State of Accredited Endovascular Neurosurgery Training in India in 2021: Challenges to Capacity Building in Subspecialty Neurosurgical Care.
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ABSTRACT:
SUBMITTER: Chaganty SS
PROVIDER: S-EPMC8448280 | biostudies-literature | 2021
REPOSITORIES: biostudies-literature
Publications
State of Accredited Endovascular Neurosurgery Training in India in 2021: Challenges to Capacity Building in Subspecialty Neurosurgical Care.
Chaganty Saisunder Shashank SS Ozair Ahmad A Rahman Faique F
Frontiers in surgery 20210831
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Project description:Health workers, especially auxiliary nurse midwives (ANMs), are among the most critical resources in improving the quality of immunization services and reducing vaccine hesitancy under the Universal Immunization Programme (UIP) in India. To improve health worker immunization skills, UIP trainings in India are primarily conducted through instructor-led classroom, cascade trainings. However, a 2018 capacity-building need assessment revealed several challenges involved in traditional classroom training, such as a single-time exposure to new guidelines, complicated logistics arrangements, a lack of refresher training, and varying quality of training. These complexities make it difficult to meet the timely knowledge and skill needs of every health worker effectively and uniformly in a rapidly changing scenario of UIP. To meet health worker capacity-building needs and address these challenges, Rapid Immunization Skill Enhancement (RISE), a learning management system (LMS) application, was conceptualized. The RISE LMS application was developed as a human-centered, interactive, continuous, and adaptable knowledge and skill-building platform for health workers engaged in the UIP. RISE complements existing classroom-based cascade training for health workers by leveraging digital technologies for faster, easier, and more effective knowledge transfer to accommodate the fast-changing needs of a dynamic health program like UIP. In this article, we share the challenges and strategic solutions to digital training applications, lessons learned, sustainability of the application, and the impact RISE has made in India, all of which stemmed from leadership, coordinated efforts from a team of skilled professionals, government acceptance, detailed planning, and continued stakeholder engagement.
| S-EPMC11216696 | biostudies-literature
Project description:Tackling global health challenges demands the appropriate use of available technologies. Although digital health could significantly improve health care access, use, quality, and outcomes, realizing this possibility requires personnel trained in digital health. There is growing evidence of the benefits of digital health for improving the performance of health systems and outcomes in developed countries. However, significant gaps remain in resource-constrained settings. Technological and socio-cultural disparities between different regions or between provinces within the same country are prevalent. Rural areas, where the promise and need are highest, are particularly deprived. In Latin America, there is an unmet need for training and building the capacity of professionals in digital health. This viewpoint paper aims to present a selection of experiences in building digital health capacity in Latin America to illustrate a series of challenges and opportunities for strengthening digital health training programs in resource-constrained environments. These describe how a successful digital health ecosystem for Latin America requires culturally relevant and collaborative research and training programs in digital health. These programs should be responsive to the needs of all relevant regional stakeholders, including government agencies, non-governmental organizations, industry, academic or research entities, professional societies, and communities. This paper highlights the role that collaborative partnerships can play in sharing resources, experiences, and lessons learned between countries to optimize training and research opportunities in Latin America.
| S-EPMC6939247 | biostudies-literature
Project description:IntroductionOpportunities for in-country neurosurgical training are severely limited in LMICs, particularly due to rigorous educational requirements and prohibitive upfront costs.Research questionThis study aims to evaluate financial barriers aspiring neurosurgeons face in accessing and completing neurosurgical training, specifically in LMICs, in order to determine the barriers to equitable access to training.Material and methodsIn order to assess the financial costs of accessing and completing neurosurgery residency, an electronic survey was administered to those with the most recent experience with the process: aspiring neurosurgeons, neurosurgical trainees, and recent neurosurgery graduates. We attempted to include a broad representation of World Health Organization (WHO) geographic regions and World Bank income classifications in order to determine differences among regions and countries of different income levels.ResultsOur survey resulted in 198 unique responses (response rate 31.3%), of which 83% (n = 165) were from LMICs. Cost data were reported for 48 individual countries, of which 26.2% were reported to require trainees to pay for their neurosurgical training. Payment amounts varied amongst countries, with multiple countries having costs that surpassed their annual gross national income as defined by the World Bank.Discussion and conclusionsOpportunities for formal neurosurgical training are severely limited, especially in LMICs. Cost is an important barrier that can not only limit the capacity to train neurosurgeons but can also perpetuate inequitable access to training. Additional investment by governments and other stakeholders can help develop a sufficient workforce and reduce inequality for the next generation of neurosurgeons worldwide.
