participant demographics, details of and perceived impact of the observership, and barriers faced before, during, and after the program. Responses from 148 international surgeons (ISs) from 49 countries were analyzed.Results: Sixty percent of observerships were at academic programs, 57% lasted 1-3 months, and 60% were self-funded. Participants identified cost and housing as primary barriers. After completing their observership, lack of funding, equipment and support staff, and excessive workload prevented participants from implementing changes at their clinical practice. Most observers believed that they gained relevant clinical (89%) and surgical knowledge (67%) and developed a professional network of North American hosts (63%). The most common suggested changes to the observership were greater hands-on experience in the operating room and structured goal setting relevant to the visiting surgeon.Conclusions: Visiting surgeons find North American orthopaedic trauma observerships helpful in improving their surgical and clinical skills. However, financial constraints and resource limitations at their clinical practice and limited operative experience during the observership present barriers to maximizing this clinical experience. To enhance the relevance of clinical observerships for ISs and impact global orthopaedic trauma care, the unique needs and challenges facing ISs must be addressed.
“…Currently, many North American (NA) academic centers and professional societies provide such teaching and training opportunities for international surgeons (ISs) from LMICs. [6][7][8] A recent webbased search found that orthopaedic trauma was one of the most prevalent subspecialties among orthopaedic observerships available in North America to ISs. [12] However, the perceived impact of trauma-focused observerships on the visiting LMIC surgeons in the context of their own clinical practice has not been well studied.…”
Section: Introductionmentioning
confidence: 99%
“…[3,4] The need for improving access to quality surgical care in medically underserved regions globally is well known to the orthopaedic community. [5–11]…”
International observerships are one of many efforts aimed at addressing disparities in orthopaedic trauma care globally. However, their impact on visiting surgeons and their home countries, as well as the challenges faced by participating surgeons, are not well-documented.Methods: A survey was distributed to overseas surgeons who participated in an orthopaedic trauma observership from 2009 to 2020. Surgeons were identified through North American institutions previously recognized by the authors as having hosted international observerships. Information gathered included participant demographics, details of and perceived impact of the observership, and barriers faced before, during, and after the program. Responses from 148 international surgeons (ISs) from 49 countries were analyzed.Results: Sixty percent of observerships were at academic programs, 57% lasted 1-3 months, and 60% were self-funded. Participants identified cost and housing as primary barriers. After completing their observership, lack of funding, equipment and support staff, and excessive workload prevented participants from implementing changes at their clinical practice. Most observers believed that they gained relevant clinical (89%) and surgical knowledge (67%) and developed a professional network of North American hosts (63%). The most common suggested changes to the observership were greater hands-on experience in the operating room and structured goal setting relevant to the visiting surgeon.Conclusions: Visiting surgeons find North American orthopaedic trauma observerships helpful in improving their surgical and clinical skills. However, financial constraints and resource limitations at their clinical practice and limited operative experience during the observership present barriers to maximizing this clinical experience. To enhance the relevance of clinical observerships for ISs and impact global orthopaedic trauma care, the unique needs and challenges facing ISs must be addressed.
