Best practices in developing global collaborations in education

This purpose of this study was to examine the best practices used by facilitators of global collaborations in education. Four research questions were examined to address this purpose, which included: (a) challenges faced by facilitators in developing online international collaborations in education (b) current strategies used by facilitators in developing online international collaborations in education (c) how success is measured and tracked (d) recommendations for future online international collaborations in education. This qualitative, phenomenological study utilized a purposive sample of 14 participants who were ISTE (International Society for Technology in Education) award recipients or conference presenters between 2014 - 2017 affiliated with global collaboration. Data collection was done through a semi-structured interview protocol comprised of six questions. The recorded interviews were transcribed, coded and analyzed to determine 27 total themes that emerged from the data. With some themes reinforced by literature and some unique to the study, results led to establishing “dimensions of leading global collaboration.” This includes two primary dimensions: (a) the responsibilities dimension, which entails the tasks and logistical aspects needed in global collaboration efforts, such as planning, practices during the collaboration, and logistical considerations (b) the characteristics dimension, which refers to the qualities that characterize a good global collaboration leader and partner, such as empathy, accountability, and willingness to take risks. Additionally, this study highlights the importance of people and developing a peer to peer network in the dynamic among facilitators (who should be seen as leaders) of global collaboration

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)