Carrillo Laura A, Sabharwal Sanjeev
Medical College of Wisconsin, Milwaukee, Wisconsin.
UCSF Benioff Children's Hospital Oakland, Oakland, California.
J Bone Joint Surg Am. 2021 Apr 7;103(7):e26. doi: 10.2106/JBJS.20.01464.
There is substantial disparity in access to surgical care worldwide that largely impacts children in resource-limited environments. Although it has been suggested that surgeons in high-income countries work alongside their overseas peers to bridge this gap, there is limited information regarding the impact of pediatric orthopaedic observerships that are available to international surgeons. This study aimed to assess the perceived impact of such visitations on overseas surgeons, including their professional development and clinical practice.
A survey was distributed to overseas surgeons who participated in a pediatric orthopaedic observership in North America in the years 2009 to 2019. Details were collected regarding each respondent's demographics and observership program, and the impact of this short-term clinical experience as perceived by the visiting surgeon.
Of the 181 international surgeons from 56 countries who participated in a pediatric orthopaedic observership, most were young male surgeons residing in a middle-income nation. The majority of surgeons observed in outpatient clinics (98%) and in the operating room (96%) and attended educational in-house conferences (92%). Most observers (75%) acknowledged gaining relevant orthopaedic knowledge and clinical skills that improved local patient care, and nearly all (99%) shared the newly acquired knowledge with their peers and trainees. Most (97%) were still living and working in the country that had been their residence at the time of their observership. No noteworthy trends were identified between the income classification of the surgeons' country of residence and their ability to incorporate the acquired skills into their practice.
Participating in a North American pediatric orthopaedic observership has a positive perceived impact on the majority of visiting surgeons, with potential gains in clinical skills and knowledge that likely benefit their patients, peers, and trainees. Such participation does not contribute to substantial brain drain and may assist with local capacity building. Identifying ways to increase access to such educational opportunities, particularly for surgeons from lower-income countries, should be explored further.
全球范围内外科治疗的可及性存在巨大差异，这在很大程度上影响了资源有限环境中的儿童。尽管有人建议高收入国家的外科医生与海外同行合作以弥合这一差距，但关于国际外科医生可获得的小儿骨科观摩实习的影响的信息有限。本研究旨在评估此类访问对外科医生的感知影响，包括他们的专业发展和临床实践。
对2009年至2019年期间在北美参加小儿骨科观摩实习的海外外科医生进行了一项调查。收集了每位受访者的人口统计学和观摩实习项目的详细信息，以及访问外科医生所感知的这种短期临床经验的影响。
来自56个国家的181名国际外科医生参加了小儿骨科观摩实习，其中大多数是居住在中等收入国家的年轻男性外科医生。大多数外科医生在门诊诊所（98%）和手术室（96%）进行观摩，并参加内部教育会议（92%）。大多数观摩者（75%）承认获得了相关的骨科知识和临床技能，改善了当地患者的护理，几乎所有（99%）都与同行和学员分享了新获得的知识。大多数（97%）仍在他们观摩实习时居住的国家生活和工作。在外科医生居住国的收入分类与其将所学技能应用于实践的能力之间未发现显著趋势。
参加北美小儿骨科观摩实习对大多数访问外科医生有积极的感知影响，在临床技能和知识方面可能有所收获，这可能使他们的患者、同行和学员受益。这种参与不会导致大量人才外流，可能有助于当地能力建设。应进一步探索增加获得此类教育机会的途径，特别是对于来自低收入国家的外科医生。
