Building Surgical Research Capacity Globally: Efficacy of a Clinical Research Course for Surgeons in Low-Resource Settings

Abstract

Musculoskeletal injury confers an enormous burden of preventable disability and mortality in low-and moderate-income countries (LMICs). Appropriate orthopedic and trauma care services are lacking. Leading international health agencies emphasize the critical need to create and sustain research capacity in the developing world as a strategic factor in the establishment of functional, independent health systems. One aspect of building research capacity is partnership between developing and developed countries, and knowledge sharing via these collaborations. This study evaluated the efficacy of a short, intensive course designed to educate surgeons on fundamental aspects of clinical research using evidence-based medicine (EBM) principles. Orthopedic surgeons from the United States and Canada presented a one-day course on the fundamentals of clinical research in Havana, Cuba. Knowledge acquisition was assessed on the part of course participants and surveyed current involvement with and attitudes toward clinical research. Questionnaires were presented to participants immediately preceding and following the course. The mean pre-test score was 43.9% (95% CI: 41.1-46.6%). The mean post-test score was 59.3% (95% CI: 56.5-62.1%). There were relative score increases in each subgroup based on professional level, subjective level of familiarity with EBM concepts, and subjective level of experience in research. This study establishes the short-term efficacy of an intensive course designed to impart knowledge in EBM and clinical research. Further study is necessary to determine the long-term benefits of this type of course. This may be a useful part of an overall strategy to build health research capacity in LMICs, ultimately contributing to improved access to high-quality surgical care.

Creación de capacidades para el desarrollo de liderazgo a los cirujanos ortopédicos en América Latina

“…15,16 Las oportunidades de desarrollo profesional, como el desarrollo del liderazgo, son fundamentales para desarrollar vías de intercambio de conocimientos y creación de capacidades. [17][18][19] Una de las soluciones es la creación de asociaciones multinacionales que promuevan los esfuerzos de colaboración en el trabajo de investigación y la infraestructura de liderazgo. Por lo tanto, en 2017 se desarrolló la Asociación de Cirujanos Traumatólogos de las Américas (ACTUAR) con el fin de fomentar las alianzas y facilitar el trabajo en red entre el Norte-Sur Global.…”

“…Esto también se logró a través de una actividad de grupo interactiva y la instrucción fue impartida por cirujanos-líderes locales con un interés y experiencia en áreas selectivas de desarrollo de liderazgo (Figura 1). El programa de los cursos se diseñó identificando los temas y tópicos clave a partir de revisiones bibliográficas centradas en América Latina, 17,[24][25][26][27] programas formales de liderazgo de las principales escuelas de negocios de Estados Unidos y recomendaciones solicitadas a expertos. El plan de estudios incluía conceptos diseñados para impartir los principios fundamentales del desarrollo del liderazgo, en concreto, los elementos críticos del liderazgo, los estilos de aprendizaje personal, la comunicación, la dinámica de equipo y las actividades pedagógicas prácticas, incluido un estudio de caso y una actividad de grupo interactiva.…”

Reliability of Modified Radiographic Union Score for Tibia Scores in the Evaluation of Femoral Shaft Fractures in a Low-resource Setting

“…Improving research capacity in LMICs is essential to establishing the contextually appropriate guidelines of care for these injuries. 2,5 One aspect of musculoskeletal research in which LMICs face unique challenges is outcome assessment, particularly radiographic evaluation. Hospitals in LMICs have less access to basic medical imaging, and the radiologic resources that do exist are often less modern than those in high-income countries.…”

“…Discussion: These results demonstrate that the mRUST score is a valid method of evaluating the healing of femoral shaft fractures in resource-limited settings, with high interrater reliability, correlation with widely used quality of life measures (EQ-5D and VAS), and expected divergence in the setting of complications requiring revision surgery.T he global burden of trauma is increasing rapidly, 1 particularly in lowand middle-income countries (LMICs), where long-bone fractures and other musculoskeletal injuries cause notable disability and mortality. [2][3][4] Owing to resource limitations in these settings, long-bone fractures can result in long-term sequelae that are often preventable in high-resource settings, where the established treatment guidelines are more locally applicable.…”

“…The global burden of trauma is increasing rapidly, 1 particularly in low- and middle-income countries (LMICs), where long-bone fractures and other musculoskeletal injuries cause notable disability and mortality. 2 – 4 Owing to resource limitations in these settings, long-bone fractures can result in long-term sequelae that are often preventable in high-resource settings, where the established treatment guidelines are more locally applicable. Improving research capacity in LMICs is essential to establishing the contextually appropriate guidelines of care for these injuries.…”