A global "School for Surgeons" could help bridge the Healthcare Human Resource Crisis in Sub-Saharan Africa

Abstract

Appropriately designed elearning programmes (including Best or School for Surgeons) may allow more efficient use of consultant teaching time. Using funding from Irish Aid, we piloted these existing e-learning tools in a sub-Saharan African country (Zambia) where low specialist numbers and limited Consultant time for teaching limits expansion of surgical training programmes. Eight MMed trainees preparing for the Membership (COSECSA) examination in the University Department of Surgery, Lusaka acted as the study group and four from elsewhere served as controls. Each trainee was supplied with BeST (an RCSI elearning basic knowledge course) on a hand held computer and weekly online case based discussions were arranged using the RCSI School for Surgeons platform. Structured feedback, following an initial eight cases previously developed for Irish trainees, identified trainee preference for local cases and faculty involvement. Eight cases appropriate to the healthcare context of the region developed by local faculty members (ML, SWO) were used subsequently. Student feedback on both BeST and School for Surgeons was positive. Among the key issues identified were the need for case material to be localized and the involvement of regional faculty. Average participation scores in School for Surgeons in the initial phase were 62.5% which is comparable to early experience among Irish trainees (for whom participation is mandatory). 8/8 trainees in the pilot group were subsequently successful in the MCS exams versus 3/4 trainees who were not included. Appropriately adapted elearning programmes may be an effective adjunct in surgical training programmes in developing countries.