Eskind Family Biomedical Library and Learning Center, Vanderbilt University School of Medicine, 2209 Garland Avenue, Nashville, TN, 37240, USA.
Department of Surgery, Africa Inland Church Kijabe Hospital, Kijabe, Kenya.
World J Surg. 2022 Nov;46(11):2570-2584. doi: 10.1007/s00268-022-06692-w. Epub 2022 Aug 17.
As globalization of surgical training increases, growing evidence demonstrates a positive impact of global surgery experiences on trainees from high-income countries (HIC). However, few studies have assessed the impact of these largely unidirectional experiences from the perspectives of host surgical personnel from low- and middle-income countries (LMIC). This study aimed to assess the impact of unidirectional visitor involvement from the perspectives of host surgical personnel in Kijabe, Kenya.
Voluntary semi-structured interviews were conducted with 43 host surgical personnel at a tertiary referral hospital in Kijabe, Kenya. Qualitative analysis was used to identify salient and recurring themes related to host experiences with visiting surgical personnel. Perceived benefits and challenges of HIC involvement and host interest in bidirectional exchange were assessed.
Benefits of visitor involvement included positive learning experiences (95.3%), capacity building (83.7%), exposure to diverse practices and perspectives (74.4%), improved work ethic (51.2%), shared workload (44.2%), access to resources (41.9%), visitor contributions to patient care (41.9%), and mentorship opportunities (37.2%). Challenges included short stays (86.0%), visitor adaptation and integration (83.7%), cultural differences (67.4%), visitors with problematic behaviors (53.5%), learner saturation (34.9%), language barriers (32.6%), and perceived power imbalances between HIC and LMIC personnel (27.9%). Nearly half of host participants expressed concerns about the lack of balanced exchange between HIC and LMIC programs (48.8%). Almost all (96.9%) host trainees expressed interest in a bidirectional exchange program.
As the field of global surgery continues to evolve, further assessment and representation of host perspectives is necessary to identify and address challenges and promote equitable, mutually beneficial partnerships between surgical programs in HIC and LMIC.
随着外科培训的全球化进程不断推进，越来越多的证据表明，全球外科经历对来自高收入国家（HIC）的受训者有积极影响。然而，很少有研究从来自中低收入国家（LMIC）的宿主外科人员的角度评估这些主要单向体验的影响。本研究旨在评估从肯尼亚基贾贝的宿主外科人员的角度来看，单向访客参与的影响。
对肯尼亚基贾贝的一家三级转诊医院的 43 名宿主外科人员进行了自愿的半结构化访谈。使用定性分析来确定与宿主对访问外科人员的经验相关的显著和反复出现的主题。评估了 HIC 参与的益处和挑战，以及宿主对双向交流的兴趣。
访客参与的好处包括积极的学习体验（95.3%）、能力建设（83.7%）、接触多样化的实践和观点（74.4%）、改善职业道德（51.2%）、分担工作量（44.2%）、获得资源（41.9%）、访客对患者护理的贡献（41.9%）和指导机会（37.2%）。挑战包括逗留时间短（86.0%）、访客适应和融入（83.7%）、文化差异（67.4%）、访客行为有问题（53.5%）、学习者饱和（34.9%）、语言障碍（32.6%）以及 HIC 和 LMIC 人员之间的权力不平衡（27.9%）。近一半的宿主参与者对 HIC 和 LMIC 项目之间缺乏平衡的交流表示担忧（48.8%）。几乎所有（96.9%）的宿主受训者都表示有兴趣参与双向交流计划。
随着全球外科学领域的不断发展，需要进一步评估和代表宿主的观点，以识别和解决挑战，并促进 HIC 和 LMIC 之间的外科项目之间的公平、互利伙伴关系。
