Academic global surgical competencies: A modified Delphi consensus study

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 effectivel

Management of cardiac trauma at the Vicente Corral Moscoso Hospital. 2015-2017

ntroduction: cardiac injuries are challenging entities in emergency surgery, their high mortality forces to make prompt and precise decisions.Methodology: there was a series of cases that analyzed the medical records of patients with cardiac trauma treated at the Trauma and Emergency Center of the Vicente Corral Moscoso Hospital (HVCM) during the period November 2015 - April 2017.Objectives: to expose the management of this pathology, as well as its mortality in our environmentResults: a total of 18 patients with cardiac trauma, 12 due to penetrating injury, 2 iatrogenic and 4 contusions were treated during the analyzed period. The male sex was the most exposed to these injuries. Among the violence injuries, the most frequent was: 8 white weapon injuries and 4 gunshot. The incision most used for cardiac repair was the left lateral thoracotomy. The left ventricle was the most affected in 6 patients and the right ventricle in 5 patients. The mortality in this group of patients was 17%.Conclusion: the mortality in these cases was 17%, the surgical approach was preferably by left lateral thoracotomy in 67%Introducción: las lesiones cardiacas son entidades desafiantes en la ci-rugía de emergencia, su alta mortalidad obliga a tomar decisiones rápidas y precisas. Metodología: serie de casos que analizó las historias clínicas de pacien-tes con trauma cardiaco atendidos en el Centro de Trauma y Emergencia del Hospital Vicente Corral Moscoso (HVCM) durante el período noviembre del 2015 – abril 2017. Objetivos: presentar el manejo de esta patología, así como su mortalidad en nuestro medioResultados: durante el período analizado se atendieron 18 pacientes con trauma cardiaco, 12 por lesión penetrante, 2 iatrogénicas y 4 contusos. El sexo masculino fue el más expuesto a estas lesiones. Dentro de las lesiones por violencia la más frecuente fue: lesión por arma blanca 8 casos y fuego 4. La incisión más utilizada para la reparación cardiaca fue la to-racotomía lateral izquierda. El ventrículo izquierdo fue el más afectado en 6 pacientes y el derecho en 5. La mortalidad en este grupo de pacientes fue del 17%. Conclusión: la mortalidad en esta serie de casos fue del 17%, el aborda-je quirúrgico fue preferentemente por toracotomía lateral izquierda en un 67

The successful implementation of a trauma and acute care surgery model in Ecuador

Durante años, las emergencias quirúrgicas en Ecuador se manejaron caso por caso sin una estandarización significativa. Para abordar estos problemas, el Hospital Regional Vicente Corral Moscoso adaptó e implementó un modelo de “cirugía de trauma y atención aguda” (TACS) a la realidad de Cuenca, Ecuador. Se realizó un estudio de cohorte, comparando pacientes expuestos al modelo tradicional y pacientes expuestos al modelo TACS. Las variables evaluadas incluyeron el número de pacientes quirúrgicos atendidos en el departamento de emergencias, el número de intervenciones quirúrgicas, el número de cirugías realizadas por cirujano, el tiempo de espera quirúrgico, la duración de la estadía y la mortalidad hospitalaria.For years, surgical emergencies in Ecuador were managed on a case-by-case basis without significant standardization. To address these issues, the Regional Hospital Vicente Corral Moscoso adapted and implemented a model of “trauma and acute care surgery” (TACS) to the reality of Cuenca, Ecuador. A cohort study was carried out, comparing patients exposed to the traditional model and patients exposed to the TACS model. Variables assessed included number of surgical patients attended to in the emergency department, number of surgical interventions, number of surgeries performed per surgeon, surgical wait time, length of stay and in-hospital mortality

Academic global surgical competencies: A modified Delphi consensus study.

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

Correction: Academic global surgical competencies: A modified Delphi consensus study.

[This corrects the article DOI: 10.1371/journal.pgph.0002102.]

Academic global surgical competencies: A modified Delphi consensus study.

Acknowledgements: We would like to thank Natalie Bell and Miranda Melone for managing the email reminders through the ACS OGB Office.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

Academic global surgical competencies: A modified Delphi consensus study

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