PLOS Global Public Health (Jan 2023)

Academic global surgical competencies: A modified Delphi consensus study.

  • Natalie Pawlak,
  • Christine Dart,
  • Hernan Sacoto Aguilar,
  • Emmanuel Ameh,
  • Abebe Bekele,
  • Maria F Jimenez,
  • Kokila Lakhoo,
  • Doruk Ozgediz,
  • Nobhojit Roy,
  • Girma Terfera,
  • Adesoji O Ademuyiwa,
  • Barnabas Tobi Alayande,
  • Nivaldo Alonso,
  • Geoffrey A Anderson,
  • Stanley N C Anyanwu,
  • Alazar Berhe Aregawi,
  • Soham Bandyopadhyay,
  • Tahmina Banu,
  • Alemayehu Ginbo Bedada,
  • Anteneh Gadisa Belachew,
  • Fabio Botelho,
  • Emmanuel Bua,
  • Leticia Nunes Campos,
  • Chris Dodgion,
  • Michalina Drejza,
  • Marcel E Durieux,
  • Rohini Dutta,
  • Sarnai Erdene,
  • Rodrigo Vaz Ferreira,
  • Zipporah Gathuya,
  • Dhruva Ghosh,
  • Randeep Singh Jawa,
  • Walter D Johnson,
  • Fauzia Anis Khan,
  • Fanny Jamileth Navas Leon,
  • Kristin L Long,
  • Jana B. A. Macleod,
  • Anshul Mahajan,
  • Rebecca G Maine,
  • Grace Zurielle C Malolos,
  • Craig D McClain,
  • Mary T Nabukenya,
  • Peter M Nthumba,
  • Benedict C Nwomeh,
  • Daniel Kinyuru Ojuka,
  • Norgrove Penny,
  • Martha A Quiodettis,
  • Jennifer Rickard,
  • Lina Roa,
  • Lucas Sousa Salgado,
  • Lubna Samad,
  • Justina Onyioza Seyi-Olajide,
  • Martin Smith,
  • Nichole Starr,
  • Richard J Stewart,
  • John L Tarpley,
  • Julio L Trostchansky,
  • Ivan Trostchansky,
  • Thomas G Weiser,
  • Adili Wobenjo,
  • Elliot Wollner,
  • Sudha Jayaraman

DOI
https://doi.org/10.1371/journal.pgph.0002102
Journal volume & issue
Vol. 3, no. 7
p. e0002102

Abstract

Read online

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.