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. 2023 Jul 14;3(7):e0002102.
doi: 10.1371/journal.pgph.0002102. eCollection 2023.

Academic global surgical competencies: A modified Delphi consensus study

Natalie Pawlak  1 , Christine Dart  2 , Hernan Sacoto Aguilar  3 , Emmanuel Ameh  4 , Abebe Bekele  5   6 , Maria F Jimenez  7 , Kokila Lakhoo  8 , Doruk Ozgediz  9 , Nobhojit Roy  10 , Girma Terfera  11 , Adesoji O Ademuyiwa  12 , Barnabas Tobi Alayande  13 , Nivaldo Alonso  14 , Geoffrey A Anderson  15 , Stanley N C Anyanwu  16 , Alazar Berhe Aregawi  17 , Soham Bandyopadhyay  18   19 , Tahmina Banu  20 , Alemayehu Ginbo Bedada  21 , Anteneh Gadisa Belachew  17 , Fabio Botelho  22   23 , Emmanuel Bua  24 , Leticia Nunes Campos  25 , Chris Dodgion  26 , Michalina Drejza  27 , Marcel E Durieux  28 , Rohini Dutta  29 , Sarnai Erdene  30 , Rodrigo Vaz Ferreira  31 , Zipporah Gathuya  32 , Dhruva Ghosh  33 , Randeep Singh Jawa  34 , Walter D Johnson  35 , Fauzia Anis Khan  36 , Fanny Jamileth Navas Leon  37 , Kristin L Long  11 , Jana B. A. Macleod  38   39 , Anshul Mahajan  40 , Rebecca G Maine  41 , Grace Zurielle C Malolos  42 , Craig D McClain  43 , Mary T Nabukenya  44 , Peter M Nthumba  45   46 , Benedict C Nwomeh  47 , Daniel Kinyuru Ojuka  48 , Norgrove Penny  49 , Martha A Quiodettis  50 , Jennifer Rickard  51 , Lina Roa  52 , Lucas Sousa Salgado  53 , Lubna Samad  54 , Justina Onyioza Seyi-Olajide  55 , Martin Smith  56 , Nichole Starr  9 , Richard J Stewart  57 , John L Tarpley  58   59 , Julio L Trostchansky  60 , Ivan Trostchansky  61 , Thomas G Weiser  62 , Adili Wobenjo  38 , Elliot Wollner  63 , Sudha Jayaraman  64
Affiliations

Academic global surgical competencies: A modified Delphi consensus study

Natalie Pawlak et al. PLOS Glob Public Health. .

Erratum in

  • Correction: Academic global surgical competencies: A modified Delphi consensus study.
    Pawlak N, Dart C, Aguilar HS, Ameh E, Bekele A, Jimenez MF, Lakhoo K, Ozgediz D, Roy N, Terfera G, Ademuyiwa AO, Alayande BT, Alonso N, Anderson GA, Anyanwu SNC, Aregawi AB, Bandyopadhyay S, Banu T, Bedada AG, Belachew AG, Botelho F, Bua E, Campos LN, Dodgion C, Drejza M, Durieux ME, Dutta R, Erdene S, Vaz Ferreira R, Gathuya Z, Ghosh D, Jawa RS, Johnson WD, Khan FA, Navas Leon FJ, Long KL, Macleod JBA, Mahajan A, Maine RG, Malolos GZC, McClain CD, Nabukenya MT, Nthumba PM, Nwomeh BC, Ojuka DK, Penny N, Quiodettis MA, Rickard J, Roa L, Salgado LS, Samad L, Seyi-Olajide JO, Smith M, Starr N, Stewart RJ, Tarpley JL, Trostchansky JL, Trostchansky I, Weiser TG, Wobenjo A, Wollner E, Jayaraman S. Pawlak N, et al. PLOS Glob Public Health. 2023 Sep 14;3(9):e0002414. doi: 10.1371/journal.pgph.0002414. eCollection 2023. PLOS Glob Public Health. 2023. PMID: 37708095 Free PMC article.

Abstract

Academic global surgery is a rapidly growing field that aims to improve access to safe surgical care worldwide. However, no universally accepted competencies exist to inform this developing field. A consensus-based approach, with input from a diverse group of experts, is needed to identify essential competencies that will lead to standardization in this field. A task force was set up using snowball sampling to recruit a broad group of content and context experts in global surgical and perioperative care. A draft set of competencies was revised through the modified Delphi process with two rounds of anonymous input. A threshold of 80% consensus was used to determine whether a competency or sub-competency learning objective was relevant to the skillset needed within academic global surgery and perioperative care. A diverse task force recruited experts from 22 countries to participate in both rounds of the Delphi process. Of the n = 59 respondents completing both rounds of iterative polling, 63% were from low- or middle-income countries. After two rounds of anonymous feedback, participants reached consensus on nine core competencies and 31 sub-competency objectives. The greatest consensus pertained to competency in ethics and professionalism in global surgery (100%) with emphasis on justice, equity, and decolonization across multiple competencies. This Delphi process, with input from experts worldwide, identified nine competencies which can be used to develop standardized academic global surgery and perioperative care curricula worldwide. Further work needs to be done to validate these competencies and establish assessments to ensure that they are taught effectively.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Modified Delphi process for consensus driven development of global surgery competencies.
OGB: American College of Surgeons Operation Giving Back.
Fig 2
Fig 2. World map depicting the location of Delphi respondents and task force members.
Experts from countries highlighted in blue participated in the modified Delphi Process. This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License from Mapchart. https://www.mapchart.net/world.html.
See this image and copyright information in PMC

References

    1. Alkire BC, Raykar NP, Shrime MG, Weiser TG, Bickler SW, Rose JA, et al.. Global access to surgical care: A modelling study. Lancet Glob Health. 2015. Jun;3(6):e316–23. Epub 2015 Apr 27. doi: 10.1016/S2214-109X(15)70115-4 . - DOI - PMC - PubMed
    1. Mock CN, Donkor P, Gawande A, Jamison DT, Kruk ME, Debas HT, et al.. Essential surgery: Key messages from Disease Control Priorities, 3rd edition. Lancet. 2015. May 30;385(9983):2209–19. doi: 10.1016/S0140-6736(15)60091-5 Epub 2015 Feb 5. . - DOI - PMC - PubMed
    1. Meara JG, Leather AJM, Hagander L, Alkire BC, Alonso N, Ameh EA, et al.. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Surgery. 2015. Jul;158(1):3–6. doi: 10.1016/j.surg.2015.04.011 Epub 2015 May 16. . - DOI - PubMed
    1. Shrime MG, Bickler SW, Alkire BC, Mock C. Global burden of surgical disease: an estimation from the provider perspective. Lancet Glob Health. 2015. Apr 27;3 Suppl 2:S8–9. doi: 10.1016/S2214-109X(14)70384-5 . - DOI - PubMed
    1. Price R, Makasa E, Hollands M. World Health Assembly Resolution WHA68.15: Surgical Care and Anesthesia as a Component of Universal Health Coverage"—Addressing the Public Health Gaps Arising from Lack of Safe, Affordable and Accessible Surgical and Anesthetic Services. World J Surg. 2015. Sep;39(9):2115–25. doi: 10.1007/s00268-015-3153-y . - DOI - PubMed