Preparing medical students for field experiences in low-resource settings: Development and evaluation of a pre-travel trigger video and large group discussion module

Abstract

outcomes according to the UN Millennium Development Goals cannot be achieved without appropriate surgical services1. The Lancet Commission on Global Surgery recognizes surgical training as a cost effective intervention equivalent to vaccination and antiretroviral public health initiatives2. Yet the number of adequately trained physicians to perform basic surgical procedures, especially in women’s health, is severely lacking3. Combining the delivery of surplus medical equipment and ongoing surgical teaching will improve women’s health globally. Surgical Training and Research (STAR) International and Danbury Hospital/Western Connecticut Health Network (WCHN) have a collaborative relationship with the Ugandan national referral center, Mulago Hospital, to improve supervision and training for OB/ GYN physicians. Structure/Method/Design: Danbury Hospital/WCHN established an innovative global health (GH) program, which includes weekly lectures, journal clubs, and monthly GH seminars. Residents are funded for a six-week elective rotation abroad. Faculty from partner institutions are invited to participate in a 4-week observership at WCHN. The OB/GYN department dedicates resources to enhance collaboration with Mulago Hospital. In one year, STAR International was created and raised twenty thousand dollars to donate four complete sets of surgical instruments necessary to perform gynecologic surgery. Additional equipment and medications including suction, cautery, antibiotics, and anesthetic agents were also donated, and a surgical teaching camp was organized. In June 2014, two gynecologic surgeons, two OB/GYN residents, an anesthesiologist, and a nurse traveled to Mulago Hospital to increase exposure, supervision, and surgical skills of Ugandan OB/GYN residents. Outcomes & Evaluation: Over the one week surgical camp, 23 procedures were performed: 6 total abdominal hysterectomies, 8 ovarian cystectomies or salpingoopherectomies, 5 ectopic pregnancies, and debridement of 4 pelvic abscesses. Ugandan residents also received advanced training on LEEPs with a new cautery machine and supplies. All cases involved one attending gynecologist, one Ugandan resident and one Danbury Hospital resident. Seven Ugandan residents participated. The attending anesthesiologist also taught 4 Ugandan anesthesiology residents. Going Forward: The first surgical training camp at Mulago Hospital was a successful introduction of a long-term partnership that focuses on building capacity of Ugandan physicians. Both Mulago faculty and residents received the camp well, as both parties identified teaching and supervision to be lacking at Uganda’s national referral hospital. With the collaboration of academic partners, STAR International plans to hold camps several times a year and provide continuity of surgical training. The mission of STAR International is to increase the number of women treated effectively for their diseases, and to enhance the surgical skill of Ugandan physicians, allowing them to provide necessary gynecologic surgical therapies to Ugandan women. Funding: Funds for the Surgical Training camp were recruited from crowd-sourced funding and from WCHN. Abstract #: 01ETC064