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Implementation of a Smartphone-Based Platform for Operative Feedback at Tenwek Hospital in Kenya: A Mixed Methods Study

  • Surgery in Low and Middle Income Countries
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

The SIMPL operative feedback tool is used in many U.S. surgical residency programs. However, the challenges of implementation and benefits of the web-based platform in low- and middle-income countries are unknown. The aim of this study was to evaluate implementation of SIMPL in a general surgery residency training program in Kenya.

Methods

SIMPL was pilot tested at Tenwek Hospital from January through December 2021. Participant perspectives of SIMPL were elicited through a survey and semi-structured interviews. Descriptive statistics were used to analyze survey data. Inductive qualitative content analysis of interview responses was performed by two independent researchers.

Results

Fourteen residents and six faculty (100% response rate) were included in the study and completed over 600 operative assessments. All respondents reported numerical evaluations and dictated feedback were useful. Respondents felt that SIMPL was easy to use, improved quality and frequency of feedback, helped refine surgical skills, and increased resident autonomy. Barriers to use included participants forgetting to complete evaluations, junior residents not submitting evaluations when minimally involved in cases, and technological challenges. Suggestions for improvement included expansion of SIMPL to surgical subspecialties and allowing senior residents to provide feedback to juniors. All respondents wanted to continue using SIMPL, and 90% recommended use at other programs.

Conclusion

Residents and faculty at Tenwek Hospital believed SIMPL were a positive addition to their training program. There were a few barriers to use and suggestions for improvement specific to the training environment in Kenya, but this study demonstrates it is feasible to use SIMPL in settings outside the U.S. with the appropriate resources.

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Acknowledgements

We would like to thank the participants in the study, including the residents and faculty of the general surgery department at Tenwek Hospital.

Funding

Serena S. Bidwell was supported by a grant from the National Institutes of Health during this study (T-35 Short Term Biomedical Research Training Program).

Author information

Authors and Affiliations

  1. University of Michigan Medical School, 1301 Catherine Street, 3960 Preserve Drive, Dexter, Ann Arbor, MI, 48130, USA

    Serena S. Bidwell

  2. Department of Surgery, Center for Surgical Training and Research, University of Michigan, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, USA

    Rebecca Gates & Brian C. George

  3. Department of General Surgery and Endoscopy, Tenwek Hospital, 39 Bomet, Bomet, Kenya

    Michael M. Mwachiro, Andrea S. Parker, Kimutai Sylvester & Robert K. Parker

  4. Department of Surgery, University of Michigan, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, USA

    Gurjit Sandhu & Grace J. Kim

Authors
  1. Serena S. Bidwell
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  2. Rebecca Gates
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  3. Michael M. Mwachiro
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  4. Andrea S. Parker
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  5. Kimutai Sylvester
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  6. Gurjit Sandhu
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  7. Brian C. George
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  8. Grace J. Kim
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  9. Robert K. Parker
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Corresponding author

Correspondence to Serena S. Bidwell.

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Conflict of interest

None. On behalf of all authors, the corresponding author states that there are no conflicts of interest.

Human rights

This study was approved by the Tenwek Hospital Institutional Scientific and Ethical Review Committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Bidwell, S.S., Gates, R., Mwachiro, M.M. et al. Implementation of a Smartphone-Based Platform for Operative Feedback at Tenwek Hospital in Kenya: A Mixed Methods Study. World J Surg 47, 2617–2625 (2023). https://doi.org/10.1007/s00268-023-07160-9

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  • DOI: https://doi.org/10.1007/s00268-023-07160-9

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