The Role of Educational Research in the Global Setting




© Springer International Publishing Switzerland 2016
Mamta Swaroop and Sanjay Krishnaswami (eds.)Academic Global SurgerySuccess in Academic Surgery10.1007/978-3-319-14298-2_12


12. The Role of Educational Research in the Global Setting



Jonathan A. Laryea  and Chandrakanth Are 


(1)
Division of Colon and Rectal Surgery, Department of Surgery, University of Arkansas for Medical Sciences, 4301 W Markham Street, Slot 520, Little Rock, AR 72205, USA

(2)
Division of Surgical Oncology, Department of Surgery, University of Nebraska Medical Center, 986345 Nebraska Medical Center, Omaha, NE 68198, USA

 



 

Jonathan A. Laryea (Corresponding author)



 

Chandrakanth Are



Keywords
EducationalResearchGlobalSurgeryHealthcareWorkforceResource-challenged



Introduction


Given that most global surgery efforts have focused on service rather than education, there is very little written about educational research in the global surgery setting. As the focus of global surgery rotations shift from a purely volunteerism-driven effort to an educational experience for surgical trainees as well as providers in host institutions, there is a need to evaluate different ways education initiatives can be tailored and adapted to meet the needs of both sides. Academic institutions can partner with institutions in resource-limited countries to facilitate bridging the gap in surgical workforce, as well as help with training needs of these countries. It is in this educational environment that educational research can flourish.

Educational research may be defined as a systematic way of using basic and applied research methodology to study the different aspects of education including teaching methods, learning styles, curriculum development, training environments, teacher training and the interactions between the teacher and learner.

The shortage of specialized surgical workforce in Africa led to the development of the concept of Surgical Task Shifting, in which essential and emergency surgical services are provided by less specialized healthcare workers including non-surgeons physicians and non-physician healthcare workers. There is widespread use of non-physician clinicians and other mid-level healthcare providers in Africa. In Mozambique, técnicos de circugia (non-physician surgeons) have been trained since 1984. In Malawi, Tanzania and Mozambique, a recent survey showed the majority of cesarean sections, obstetric hysterectomies and ectopic pregnancy operations are being performed at the district hospital level by surgical clinical officers. The training of these providers is cheaper and shorter in duration than the traditional surgery training. The impact of this system has been studied. Multiple analyses have showed that these providers have similar outcomes and comparable quality of care and decision-making compared to formally trained surgeons. The applicability of this model to other non-African low- and middle-income countries (LMICs) can be explored through research and pilot studies. The expansion of training of these non-surgeon clinicians to other essential subspecialty procedures needs to be considered and evaluated through educational research methods.

The use of Minimal Access Surgery is very widespread in the developed world. The transfer of the technology and associated technical skills to the developing world is often hampered by the cost of the equipment, disposables and lack of supplies as well as reliable electricity and carbon dioxide. There is a need to develop sustainable technologies in developing countries to provide alternatives to these expensive technologies. Education research can support the dissemination and help determine the most effective and innovative ways to develop and deploy such technologies and technical skills.

The key to providing timely, safe and quality surgical care to any populace in the world is dependent on the availability of an adequate surgical workforce. This rests on the availability of systems and resources to sustain a surgical workforce, not only for today but also to maintain a pipeline of surgeons for the future. This is where education plays a paramount role by providing training and guidance to support an adequate surgical workforce capacity. Although the long-term benefits of this are usually shadowed by other short-term needs and a lack of fiscal latitude, education is without any doubt the most important tool to address global surgical workforce needs in a sustainable fashion.

Education is not static. The field is indeed very dynamic, even more so in the recent times. The rapid pace of changes witnessed in education parallels the similarly rapid pace of changes seen in clinical care due to a multitude of factors emanating from the central focus point of advancing technology. Just as what is considered the standard of clinical care today may be obsolete tomorrow; what is considered to be the standard of educational content today may also be obsolete in the near future. To maintain up to date clinical care, we need to maintain up to date educational content. This is where educational research plays a key role. Traditionally, print textbooks and journals have been the main means of providing content for education. However, in more recent times, most textbooks and journals have online content, opening another avenue for dissemination of knowledge. The availability of online libraries has opened a new mechanism for acquisition of information and knowledge. The use of these avenues for surgical education in the global setting can be studied through qualitative and quantitative methods. Additionally, the widespread use of social media in LMICs for the dissemination of surgical knowledge and learning offers a relatively untapped potential and needs to be studied. The telecommunication platform also provides another innovative avenue for education and research, through tele-teaching, tele-conferencing, tele-consulting, tele-surgery, tele-radiology, tele-pathology, tele-mentoring and tele-simulation. These also lead to potential areas of research to determine effectiveness in the global setting. This chapter will particularly address the role, need, opportunities and limitations of educational research in a global setting.


Role and Need for Educational Research




(a)

Identifying gaps and needs in providing evidencebased care: Research in education on the global stage is essential for several reasons. One of which is to be able to identify gaps and needs in the educational system of the region with particular reference to aspects such as content and delivery. Unlike in the past where any surgical care was acceptable, the promise of delivering surgical care anywhere in the world today is based on the premise that it will adhere to the most current-evidence based guidelines. This can only be accomplished by conducting research into the educational curriculum of the particular region. In this way, any identified gaps can be addressed in a proactive fashion to enable delivery of evidence-based care. Additionally, evidence-based guidelines may not be transferrable to different environments since they may have peculiar circumstances. The applicability of evidence-based care to resource-limited environments can be studied. New guidelines can then be developed based on proven techniques that work in the particular environment given their resource challenges. This will make the adoption of any new guidelines easy and sustainable.

Only gold members can continue reading. Log In or Register to continue

Stay updated, free articles. Join our Telegram channel

Jun 27, 2017 | Posted by in Uncategorized | Comments Off on The Role of Educational Research in the Global Setting

Full access? Get Clinical Tree

Get Clinical Tree app for offline access