| S-EPMC9562254 | biostudies-literature
Project description:PurposeChat generative pre-trained transformer (GPT) is a novel large pre-trained natural language processing software that can enable scientific writing amongst a litany of other features. Given this, there is a growing interest in exploring the use of ChatGPT models as a modality to facilitate/assist in the provision of clinical care.MethodsWe investigated the time taken for the composition of neurosurgical discharge summaries and operative reports at a major University hospital. In so doing, we compared currently employed speech recognition software (i.e., SpeaKING) vs novel ChatGPT for three distinct neurosurgical diseases: chronic subdural hematoma, spinal decompression, and craniotomy. Furthermore, factual correctness was analyzed for the abovementioned diseases.ResultsThe composition of neurosurgical discharge summaries and operative reports with the assistance of ChatGPT leads to a statistically significant time reduction across all three diseases/report types: p < 0.001 for chronic subdural hematoma, p < 0.001 for decompression of spinal stenosis, and p < 0.001 for craniotomy and tumor resection. However, despite a high degree of factual correctness, the preparation of a surgical report for craniotomy proved to be significantly lower (p = 0.002).ConclusionChatGPT assisted in the writing of discharge summaries and operative reports as evidenced by an impressive reduction in time spent as compared to standard speech recognition software. While promising, the optimal use cases and ethics of AI-generated medical writing remain to be fully elucidated and must be further explored in future studies.
| S-EPMC10817836 | biostudies-literature
Project description:Building capacity for Health Policy and Systems Research (HPSR) is critical for advancing the field in lower- and middle-income countries (LMICs). The India HPSR fellowship program is a home-grown capacity-building initiative, anchored at the Health Systems Transformation Platform (HSTP), New Delhi, and developed in collaboration with a network of institutes in India and abroad. In this practice-oriented commentary, we provide an overview of the fellowship program and critically reflect upon the learnings from working with three cohorts of fellows between 2020 and 2023. This commentary draws on routine program documentation (guidelines, faculty meeting reports, minutes of meetings of curricula and course development) as well as the perspectives of faculty and program managers associated with the fellowship. We have had several important learnings in the initial years of program implementation. One, it is important to iteratively modify globally available curricula and pedagogies on HPSR to suit country-specific requirements and include a strong component of 'unlearning' in such fellowships. Secondly, the goals of such fellowship programs need to be designed with country-specific contextual realities in mind. For instance, should publication of fellows' work be an intended goal, then contextual deterrents to publication such as article processing fees, language barriers and work-related obligations of faculty and participants need to be addressed. Furthermore, to improve the policy translation of fellows' work, such programs need to make broader efforts to strengthen research-policy-practice interfaces. Lastly, fellowship programs are cost-intensive, and outputs from them, such as papers or policy translation, are less immediate and less visible to donors. In the absence of these outputs, consistent funding can be a roadblock to sustaining these fellowships in LMICs. The experience of our fellowship program suggests that LMIC-led capacity-building initiatives on HPSR have the potential to influence changes in health systems and build the capacity of researchers to generate evidence for policy-making. The sharing of resources and teaching material through the fellowship can enable learning for all institutions involved. Furthermore, such initiatives can serve as a launchpad for the creation of regional and international HPSR communities of practice, with a focus on LMICs, thereby challenging epistemic injustice in teaching and learning HPSR.
