Purpose of the consultancy

To improve the accessibility to surgical education through continuing development of a virtual competency-based educational delivery model for essential general surgery in first-level hospitals in the Pacific.

Background

Using surgical modules created for the WHO Academy, and other resources including simulation-based education (SBE) modalities, a cycle of testing with evaluation and refinement will be conducted in pilot countries in the Pacific, in collaboration with relevant academic institutions.

There is an urgent need to increase the number of providers capable to perform surgical, anaesthetic, and obstetric (SOA) procedures in the Western Pacific region. Currently, only 4 of 14 (29%) Pacific Island countries have at least 20 surgical, anesthesia and obstetric providers in their workforce per 100 000 population, with a range of 1.6 (Samoa) to 22 (Cook Islands). (1) Three of 13 (23%) Pacific Island countries met the target surgical volume of 5000 procedures per 100 000 population, with five performing less than 1600. (1) Retention of local SAO providers is problematic and insufficient in-service education has occurred in local hospitals to cover this gap. This is a recurrent problem in many Low- and Middle-Income Countries.

Workforce decentralization and promoting competency-based surgical care for healthcare providers can help circumnavigate this problem including through virtual and simulation-based medical education. This is defined as the acquisition of essential core technical and cognitive skills in a safe controlled learning environment prior to patient contact, hence ensuring patient safety and clinician preparedness. There has also been a recent paradigm shift in the delivery of education to a virtual format with the COVID-19 pandemic worldwide.

A comprehensive interactive medical educational curriculum has been developed for the integrated care 2 pathway (IC2) at the WHO academy as part of the Operative Care pathway. The modules are being reviewed by the dedicated WHO TAG, but these consist of high resources settings experts, so representation of low resource end-users is vital.

Planned timelines (subject to confirmation)

Estimated start date: 1 February 2024

Duration: 88 days

 Deliverables

Output 1: Creation of the “Operative Care Course” stream of IC2 at the WHO Academy HQ into an online resource available for beta testing in the Western Pacific region
Deliverable 1.1: Collaborative work with the WHO Academy Designer team to convert the existing 52 modules into an online Beta version for testing in the region with stakeholder groups
Deliverable 1.2: Revision of the Operative Care online beta version modules utilising feedback from the WPRO stakeholder working group to guide the creation of the online material for wider international regional testing
Deliverable 1.3: Assist with Modules 1.1-1.10 (Management of Operative Care) in the Organisation of the Operative Care at 1st Level Hospitals component of the Operative Care Course
Deliverable 1.4: Drafting supporting text materials for the online courses in collaboration with WHO HQ and the Mumbai Collaborating Centre

Output 2: Co-ordination and participation with the paediatric surgical stream of IC2 at the WHO Academy HQ, representing the region
Deliverable 2.1: Revision of the 24 Global Initiative for Children’s Surgery (GICS) modules content and format of the WHO Academy as directed by the designer team, for incorporation of adapted modules into the Operative Care pathway
Deliverable 2.2: Revision of the GICS modules utilising feedback from the WPRO stakeholder working group to guide the creation of the online material for wider testing
Deliverable 2.3: Assist GICS with the delivery and co-ordination of the GICS simulation‑based educational workshop and educational content launch

Output 3: Implementation of the Integrated Clinical Care Pathway 2 Training the trainers / Facilitators Course in country to further upskill local educational leaders with the necessary educational techniques and theory to transition to delivery by themselves for long-term sustainability
Deliverable 3.1: Delivery of the IC2 cross-stream Facilitators Course/ToT in country with local champions acting as faculty with WHO support for credentialing
Deliverable 3.2: Creation of a train the trainer course manual in collaboration with WHO HQ IC2 Team for use in the IC2 Streams
Deliverable 3.3: Plan for creation of additional educational modules on topics identified at the WHO Operative Care Workshop in Fiji October 2023 including dedicated feedback and work-based assessment focused content

