From Oakland University William Beaumont School of Medicine; VA/National Clinician Scholars Program, VA HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System; the Division of Plastic Surgery, Dalhousie University, Dalhousie Medicine; and the Division of Surgery, Section of Plastic Surgery, Michigan Medicine.
Plast Reconstr Surg. 2021 Jul 1;148(1):42e-50e. doi: 10.1097/PRS.0000000000008054.
Hand surgeons have the potential to substantially decrease the surgical disability burden in the developing world through educator trips. The Lancet Commission supports contextually driven educator trips grounded in the needs of local hosts, yet few organizations perform a comprehensive assessment of learning interests or the hosting institutions' surgical capacity before the trips.
The authors adapted the Personnel, Infrastructure, Procedures, Equipment, and Supplies questionnaire, which was modified from the World Health Organization's validated Tool for Situational Analysis to Assess Emergency and Essential Surgical Care. The authors revised each aspect of the questionnaire to reflect items pertinent to upper extremity surgery and hand trauma care. They added sections to gauge self-identified learning needs, local disease burden, operative resources, and current practices. The tool was distributed by means of Qualtrics; descriptive statistics were used to summarize data. The authors analyzed the data for all participants and performed two subgroup analyses to examine variation by regions and countries.
The authors received 338 responses from 27 countries. There was wide variability in local surgical disease burden, learning interests, and skill level of upper extremity procedures. Although learners were most interested in learning tendon transfers and microsurgical techniques, the majority did not have adequate infrastructure at their institution to sustain capacity for microvascular procedures.
Needs assessments can gauge how best to provide education during short-term visiting educator trips and optimize its impact in resource-limited settings. Understanding the needs, learning interests, and availability of resources of local learners is imperative to creating a sustainable global surgical workforce.
手外科医生通过教育旅行有潜力在发展中国家大大减轻手术带来的残疾负担。柳叶刀委员会支持基于当地主办方需求的情境驱动教育旅行，但很少有组织在旅行前对学习兴趣或主办机构的手术能力进行全面评估。
作者改编了人员、基础设施、程序、设备和用品问卷，该问卷是根据世界卫生组织经过验证的紧急和基本外科护理情况分析工具修改而来。作者对问卷的每个方面都进行了修订，以反映与上肢手术和手部创伤护理相关的项目。他们增加了一些部分，以评估自我确定的学习需求、当地疾病负担、手术资源和当前实践。该工具通过 Qualtrics 分发；使用描述性统计数据总结数据。作者对所有参与者的数据进行了分析，并进行了两次亚组分析，以检查按地区和国家的差异。
作者收到了来自 27 个国家的 338 份回复。当地手术疾病负担、学习兴趣和上肢手术技能水平存在很大差异。尽管学习者最感兴趣的是学习肌腱转移和显微外科技术，但他们中的大多数人所在机构没有足够的基础设施来维持微血管手术的能力。
需求评估可以衡量在短期访问教育者旅行中提供教育的最佳方式，并优化其在资源有限环境中的影响。了解当地学习者的需求、学习兴趣和资源可用性对于创建可持续的全球外科劳动力至关重要。