“…Global surgical education has evolved from shortterm medical missions in LICs and MICs to the development of sustainable partnerships that allow for mutual learning opportunities and the creation of funding and career paths that foster collective responsibility in addressing global inequities in surgical care 2 . The need for improving surgical care in LICs and MICs is well known to the orthopaedic community [4][5][6][7][8][9][10][11] .…”
mentioning
confidence: 99%
“…Currently, many North American (NA) academic centers and professional societies provide international surgeons (ISs) short-term opportunities for clinical observerships 5,7 . In an attempt to better understand the impact of such clinical observerships on ISs and their home countries, a recent study found that participation in an NA pediatric orthopaedic observership had a positive perceived impact on the majority of visiting ISs, did not contribute to substantial brain drain, and may assist with local capacity-building 12 .…”
mentioning
confidence: 99%
“…In an attempt to better understand the impact of such clinical observerships on ISs and their home countries, a recent study found that participation in an NA pediatric orthopaedic observership had a positive perceived impact on the majority of visiting ISs, did not contribute to substantial brain drain, and may assist with local capacity-building 12 . Although the study by Carrillo and Sabharwal and other studies suggest an overall positive impact of short-term clinical observerships on the visiting ISs and their peers and patients, the challenges faced by the ISs and their NA hosts remain largely unknown [5][6][7][12][13][14][15][16] . *The values are given as the number of respondents who responded with "Considerably" (4 points) or "A great deal" (5 points) on a 5-point Likert scale, with the percentage in parentheses.…”
Background: Despite recommendations for high-income countries to partner with low-income and middle-income countries to expand surgical access, little is known about the barriers that are faced by international surgeons (ISs) who participate in short-term clinical observerships in North America and the barriers that are encountered by their North American (NA) hosts. Methods: Surveys were distributed to ISs who participated in a pediatric orthopaedic observership in North America in 2009 to 2019 and their NA hosts to assess the perceived barriers that are faced by both partners and identify possible opportunities for improvement. Results: Responses were received from 181 ISs and 46 NA hosts. The ISs reported facing a variety of barriers prior to, during, and after completion of their NA observerships, including financial burden, language and cultural barriers, and challenges with local accommodations and transportation. Only 49% of ISs reported that their NA hosts had sought feedback from them. Barriers noted by the NA hosts included financial burden, logistical challenges with hosting, language barriers, and lack of support from their co-faculty/staff. At least 43% of NA hosts reported that their observership program was unfunded. Based on the survey responses, potential areas that may enhance the observership experience include funding support, creating a centralized data bank of pediatric subspecialty opportunities that are available at each sponsoring institution, a pre-visit orientation for the visiting surgeon, improving inclusivity by addressing language and cultural barriers, improving access to observing surgical procedures, obtaining post-visit feedback, and creating a virtual community of international visitors and NA hosts for an ongoing exchange of ideas and resources. Conclusions: The ISs who participated in a pediatric orthopaedic clinical observership and their NA hosts identified limited funding as a major barrier. There are several opportunities for enhancing this unique learning experience and exploring the role of contextual remote learning for all participants. Additional studies are needed to investigate the value of clinical observerships for ISs, including the downstream impact of such opportunities on capacity-building, bidirectional learning, and improving patient care.
Background:
There is substantial disparity in access to surgical care worldwide that largely impacts children in resource-limited environments. Although it has been suggested that surgeons in high-income countries work alongside their overseas peers to bridge this gap, there is limited information regarding the impact of pediatric orthopaedic observerships that are available to international surgeons. This study aimed to assess the perceived impact of such visitations on overseas surgeons, including their professional development and clinical practice.
Methods:
A survey was distributed to overseas surgeons who participated in a pediatric orthopaedic observership in North America in the years 2009 to 2019. Details were collected regarding each respondent’s demographics and observership program, and the impact of this short-term clinical experience as perceived by the visiting surgeon.
Results:
Of the 181 international surgeons from 56 countries who participated in a pediatric orthopaedic observership, most were young male surgeons residing in a middle-income nation. The majority of surgeons observed in outpatient clinics (98%) and in the operating room (96%) and attended educational in-house conferences (92%). Most observers (75%) acknowledged gaining relevant orthopaedic knowledge and clinical skills that improved local patient care, and nearly all (99%) shared the newly acquired knowledge with their peers and trainees. Most (97%) were still living and working in the country that had been their residence at the time of their observership. No noteworthy trends were identified between the income classification of the surgeons’ country of residence and their ability to incorporate the acquired skills into their practice.
Conclusions:
Participating in a North American pediatric orthopaedic observership has a positive perceived impact on the majority of visiting surgeons, with potential gains in clinical skills and knowledge that likely benefit their patients, peers, and trainees. Such participation does not contribute to substantial brain drain and may assist with local capacity building. Identifying ways to increase access to such educational opportunities, particularly for surgeons from lower-income countries, should be explored further.
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