Teaching and Practicing Congenital Hand Surgery in Cambodia - Lessons Learnt.

Abstract

The global burden of surgical conditions is becoming increasingly prevalent in the developing world. Hand surgery, in particular congenital hand surgery, presents with its own challenges, particularly the unique skill sets needed, multidisciplinary nature and heterogeneity of cases. The aim of this review article is to present our experience of practising congenital hand surgery in Cambodia, and to explore the feasibility of teaching this specialty in developing countries within a meaningful and sustainable framework. Since 2013, a group of hand surgeons and therapists have visited the Children Surgical Centre in Cambodia. A community-oriented curriculum was developed following the initial visits, with analysis of data and local surgeon's skill sets. These were further refined using the Pareto analysis and selected competency procedures to develop entrustable professional activities (EPAs). Common paediatric hand cases were identified and taught to the local surgeons. Essential elements of this model include the need for measurable outcomes, clear curriculum goals, long-term partnerships and information technology support.