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Head and Neck Surgery

Virtual Surgical Education in Kenya: Augmenting an International Capacity-Building Trip

Tuesday, October 3, 2023
10:03 AM - 10:09 AM East Coast USA Time
Location: 201AB

    Presenting Author(s)

  • Megan E. McLeod, MD, MSc

    Resident Physician
    Vanderbilt University Medical Center
    Nashville, TN, United States

    • Co-Author(s)

  • Madelyn N. Stevens, MD

    Head and Neck Fellow
    Medical University of South Carolina
    Charleston, SC, United States

  • KY

    Kristen L. Yancey, MD

    Assistant Professor
    Weill Cornell Medical Center
    New York, NY, United States

  • Mallory G. McKeon, MD

    Resident
    University of Cincinnati
    Cincinnati, OH, United States

  • KM

    Kyle Mannion, MD

    Associate Professor
    Vanderbilt University Medical Center
    nashville, Tennessee, USA

  • Robert J. Sinard, MD

    Professor of Otolaryngology - Head and Neck Surgery
    Vanderbilt University Medical Center
    Nashville, TN, United States

    • Senior Author(s)

  • James l. Netterville, MD

    Professor of Head and Neck Oncology, Director of Head and Neck Oncologic Services
    Vanderbilt University Medical Center
    Nashville, TN, USA

Disclosure(s):
Megan E. McLeod, MD, MSc: No relevant relationships to disclose.
Introduction: Low- and middle-income (LMIC) countries face a substantial burden of head and neck diseases and a need for more local well-trained otolaryngologists. Our research aims to investigate the current surgical landscape and whether virtual education can augment capacity building.

Methods: A needs assessment of Kenyan otolaryngology residents performed in 2021 identified a desire for additional educational resources. Short, recorded lectures and narrated surgical videos were produced by expert head and neck surgeons. These resources were provided to Kenyan otolaryngologists in October 2022; otolaryngologists from Rwanda and Uganda were invited to participate in January 2023. A pre- and post- knowledge test and confidence assessment of surgical steps were administered to assess efficacy.

Results: Six Kenyan otolaryngologists (4 residents [median 4 years of training, IQR 3.25-4.75 years], 2 attendings) completed the pre-resource surveys and viewed the lectures and videos. Residents reported assisting in fewer than one thyroidectomy, parotidectomy, and neck dissection (ND) each per month and were the primary surgeon even less frequently (1-3 per year).

All were confident that they could independently plan and make the incision. Most were also confident independently achieving initial exposure (thyroid – 100%, parotid – 100%, ND – 75%), but all required more supervision for other operative steps. None were confident performing a thyroidectomy or ND, either independently or with direct observation. One participant was comfortable performing a parotidectomy with direct observation. Median pre-resource knowledge scores were: thyroid 87.5% (IQR 84-91%), parotid 60% (55-65%), ND 66.7% (55.6-77.8%).

Further data collection is ongoing and resource efficacy measures will be reported once data collection is complete.

Conclusions: There is a need for capacity building in LMIC settings and pre-liminary data has confirmed a lack of knowledge and confidence. These materials may help prepare attendees to get the most from hands-on training and allow for continued study from level- and resource-appropriate information.