Evaluation of an online journal club–style course on evidence-based surgery for trainees of the College of Surgeons of East, Central and Southern Africa
Bibliographic record
Abstract
Background Evidence-based surgical practice is key to optimizing patient care. Surgeons need critical appraisal skills to apply the best evidence, so formal training in evidence-based surgery (EBS) is increasingly a part of postgraduate surgical education. Surgeons in Africa must apply research to their unique patient populations, local practices, and limited healthcare resources. To meet this need, partners in Canada and the United Kingdom collaborated with the College of Surgeons of East, Central and Southern Africa (COSECSA) to offer the Surgery in Africa Journal Club (SIAJC) as an online course for COSECSA trainees. We evaluated the participation, satisfaction, and knowledge gained by SIAJC participants over its initial 2 years. Methods Knowledge was measured by comparing precourse with postcourse test scores using validated multiple-choice questions. Scores were compared using a paired-samples t-test. Trainees gave anonymous feedback on the course, and responses were grouped into themes and analysed. Results After exclusions, there were 282 postgraduate surgical trainees who completed the SIAJC precourse test in 2015 and 2016. Postcourse tests were completed by 95 of these 282 trainees (33.7%). EBS knowledge increased significantly, with a mean postcourse test score of 20±5.28 out of 30, vs 15±3.62 out of 30 on the precourse test (t=−10.1, df=110, P<0.001). Trainees reported enthusiasm for the course, improved knowledge of best practices, empowerment to make better clinical decisions, and concerns that EBS would be expensive or conflict with local expert opinion. For some participants, poor Internet access was a barrier to accessing course materials. Conclusions The SIAJC effectively taught EBS-related material, but the course had a high attrition rate and has been difficult to sustain because of its dependence on external faculty. A blended model using course materials for local face-to-face journal clubs led by local EBS champions may be the best long-term model to improve EBS skills and practice in the COSECSA region.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".