Development of an Interactive Global Surgery Course for Interdisciplinary Learners

Abstract

Introduction: Global surgical care is increasingly recognized in the global health agenda and requires multidisciplinary engagement. Despite high interest among medical students, residents and other learners, many surgical faculty and health experts remain uniformed about global surgical care.

Methods: We have operated an interdisciplinary graduate-level course in Global Surgical Care based on didactics and interactive group learning. Students completed a pre- and post-course survey regarding their learning experiences and results were analyzed using the Wilcoxon signed-rank test.

Results: Fourteen students completed the pre-course survey, and 11 completed the post-course survey. Eleven students (79%) were enrolled in a Master's degree program in global health, with eight students (57%) planning to attend medical school. The median ranking of surgery on the global health agenda was fifth at the beginning of the course and third at the conclusion (p = 0.11). Non-infectious disease priorities tended to stay the same or increase in rank from pre- to post-course. Infectious disease priorities tended to decrease in rank (HIV/AIDS, p = 0.07; malaria, p = 0.02; neglected infectious disease, p = 0.3). Students reported that their understanding of global health (p = 0.03), global surgery (p = 0.001) and challenges faced by the underserved (p = 0.03) improved during the course. When asked if surgery was an indispensable part of healthcare, before the course 64% of students strongly agreed, while after the course 91% of students strongly agreed (p = 0.3). Students reported that the interactive nature of the course strengthened their skills in collaborative problem-solving.

Conclusions: We describe an interdisciplinary global surgery course that integrates didactics with team-based projects. Students appeared to learn core topics and held a different view of global surgery after the course. Similar courses in global surgery can educate clinicians and other stakeholders about strategies for building healthy surgical systems worldwide.

Figure 1

Diagram of the course structure. Students work in teams, based on their world region of interest. Each team chooses a LMIC country where they will focus their attention for the remainder of the course. During the course, new material is introduced in lectures and readings. Students are expected to apply what they have learned to a real-world assignment, focusing on surgical research and capacity building in LMICs. Upon return to class, the students teach the class what they have learned and share the research methods they have designed. By completing the readings and assignments, students have the necessary tools to draft a national surgical plan for a LMIC as their final project.

Figure 2

Median student ranking of global health priorities. A) The median importance rank for non-infectious disease priorities tended to increase during the course. Surgical care before the course was ranked on average as the fourth or fifth priority and after the course was ranked as the third priority in global health. B) The median importance rank for infectious disease priorities tended to decrease during the course.

Figure 3

Student self-perceived understanding of global health topics before and after the course. Students felt that their understanding of global health, global surgery and the challenges faced by the underserved had improved during the course. At the conclusion of the course, 93% of students strongly agreed that surgery is an indispensable part of healthcare.

Figure 4

Student reflections on interactive assignments and group learning. A) Most students agreed that interactive assignments increased the value of the course, enhanced their knowledge of the course material and caused them to think more deeply about the concepts presented in the course. B) Most students reported that they learned new skills from others in the group, but there were mixed experiences regarding feeling a part of a learning community and being able to actively exchange ideas. C) Students had mixed experiences regarding if group learning was effective, time-consuming, or recommended.