Table 1
Guest lecturers who contributed to the Global Surgical Care Course.
| Emanuel Ameh Professor and Chief Consultant Pediatric Surgeon National Hospital Abuja, Nigeria | Gita Mody Assistant Professor of Thoracic Surgery University of North Carolina at Chapel Hill Chapel Hill NC, USA |
| Anirudh Krishna Professor of Public Policy and Political Science Duke University Durham NC, USA | Michael Penn Director of Communications Duke Global Health Institute Durham NC, USA |
| Nyagetuba J K Muma Consultant Pediatric Surgeon Executive Director AIC Kijabe Hospital Kijabe, Kenya | Abdullah Saleh Director of Office of Global Surgery University of Alberta Edmonton, Canada |
| Alvan Ukachukwu Consultant Neurosurgeon Asokoro District Hospital Abuja, Nigeria | Emily Smith Assistant Professor of Epidemiology Baylor University Waco TX, USA |
| Osondu Ogbuoji Assistant Research Professor Deputy Director Center for Policy Impact in Global Health Duke Global Health Institute Durham NC, USA | Lubna Samad Consultant Pediatric Surgeon Aga Khan University Karachi, Pakistan |
| Tolu Oladele Consultant Obstetrician & Gynecologist Assistant Director Health Sector Response Support Division National Agency for the Control of AIDS Abuja, Nigeria | Ann Saterbak Professor of Biomedical Engineering Duke University Durham NC, USA |
| Robert Malkin Professor of Biomedical Engineering Duke University Durham NC, USA | Robert Ssekitoleko Lecturer in Biomedical Engineering Makerere University Kampala, Uganda |
Figure 1
Diagram of the course structure. Students work in teams, based on their world region of interest. Each team chooses a LMIC country where they will focus their attention for the remainder of the course. During the course, new material is introduced in lectures and readings. Students are expected to apply what they have learned to a real-world assignment, focusing on surgical research and capacity building in LMICs. Upon return to class, the students teach the class what they have learned and share the research methods they have designed. By completing the readings and assignments, students have the necessary tools to draft a national surgical plan for a LMIC as their final project.
Table 2
Course Lectures, Assignment and Readings.
| WEEK | LECTURE TOPIC | ASSIGNMENT FOR NEXT WEEK | READINGS |
|---|---|---|---|
| 1 | Lancet 5 key messages | Find a recently published media piece about global surgery and discuss what message is conveyed. | [1328] |
| 2 | Burden of Surgical Disease | Using the Burden of Disease website [29], conduct a conversation with 5 lay persons regarding how the burden of disease has changed over time in your LMIC. | [303132] |
| 3 | Infrastructure | Design a survey study to assess surgical infrastructure in your chosen LMIC. | [333435] |
| 4 | Safety and Quality | Design a Safety & Quality Improvement Project for a global surgery issue relevant to your chosen LMIC. | [3637] |
| 5 | Ethics | Prepare an ethical debate on a topic relevant to global surgery in your chosen LMIC. | [38] |
| 6 | Midterm – Design a media piece to advocate for a global surgery issue in your chosen LMIC. | ||
| 7 | Innovation & BME | Design a feasibility study to assess a medical device developed for use in LMICs. | [39404142] |
| 8 | Surgical Workforce: Metrics & Task Shifting | Design a Surgical Workforce Assessment to be conducted in your chosen LMIC. | [4344] |
| 9 | Surgical Workforce: Education | Develop a surgical education initiative for your chosen LMIC and describe how you will assess its efficacy. | [4546] |
| 10 | Macroeconomics | Conduct an economic analysis for your chosen LMIC. | [4748] |
| 11 | Microeconomics | Design a survey to assess economic impact of a surgical condition to the patient’s family in your chosen LMIC. | [74950] |
| 12 | Financing | Final Project: | [515253] |
| 13 | National Surgical Planning | Develop a national surgical plan for your chosen LMIC. | [5455565758] |
| 14 | Final Exam – Presentations of National Surgical Plans. | ||
Table 3
Demographics of Participants.
| PRE-COURSE N = 14 (%) | POST-COURSE N = 11 (%) | |
|---|---|---|
| Gender | ||
| Male | 6 (43%) | |
| Female | 8 (57%) | |
| Current Academic Pursuit | ||
| Master’s in global health | 11 (79%) | |
| Undergraduate major in global health | 2 (14%) | |
| Ph.D. | 1 (7%) | |
| Future Goals | ||
| Medical school | 8 (57%) | 5 (36%) |
| Law School | 1 (7%) | 1 (7%) |
| Research analyst for NGO | 1 (7%) | 0 |
| Program management for NGO | 1 (7%) | 0 |
| Global Health Academic Research | 1 (7%) | 2 (14%) |
| Other professional school | 0 | 2 (14%) |
| Undecided | 2 (14%) | 1 (7%) |
| Future Focus in Global Health | ||
| Health Systems Strengthening | 2 (14%) | 2 (14%) |
| Cancer | 2 (14%) | 1 (7%) |
| Surgery | 2 (14%) | 1 (7%) |
| Infectious disease | 2 (14%) | 2 (14%) |
| Maternal child health | 2 (14%) | 1 (7%) |
| Non-communicable diseases | 1 (7%) | 2 (14%) |
| Immigration | 1 (7%) | 1 (7%) |
| Mental health | 0 | 1 (7%) |
| Undecided | 2 (14%) | 0 |
Figure 2
Median student ranking of global health priorities. A) The median importance rank for non-infectious disease priorities tended to increase during the course. Surgical care before the course was ranked on average as the fourth or fifth priority and after the course was ranked as the third priority in global health. B) The median importance rank for infectious disease priorities tended to decrease during the course.
Figure 3
Student self-perceived understanding of global health topics before and after the course. Students felt that their understanding of global health, global surgery and the challenges faced by the underserved had improved during the course. At the conclusion of the course, 93% of students strongly agreed that surgery is an indispensable part of healthcare.
Figure 4
Student reflections on interactive assignments and group learning. A) Most students agreed that interactive assignments increased the value of the course, enhanced their knowledge of the course material and caused them to think more deeply about the concepts presented in the course. B) Most students reported that they learned new skills from others in the group, but there were mixed experiences regarding feeling a part of a learning community and being able to actively exchange ideas. C) Students had mixed experiences regarding if group learning was effective, time-consuming, or recommended.
Table 4
Themes identified in free responses regarding students’ attitudes towards the course.
| THEMES | N = 11 (%) |
|---|---|
| Group assignments fostered discussion/ideas exchange/learning from one another. | 11 (100%) |
| Individuals did not contribute equally to group work and that was a source of stress. | 9 (82%) |
| Assignments were time-consuming. | 5 (45%) |
| Coordinating schedules to work in groups was difficult. | 4 (36%) |
| Collaboration drew attention to aspects of the course material that I may have overlooked on my own. | 3 (27%) |
| I learned something about myself from working in a group. | 2 (18%) |
| Having diverse lecturers was a strength of the course. | 2 (18%) |
| Working in a group made it easier to distribute the work. | 2 (18%) |
| Wanted more class discussion of the readings. | 2 (18%) |
| Wanted to study more countries. | 1 (9%) |
| Group learning made more effort to compile the work and come to agreement. | 1 (9%) |
| The assignments made the material more applicable to real life. | 1 (9%) |