Drilling into a patient’s bone for the first time takes skill and confidence. But how can you gain that experience, outside of the operating theatre?
Accessibility to surgical training can be hard to come by in lower and middle income countries because of the lack of simulation centres, places where surgeons learn new skills before they put them into practice in operating theatres Traditionally these centres have been capital and labour intensive, making them impractical to deploy and manage in resource poor countries.
In addition to avoidable disfigurement and disability, more than 10 million people die every year from lack of access to surgical care. An increase in infrastructure, facilities, and medical equipment is needed, but alone it does not address the critical lack of trained surgical practitioners who are needed in these communities.
That’s why the Intuitive Foundation funded and worked with us to create the Global Surgical Training Challenge, a bold new paradigm to transform the space of surgical training.
How the Challenge dramatically changed surgical training
In partnership with the Royal College of Surgeons in Ireland, MIT Solve and Appropedia we launched this three year challenge. It invited innovator teams to design open-source, self-build and self-learn modules that allow clinicians to teach themselves and evaluate their own progress to perform common surgical procedures with confidence and competence.
- Rigorous research and a design that dug deep: We carried out research and design, using a rigorous and tested system to help realise the Intuitive Foundation’s vision for change. This included stress-testing an initial model with both experts and potential beneficiaries of the trainings including leading academics and surgeons and clinical officers in the field. A process of 1:1 interviews and workshops fed the prize design and assessment and eligibility criteria that delivered results.
- A ‘who’s who’ of surgical educators: Already connected to the global health community, we supported relationship building with health ministers, key opinion leaders, leading NGOs and charities, surgical training providers and innovators. With considerable input from the Intuitive Foundation we created and managed a panel of high-profile judges who didn’t only assess entries, but used their expertise to inform the Challenge. Our existing connections were crucial in joining the dots between the US-based Foundation and experts working in central and sub-Saharan Africa.
- Catalysts for collaboration: In autumn 2020, along with MIT Solve, we ran a series of virtual webathons, involving surgical training and high tech experts and 250 innovators from around the globe. Importantly, these drew together teams of surgical practitioners, technologists and educators – with some technologists entering the surgical space for the first time. The webathons helped innovators build expertise internationally on their teams and allowed them to workshop their ideas for surgical training modules. Facilitating design-thinking activities it brought together people from different professions, with different perspectives, whether they had surgical expertise or not. Expanding who was working on this challenge, and increased the chances for out-of-the-box solutions. As one participant explained: “The webathons were key. They expanded my network and my horizons in terms of how we can apply technology for social good.”
- Prestigious support and mentoring: The Challenge received 41 applications, with collaborative teams spanning 44 countries. Ten teams won Discovery Award grants, with diverse projects ranging from orthopaedics to managing trauma patients. Each team was mentored in a programme run by the Royal College of Surgeons in Ireland and took part in workshops which we designed and ran in partnership with MIT Solve. This expert support helped teams drive forward their prototypes, and gave invaluable access to subject matter leaders.
- Shaking up traditional learning: The ground-breaking solutions included two grand prize winners who were Team ALL-SAFE, that focused on self-training modules for laparoscopic surgery, and Tibial Fracture Fixation, which used 3D printed models and cutting edge online learning techniques to teach essential fracture management. See more about the winners here.
According to Catherine Mohr, president of Intuitive Foundation: “We were impressed by the high quality of submissions for this global surgical training prize. The teams demonstrated a commitment to simulation-based training and self assessment that have the potential to change the paradigm of surgical training around the world.”
Dismantling boundaries to education
The Challenge raised awareness of the problem, invigorated innovation and drove excitement around bold new approaches.
Overall, the teams delivered 20 open-source modules to help surgical practitioners learn and assess new skills. All are free to download, inexpensive to reproduce and designed for mid-career professionals to gain new skills.
Looking ahead, SELF: The Surgical Education Learners Forum, which is also sponsored by Intuitive Foundation continues to empower any clinician to learn independently and self-assess specific surgical skills. New training modules will continue to be clinically validated, and innovators can apply for grants to drive forward their work.
The upshot? Thousands of clinicians, from Ethiopia to Guatemala, are teaching themselves to deliver the surgical services their communities need.
