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Original Investigation |

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

Seth D. Goldstein, MD1; Dominic Papandria, MD2; Allison Linden, MD, MPH3; Georges Azzie, MD4; Eric Borgstein, FRCS5; James Forrest Calland, MD6; Samuel R. G. Finlayson, MD, MPH7; Pankaj Jani, MBChB8; Mary Klingensmith, MD9; Mohamed Labib, MD10; Frank Lewis, MD11; Mark A. Malangoni, MD11; Eric O’Flynn, BS12; Stephen Ogendo, MbChB8; Robert Riviello, MD, MPH7; Fizan Abdullah, MD, PhD1
[+] Author Affiliations
1Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
2Department of Surgery, St Vincent Hospital, Indianapolis, Indiana
3Department of Surgery, Georgetown University Hospital, Washington, DC
4Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
5Department of Surgery, University of Malawi, Blantyre, Malawi
6Department of Surgery, University of Virginia School of Medicine, Charlottesville
7Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
8Department of Surgery, University of Nairobi, Nairobi, Kenya
9Department of Surgery, Washington University, St Louis, Missouri
10Department of Surgery, University of Namibia, Windhoek, Namibia
11American Board of Surgery, Philadelphia, Pennsylvania
12Royal College of Surgeons in Ireland, Dublin, Ireland
JAMA Surg. 2014;149(4):341-346. doi:10.1001/jamasurg.2013.4830.
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Importance  Surgical conditions are an important component of global disease burden, due in part to critical shortages of adequately trained surgical providers in low- and middle-income countries.

Objectives  To assess the use of Internet-based educational platforms as a feasible approach to augmenting the education and training of surgical providers in these settings.

Design, Setting, and Participants  Access to two online curricula was offered to 75 surgical faculty and trainees from 12 low- and middle-income countries for 60 days. The Surgical Council on Resident Education web portal was designed for general surgery trainees in the United States, and the School for Surgeons website was built by the Royal College of Surgeons in Ireland specifically for the College of Surgeons of East, Central and Southern Africa. Participants completed an anonymous online survey detailing their experiences with both platforms. Voluntary respondents were daily Internet users and endorsed frequent use of both print and online textbooks as references.

Main Outcomes and Measures  Likert scale survey questionnaire responses indicating overall and content-specific experiences with the Surgical Council on Resident Education and School for Surgeons curricula.

Results  Survey responses were received from 27 participants. Both online curricula were rated favorably, with no statistically significant differences in stated willingness to use and recommend either platform to colleagues. Despite regional variations in practice context, there were few perceived hurdles to future curriculum adoption.

Conclusions and Relevance  Both the Surgical Council on Resident Education and School for Surgeons educational curricula were well received by respondents in low- and middle-income countries. Although one was designed for US surgical postgraduates and the other for sub-Saharan African surgical providers, there were no significant differences detected in participant responses between the two platforms. Online educational resources have promise as an effective means to enhance the education of surgical providers in low- and middle-income countries.

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