Urva Mayur, Cortez Abigail, Katyal Toshali, Shearer David W, Morshed Saam, Miclau Theodore, MacKechnie Madeline C, Sabharwal Sanjeev
Institute for Global Orthopaedics and Traumatology, Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA; and.
UCSF Benioff's Children's Hospital Oakland, Department of Pediatric Orthopaedics, Oakland, CA.
OTA Int. 2023 Jan 13;6(1):e229. doi: 10.1097/OI9.0000000000000229. eCollection 2023 Mar.
International observerships are one of many efforts aimed at addressing disparities in orthopaedic trauma care globally. However, their impact on visiting surgeons and their home countries, as well as the challenges faced by participating surgeons, are not well-documented.
A survey was distributed to overseas surgeons who participated in an orthopaedic trauma observership from 2009 to 2020. Surgeons were identified through North American institutions previously recognized by the authors as having hosted international observerships. Information gathered included participant demographics, details of and perceived impact of the observership, and barriers faced before, during, and after the program. Responses from 148 international surgeons (ISs) from 49 countries were analyzed.
Sixty percent of observerships were at academic programs, 57% lasted 1-3 months, and 60% were self-funded. Participants identified cost and housing as primary barriers. After completing their observership, lack of funding, equipment and support staff, and excessive workload prevented participants from implementing changes at their clinical practice. Most observers believed that they gained relevant clinical (89%) and surgical knowledge (67%) and developed a professional network of North American hosts (63%). The most common suggested changes to the observership were greater hands-on experience in the operating room and structured goal setting relevant to the visiting surgeon.
Visiting surgeons find North American orthopaedic trauma observerships helpful in improving their surgical and clinical skills. However, financial constraints and resource limitations at their clinical practice and limited operative experience during the observership present barriers to maximizing this clinical experience. To enhance the relevance of clinical observerships for ISs and impact global orthopaedic trauma care, the unique needs and challenges facing ISs must be addressed.
IV-Cross-Sectional Study.
国际观摩学习项目是全球范围内旨在解决骨科创伤护理差异的众多努力之一。然而，它们对来访外科医生及其本国的影响，以及参与项目的外科医生所面临的挑战，记录并不充分。
对2009年至2020年参加骨科创伤观摩学习项目的海外外科医生进行了一项调查。通过北美机构识别外科医生，这些机构此前被作者认定为曾主办过国际观摩学习项目。收集的信息包括参与者的人口统计学资料、观摩学习项目的细节及感知到的影响，以及项目前、项目期间和项目后的障碍。对来自49个国家的148名国际外科医生（ISs）的回复进行了分析。
60%的观摩学习项目在学术项目中进行，57%持续1至3个月，60%是自费。参与者将费用和住房确定为主要障碍。完成观摩学习后，资金短缺、设备和支持人员不足以及工作量过大阻碍了参与者在临床实践中实施变革。大多数观摩者认为他们获得了相关临床知识（89%）和手术知识（67%），并建立了与北美东道主的专业网络（63%）。对观摩学习项目最常见的建议改进是在手术室有更多的实践经验以及与来访外科医生相关的结构化目标设定。
来访外科医生发现北美骨科创伤观摩学习项目有助于提高他们的手术和临床技能。然而，他们临床实践中的经济限制和资源限制以及观摩学习期间有限的手术经验，成为了充分利用这种临床经验的障碍。为了提高临床观摩学习项目对国际外科医生的相关性并影响全球骨科创伤护理，必须解决国际外科医生面临的独特需求和挑战。
IV - 横断面研究。
