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Public Library of Science, PLOS Global Public Health, 7(3), p. e0002102, 2023

DOI: 10.1371/journal.pgph.0002102

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Academic global surgical competencies: A modified Delphi consensus study

Journal article published in 2023 by Natalie Pawlak ORCID, Christine Dart, Hernan Sacoto Aguilar ORCID, Emmanuel Ameh, Abebe Bekele ORCID, Maria F. Jimenez, Kokila Lakhoo ORCID, Doruk Ozgediz, Nobhojit Roy, Girma Terfera, Adesoji O. Ademuyiwa, Barnabas Tobi Alayande ORCID, Nivaldo Alonso ORCID, Geoffrey A. Anderson ORCID, Stanley N. C. Anyanwu ORCID and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

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.