Output 4: In co-ordination with Fiji National University (FNU) educators, provide guidance and advice for the surgical simulation centre being planned with Korea International Cooperation Agency (KOICA) in Nadi, Fiji
Deliverable 4.1: Conduct a needs analysis with local educators for a simulation-based educational programme that will be aligned with the Master of Surgery Course at FNU
Deliverable 4.2: Creation of a draft of a SBE curriculum for surgical intervention-based specialities such as general surgery and obstetrics and gynaecology at FNU for implementation into the formal curriculum

Output 5: In collaboration with other members of the SAS team, creation of adult and paediatric appendicitis, diabetic foot and open fracture coaching checklists
Deliverable 5.1: Refinement of the Diabetic foot checklist and lesson plan
Deliverable 5.2: Adaptation and revision of the checklist following feedback utilising a test revise cycle
Deliverable 5.3: Draft coaching checklists for adult and paediatric appendicitis
Deliverable 5.4: Adaptation and revision of the checklist following feedback from the WPRO stakeholder working group, utilising a test revise cycle

Methods to carry out the activities

Lead the creation, refinement, and implementation of the Operative Care Course in WPRO. Liaise with key content creators or designers at the WHO Academy and stakeholders in the WPRO region to continue to develop the created modules into a virtual online learning environment.  With the aim to create a novel immersive and interactive learning environment for the healthcare worker in a low resource setting to improve the care that is provided. Lead the launch and the beta testing of the online modules in the WPRO region with further refinement dependant on the feedback received from the local champions who have been on boarded at the recent WHO WPRO Operative Care workshop in Fiji in Oct 2023.

Contribute to the leadership and design of the Integrated Care 2 team providing educational expertise when required. Also provide leadership and co-ordination in the operative care pathway of the IC2 stream to ensure cohesiveness of the educational content and ensure completion of the educational resource. Act as a link between the wider IC2 Streams at WHO HQ and WPRO to avoid duplication and co-ordination of the educational content. Provide advice from the unique position of a clinician educator to apply educational theory to the design and implementation of the content for the IC2 streams.

Refine content from the beta version of the online material in collaboration with the established working group composed of end-user stakeholders for surgical care in the Pacific. This group will provide feedback for any further revision and subsequent iterations of the modules or their components in the beta testing phase.

Qualifications, experience, skills and knowledge, and languages

QUALIFICATIONS

Essential:  Masters of Surgical education or equivalent

EXPERIENCE

Essential: Minimum of 10 years working in surgical simulation-based medical education and proven application of the principles and techniques of simulation-based education to low resource settings.
Desirable:  Published evidence of evaluation and assessment of techniques used in a low resource setting

TECHNICAL SKILLS & KNOWLEDGE

Extensive experience in surgical education in High- and Low- resource settings
Evidence of a high level of evaluation and assessment techniques with educational interventions within a low resource setting
Creation of educational resources that include simulation-based educational methods
Ability to apply simulation-based and other educational techniques to create interactive learning resources that maximise the learner and participant engagement
Ability to create simulation-based and other educational curriculum in both high- and low-resource settings
Research background in educational techniques including data analysis and interpretation
Ability to lead working groups and incorporate feedback into a continual process of refinement and adaptation to individual circumstances

 LANGUAGES

English language; expert level required for reading – writing – speaking

Competencies

Communicating in a credible and effective way
Producing results
Technical Expertise including educational and clinical surgical domains.
Teamwork and collaborative practice
Respecting and Promoting Individual and Cultural Differences

Location

Off-site support will be provided. Duty travel to WHO WPRO will be scheduled as required by the Maternal Child Health and Quality Safety (MCQ) Unit, and to countries when requested by WHO country offices and Ministries of Health.

Travel

The Consultant is expected to travel according to the itinerary and estimated schedule below:
Travel date(s): 2024
Location: Fiji
Purpose: Implementation of the Integrated Clinical Care Pathway 2 Training the trainers / Facilitators Course in country

Additional Information

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