| S-EPMC11411990 | biostudies-literature
Project description:Impact of E-waste on Mother Nature, humans and animals-
| PRJNA221773 | ENA
Project description: Not available
| S-EPMC6513627 | biostudies-literature
Project description:BackgroundMany health sciences librarians are noticing an increase in demand for systematic review support. Developing a strategic approach to supporting systematic review activities can address commonly reported barriers and challenges including time factors, methodological issues, and supporting student-led projects.Case presentationThis case report describes how a health sciences library at a mid-sized university developed and implemented a structured and defined systematic review service in order to build capacity for increased librarian support and to maximize librarians' time and expertise. The process also revealed underlying collaboration challenges related to student-led systematic reviews and research quality concerns that needed to be addressed. The steps for developing a formal service included defining the librarian's role and a library service model, building librarian expertise, developing documentation to guide librarians and patrons, piloting and revising the service model, marketing and promoting the service, and evaluating service usage.ConclusionsThe two-tiered service model developed for advisory consultation and collaboration provides a framework for supporting systematic review activities that other libraries can adapt to meet their own needs. Librarian autonomy in deciding whether to collaborate on reviews based on defined and explicit considerations was crucial for maximizing librarians' time and expertise and for promoting higher quality research. Monitoring service usage will be imperative for managing existing and future librarian workload. These data and tracking of research outputs from librarian collaborations may also be used to advocate for new librarian positions.
| S-EPMC6579587 | biostudies-literature
Project description:Performance of local health services managers at district level is crucial to ensure that health services are of good quality and cater to the health needs of the population in the area. In many low- and middle-income countries, health services managers are poorly equipped with public health management capacities needed for planning and managing their local health system. In the south Indian Tumkur district, a consortium of five non-governmental organizations partnered with the state government to organize a capacity-building program for health managers. The program consisted of a mix of periodic contact classes, mentoring and assignments and was spread over 30 months. In this paper, we develop a theoretical framework in the form of a refined program theory to understand how such a capacity-building program could bring about organizational change. A well-formulated program theory enables an understanding of how interventions could bring about improvements and an evaluation of the intervention. In the refined program theory of the intervention, we identified various factors at individual, institutional, and environmental levels that could interact with the hypothesized mechanisms of organizational change, such as staff's perceived self-efficacy and commitment to their organizations. Based on this program theory, we formulated context-mechanism-outcome configurations that can be used to evaluate the intervention and, more specifically, to understand what worked, for whom and under what conditions. We discuss the application of program theory development in conducting a realist evaluation. Realist evaluation embraces principles of systems thinking by providing a method for understanding how elements of the system interact with one another in producing a given outcome.
| S-EPMC4110717 | biostudies-literature
Project description:IntroductionThe Muhimbili Orthopaedic Institute in collaboration with Weill Cornell Medicine organises an annual neurosurgery training course in Dar es Salaam, Tanzania. The course teaches theory and practical skills in neurotrauma, neurosurgery, and neurointensive care to attendees from across Tanzania and East Africa. This is the only neurosurgical course in Tanzania, where there are few neurosurgeons and limited access to neurosurgical care and equipment.Research questionTo investigate the change in self-reported knowledge and confidence in neurosurgical topics amongst the 2022 course attendees.Material and methodsCourse participants completed pre and post course questionnaires about their background and self-rated their knowledge and confidence in neurosurgical topics on a five point scale from one (poor) to five (excellent). Responses after the course were compared with those before the course.ResultsFour hundred and seventy participants registered for the course, of whom 395(84%) practiced in Tanzania. Experience ranged from students and newly qualified professionals to nurses with more than 10 years of experience and specialist doctors. Both doctors and nurses reported improved knowledge and confidence across all neurosurgical topics following the course. Topics with lower self-ratings prior to the course showed greater improvement. These included neurovascular, neuro-oncology, and minimally invasive spine surgery topics. Suggestions for improvement were mostly related to logistics and course delivery rather than content.Discussion and conclusionThe course reached a wide range of health care professionals in the region and improved neurosurgical knowledge, which should benefit patient care in this underserved region.
| S-EPMC10293233 | biostudies-literature