The Evaluation of a Surgical Task-Sharing Program in South Sudan
Five billion people lack access to surgery, with the highest burden being in sub-Saharan Africa. As the surgical workforce is crucial in closing this gap, the University of British Columbia collaborated with Médecins Sans Frontières to create and launch the Essential Surgical Skills (ESS) task-shari...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Surgeries |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2673-4095/4/2/19 |
| _version_ | 1797592563026231296 |
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| author | Mina Salehi Irena Zivkovic Stephanie Mayronne Jean-Pierre Letoquart Shahrzad Joharifard Emilie Joos |
| author_facet | Mina Salehi Irena Zivkovic Stephanie Mayronne Jean-Pierre Letoquart Shahrzad Joharifard Emilie Joos |
| author_sort | Mina Salehi |
| collection | DOAJ |
| description | Five billion people lack access to surgery, with the highest burden being in sub-Saharan Africa. As the surgical workforce is crucial in closing this gap, the University of British Columbia collaborated with Médecins Sans Frontières to create and launch the Essential Surgical Skills (ESS) task-sharing program, which consists of online learning modules and hands-on surgical training. Our study aimed to evaluate this pilot program. This is a mixed-method prospective cohort study to evaluate the effectiveness of the ESS program in South Sudan. Quantitative data included patient outcomes (complications, re-operation, and mortality), surgical proficiency of the trainees (quiz, entrustable professional activity (EPA), and logbook data), and electronic surveys. We used semi-structured interviews to collect qualitative data. From July 2019 to February 2021, three trainees performed 385 operations. The most common procedures were skin graft (14.8%) and abscess drainage (9.6%). A total of 172 EPAs were completed, of which 136 (79%) demonstrated the independence of the trainees. During the training, surgical mortality (0.56% vs. 0.13%, <i>p</i> = 0.0541) and morbidity (17% vs. 12%, <i>p</i> = 0.1767) remained unchanged from the pretraining phase. Interviews and surveys revealed that surgical knowledge and interprofessional teamwork improved throughout the training. The program empowered trainees to develop surgical career paths and increased their local acceptance among patients and other healthcare providers. This study confirmed the feasibility of a surgical task-sharing program in South Sudan. This program evaluation will hopefully inform Ministries of Health and their partners for the development of a training pillar of National Surgical, Obstetric, and Anesthesia Plans in the sub-Saharan African region. |
| first_indexed | 2024-03-11T01:55:52Z |
| format | Article |
| id | doaj.art-599dea0fef504fe0a1a2b6c47025358a |
| institution | Directory Open Access Journal |
| issn | 2673-4095 |
| language | English |
| last_indexed | 2024-03-11T01:55:52Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Surgeries |
| spelling | doaj.art-599dea0fef504fe0a1a2b6c47025358a2023-11-18T12:39:38ZengMDPI AGSurgeries2673-40952023-04-014217518710.3390/surgeries4020019The Evaluation of a Surgical Task-Sharing Program in South SudanMina Salehi0Irena Zivkovic1Stephanie Mayronne2Jean-Pierre Letoquart3Shahrzad Joharifard4Emilie Joos5Section of Trauma and Acute Care Surgery, Division of General Surgery, Vancouver General Hospital, 767 West 12th Avenue, Vancouver, BC V5Z 1M9, CanadaSection of Trauma and Acute Care Surgery, Division of General Surgery, Vancouver General Hospital, 767 West 12th Avenue, Vancouver, BC V5Z 1M9, CanadaResponsable Médical Médecins Sans Frontières, Doctors Without Borders (OCP) Haïti, Liberia, Somaliland, Sudan & South Sudan, 40 Rector St. 16th Floor, New York, NY 10006, USARéférent Chirurgie, Surgical Advisor, MSF-OCP, 34 Av. Jean Jaurès, 75019 Paris, FranceDivision of Pediatric Surgery, Department of Surgery, British Columbia Children’s Hospital, 4500 Oak St., Vancouver, BC V6H 3N1, CanadaSection of Trauma and Acute Care Surgery, Division of General Surgery, Vancouver General Hospital, 767 West 12th Avenue, Vancouver, BC V5Z 1M9, CanadaFive billion people lack access to surgery, with the highest burden being in sub-Saharan Africa. As the surgical workforce is crucial in closing this gap, the University of British Columbia collaborated with Médecins Sans Frontières to create and launch the Essential Surgical Skills (ESS) task-sharing program, which consists of online learning modules and hands-on surgical training. Our study aimed to evaluate this pilot program. This is a mixed-method prospective cohort study to evaluate the effectiveness of the ESS program in South Sudan. Quantitative data included patient outcomes (complications, re-operation, and mortality), surgical proficiency of the trainees (quiz, entrustable professional activity (EPA), and logbook data), and electronic surveys. We used semi-structured interviews to collect qualitative data. From July 2019 to February 2021, three trainees performed 385 operations. The most common procedures were skin graft (14.8%) and abscess drainage (9.6%). A total of 172 EPAs were completed, of which 136 (79%) demonstrated the independence of the trainees. During the training, surgical mortality (0.56% vs. 0.13%, <i>p</i> = 0.0541) and morbidity (17% vs. 12%, <i>p</i> = 0.1767) remained unchanged from the pretraining phase. Interviews and surveys revealed that surgical knowledge and interprofessional teamwork improved throughout the training. The program empowered trainees to develop surgical career paths and increased their local acceptance among patients and other healthcare providers. This study confirmed the feasibility of a surgical task-sharing program in South Sudan. This program evaluation will hopefully inform Ministries of Health and their partners for the development of a training pillar of National Surgical, Obstetric, and Anesthesia Plans in the sub-Saharan African region.https://www.mdpi.com/2673-4095/4/2/19surgical trainingvirtual trainingmedical evaluationlow- and middle-income countriestask-sharing |
| spellingShingle | Mina Salehi Irena Zivkovic Stephanie Mayronne Jean-Pierre Letoquart Shahrzad Joharifard Emilie Joos The Evaluation of a Surgical Task-Sharing Program in South Sudan Surgeries surgical training virtual training medical evaluation low- and middle-income countries task-sharing |
| title | The Evaluation of a Surgical Task-Sharing Program in South Sudan |
| title_full | The Evaluation of a Surgical Task-Sharing Program in South Sudan |
| title_fullStr | The Evaluation of a Surgical Task-Sharing Program in South Sudan |
| title_full_unstemmed | The Evaluation of a Surgical Task-Sharing Program in South Sudan |
| title_short | The Evaluation of a Surgical Task-Sharing Program in South Sudan |
| title_sort | evaluation of a surgical task sharing program in south sudan |
| topic | surgical training virtual training medical evaluation low- and middle-income countries task-sharing |
| url | https://www.mdpi.com/2673-4095/4/2/19 |
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