Department of Surgery, University of California/East Bay, Oakland, California.
Department of Surgery, Oregon Health Science University, Portland, Oregon; The Alliance for Global Clinical Training, San Francisco, California.
J Surg Educ. 2018 May-Jun;75(3):688-696. doi: 10.1016/j.jsurg.2017.08.019. Epub 2017 Sep 1.
Assessment of the effect of the collaborative relationship between the high-income country (HIC) surgical educators of the Alliance for Global Clinical Training (Alliance) and the low-income country surgical educators at the Muhimbili University of Health and Allied Sciences/Muhimbili National Hospital (MUHAS/MNH), Dar Es Salaam, Tanzania, on the clinical global surgery training of the HIC surgical residents participating in the program.
A retrospective qualitative analysis of Alliance volunteer HIC faculty and residents' reports, volunteer case lists and the reports of Alliance academic contributions to MUHAS/MNH from 2012 to 2017. In addition, a survey was circulated in late 2016 to all the residents who participated in the program since its inception.
Twelve HIC surgical educators provided rotating 1-month teaching coverage at MUHAS/MNH between academic years 2012 and 2017 for a total of 21 months. During the same time period 11 HIC residents accompanied the HIC faculty for 1-month rotations. HIC surgery residents joined the MUHAS/MNH Department of Surgery, made significant teaching contributions, performed a wide spectrum of "open procedures" including hand-sewn intestinal anastomoses. Most had had either no or limited previous exposure to hand-sewn anastomoses. All of the residents commented that this was a maturing and challenging clinical rotation due to the complexity of the cases, the limited resources available and the ethical and emotional challenges of dealing with preventable complications and death in a resource constrained environment.
The Alliance provides an effective clinical global surgery rotation at MUHAS/MNH for HIC Surgery Departments wishing to provide such an opportunity for their residents and faculty.
评估高收入国家(HIC)联盟全球临床培训(Alliance)外科教育者与坦桑尼亚达累斯萨拉姆穆希比利大学卫生与联合科学学院/穆希比利国家医院(MUHAS/MNH)低收入国家外科教育者之间的合作关系对参与该项目的 HIC 外科住院医师全球外科培训的影响。
对 Alliance 志愿 HIC 教员和住院医师的报告、志愿病例清单以及 2012 年至 2017 年 Alliance 对 MUHAS/MNH 的学术贡献报告进行回顾性定性分析。此外,2016 年末,向自项目启动以来参与该项目的所有住院医师发放了一份调查。
2012 年至 2017 年,12 名 HIC 外科教育者在 MUHAS/MNH 提供为期 1 个月的轮转教学,总计 21 个月。同期,11 名 HIC 住院医师陪同 HIC 教员进行 1 个月的轮转。HIC 外科住院医师加入 MUHAS/MNH 外科系,做出了重大的教学贡献,完成了广泛的“开放手术”,包括手工缝合肠吻合术。大多数人以前要么没有接触过手工吻合术,要么接触有限。所有住院医师都评论说,由于病例的复杂性、有限的可用资源以及在资源有限的环境中处理可预防并发症和死亡的伦理和情感挑战,这是一次成熟和具有挑战性的临床轮转。
联盟为希望为其住院医师和教员提供这种机会的 HIC 外科系在 MUHAS/MNH 提供了有效的全球外科临床轮转。