As the pilot site for the ACS-COSECSA Surgical Training Collaborative, Hawassa University is helping lead efforts at surgical workforce development in sub-Saharan Africa.
“The goal of this collaborative is to collectively develop a surgical training center of excellence that can better serve the region by providing opportunities to increase the surgical workforce, transfer knowledge and skills, and build the infrastructure for better patient care and research. This collaborative is based on the principles of twinning partnership, where shared goals are collectively developed, long-term institutional commitment is emphasized, responsibility is shared, and mutual benefit is acknowledged.” — David B. Hoyt, MD, FACS, Executive Director, ACS
New York, NY
Houston Methodist Hospital
Johns Hopkins University
Medical College of Wisconsin
Rutgers New Jersey Medical School
Texas Tech University Health Sciences Center
University of California-Irvine
University of Chicago
UT (University of Texas) Southwestern
University of Wisconsin-Madison
Virginia Commonwealth University
The members of the U.S. consortia schools are integrated completely into the clinical activities of Hawassa University Hospital, which is the referral hospital for the region. Of the hospital’s 480 beds, 54 are assigned for general surgery. The hospital admits approximately 11,000 patients per year, and approximately 117,000 are evaluated in the outpatient services. The hospital has 10 operating room (OR) tables, but only two are reserved for general surgery.
Example: Strategic Programming Focus
Having a focused programmatic approach has helped to align all participating teams to accelerate the development of clinical programming in Hawassa. A brief survey regarding the Clinical Programming between the American College of Surgeons and Hawassa University was administered with the goal to define which programs we will focus on as we continue our partnership in the coming year. To ensure development in the areas of expressed need, clinical programming has been bucketed into the following categories:
Example: Trauma and ER Systems Implementation in Ethiopia
As part of the Ethiopia Ministry of Health’s initiative to improve EMS, Hawassa University was recently charged with developing the ER and trauma care system in the region, including the establishment of a dispatch center and standardization of pre-hospital protocols. U.S. faculty were tasked with providing guidance to HU faculty through the various stages of implementation through their own knowledge and by reaching out to their networks to obtain insights. Examples of achievements include but are not limited to: the establishment of a dispatch center; the standardization of pre-hospital protocols; and the administration of two virtual TEAM courses to surgical trainees, trauma nurses, and ambulance drivers, to name a few. Individuals from the Ministry and from other regions, such as Jimma, Ethiopia, involved with the implementation of this initiative have joined the meeting for increased shared learning.
The Education Workgroup focuses on all levels of training, including medical students, residents, faculty, and other specialists including anesthesiology and nursing. Educational activities of the workgroup focus on building capacity using a systems-based perspective and consider limitations, specifically regarding available capacity and resources.
Example: Resident Curriculum Assistance Program
Amid COVID-19, the workgroup developed a plan to increase ACS faculty presence in the Hawassa resident education curriculum virtually. A drafted schedule assigned each participating institution a single month to help provide faculty coverage for the resident lectures. Assignments were made to match designated specialties with the general topics of curriculum covered during that month. Responsibilities associated with this program include attending (via Zoom) and providing commentary for the resident lectures, seminars, and bi-monthly journal club.
Hawassa faculty members are expected to devote 25 percent of their time to research, as research and publications are part of the criterion for academic promotion. Nonetheless, Hawassa faculty members have difficulty advancing their careers because of a lack of publishing opportunities. This group was tasked with developing a research methodology for training residents and collaborative scientific research opportunities for faculty.
Example: Basics of Research Methods Course
To increase training and publishing opportunities in research, the Research Workgroup implemented a research course and mentorship program for Hawassa University residents and faculty. The virtual course schedule was first designed by the workgroup and then reviewed by the Hawassan faculty to ensure content reflected the proper level of participant competency. Topics of the course included major clinical study design, bias and how to minimize bias, development of data collection tools, and practice on searching literature on research questions, to name a few. Lecturers consisted of both faculty from the US and Hawassa, and guest speakers were invited from the Hawassa University School of Public Health for additional contextual insights. Each of the 18 course participants were tasked with creating their own research question and fine-tuning a research plan throughout the eight-week virtual course.
Example: Mentorship Program
Upon completion of the Research Methods Course, each participant was paired with a U.S. mentor who was responsible for reviewing and synthesizing applicable literature, refining the research question as needed, assisting with the creation of a study design and data collection strategy, guiding the mentee through statistical analysis, and editing abstracts and manuscripts. Data collected will be useful in obtaining findings in a local context, ultimately furthering the knowledge around a specific topic of problem in the community.
The quality workgroup introduced the M&M format and discussion to Hawassa. M&M is now held weekly and has been met with great enthusiasm from all participants. Journal Club was also introduced and is held weekly along with M&M. A quality database was created to look at different quality variables.