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J Surg Educ. 2017 Aug 29. pii: S1931-7204(16)30377-4. doi: 10.1016/j.jsurg.2017.06.007. [Epub ahead of print]

A Self-Reported Needs Assessment Survey of Pediatric Orthopaedic Education in Haiti.

Author information

1
Department of Orthopaedic Surgery, Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, Massachusetts; Department of Orthopaedic Surgery, Policy and Innovation Evaluation in Orthopaedic Treatments (PIVOT) Center, Brigham and Women's Hospital, Boston, Massachusetts; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts; Harvard Combined Orthopaedic Residency Program, Harvard University, Boston, Massachusetts; Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Electronic address: rqudsi@partners.org.
2
Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California.
3
Harvard Combined Orthopaedic Residency Program, Harvard University, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
4
Department of Orthopaedic Surgery, Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, Massachusetts; Department of Orthopaedic Surgery, Policy and Innovation Evaluation in Orthopaedic Treatments (PIVOT) Center, Brigham and Women's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts.
5
Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts.
6
Department of Orthopaedic Surgery, Adventist Hospital, Diquini, Haiti.
7
Harvard Medical School, Boston, Massachusetts; Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.

Abstract

OBJECTIVE:

The burden of musculoskeletal disease remains high in low-income countries, with a high rate of pediatric disease. Efforts continue for orthopedic education, but there is little guidance on local needs and desires. Our aim was to determine the specific content and modalities that would be most useful for pediatric orthopedic educational programs abroad, and we demonstrate a practical method of identifying country-specific educational deficits through a self-reported needs survey in Haiti.

DESIGN:

A cross-sectional survey was administered using an automated response system. We obtained demographic information as well as training and practice patterns, comfort levels with pediatric diagnoses, and desired topics for education using a 5-point Likert Scale.

SETTING:

Haitian Annual Assembly for Orthopaedic Trauma (HAAOT), the only national, continuing medical education conference for orthopedic providers in Haiti.

PARTICIPANTS:

Of 60 eligible participants, 51 were included in the final analysis.

RESULTS:

Time spent on pediatric orthopedics varied widely, centered at 10% to 25%. Median comfort level with pediatric orthopedics was 3 of 5. Skills with lowest self-reported competence included spica casting, clubfoot casting, and management of supracondylar humerus fractures. Skills with highest self-reported competence were long-leg casting and Salter-Harris classification. Modes of education highly requested included didactics/lectures, hands-on sessions, dedicated rotations, and exchanges with foreign peers/mentors. Diagnoses most encountered were osteomyelitis, trauma, and clubfoot; lowest comfort levels were in neuromuscular, spine, lower extremity deformity, congenital hip, and clubfoot; and most requested for future teaching were congenital hip, neuromuscular, and spine.

CONCLUSIONS:

Haitian orthopedic providers express a strong desire and need for ongoing pediatric orthopedic education. They describe a high prevalence of trauma and infection, but convey a requirement for more comprehensive, multimodal teaching that also includes congenital deformities/dysplasias, neuromuscular, and spine. Our results demonstrate the importance of assessing country-specific needs and involving local care providers in curriculum development.

KEYWORDS:

Haiti; Medical Knowledge; Practice Based Learning and Improvement; Systems Based Practice; developing country; needs assessment; pediatric orthopedics; surgical education

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