The 2023 Austrian-Swiss-German Fellowship.

ABSTRACT: The Austrian-Swiss-German Fellowship was set up in 1978 to facilitate a program through which surgeons from the German-speaking countries of Austria, Switzerland, and Germany could visit the United Kingdom, Canada, and the United States of America. In 2023, surgeons Brian Mullis and Satish Kutty, representing the American Orthopaedic Association and the British Orthopaedic Association, respectively, visited centers in Austria, Switzerland, and Germany over the course of 4 weeks. This article describes their journey and experiences.

Visibility of International Rotations on Plastic Surgery Program Websites.

Plastic surgery residency programs are offering increasing opportunities for international rotations, recognizing the importance of early exposure and the need to promote better capacity building in host countries. While a greater number of residency programs are offering international opportunities, it is not clear whether applicants are aware of these opportunities based on program websites. The purpose of this study was to determine the availability and ease of access to international rotation information on plastic surgery residency websites. All 101 integrated and independent program websites were visited and assessed for information on international rotations. Programs were noted for any information about rotations and ease of access was determined based on the location of information on the website (homepage, 1 or 2 clicks from homepage, and greater than 2 clicks). Approximately 33% of programs offered any information on international rotations on their program websites. Thirty-six percent of these program websites displayed information on their homepage ("Easy"); 30% of these programs displayed their information 1 or 2 clicks away from the homepage ("Moderate"); and 33% of these programs displayed their information greater than 2 clicks away from the homepage ("Difficult"). Previous studies have established that international rotations are widely available to plastic surgery residents, but this study revealed that only a minority of residency programs are advertising this opportunity on their websites. These data may serve to galvanize faculty to increase website visibility of available international rotations to better promote their programs and attract prospective residents who seek opportunities in global health care.

Contribuições da mobilidade acadêmica internacional realizada na austrália para a formação da enfermeira no brasil / Aportes de movilidad académica internacional realizados en australia para la formación de enfermeras en brasil / Contributions of international academic mobility held in australia for the training of nurses in brazil

Objetivo: identificar as contribuições da mobilidade acadêmica internacional, realizada na Austrália, para a formação da enfermeira no Brasil. Método: estudo exploratório com abordagem qualitativa, realizado com oito ex-intercambistas do Programa Ciência sem Fronteiras. A análise foi feita pela proposta do Discurso do Sujeito Coletivo. Resultados: a experiência ofereceu às (ex)intercambistas uma gama de oportunidades e de trocas de experiências para a formação em enfermagem. Foi apontada a rica experiência em cursar disciplinas na Austrália, comparando a metodologia Problem Based Learning com a metodologia tradicional vivenciada no Brasil e destacando seus efeitos positivos. O intercâmbio proporcionou desenvolvimento de habilidades técnico-científicas e interpessoais, vivências de sistemas comparados de saúde, além de aperfeiçoamento das competências linguísticas e de construção de compromisso ético-político-social e perspectivas profissionais futuras. Considerações finais: a mobilidade acadêmica internacional contribuiu positivamente na formação das enfermeiras brasileiras, com evidência de desenvolvimento pessoal e profissional.

Objetivo: identificar las contribuciones de la movilidad académica internacional, realizada en Australia, a la formación de enfermeras en Brasil. Método: estudio exploratorio con enfoque cualitativo, realizado con ocho ex alumnos de intercambio del programa Ciencia sin Fronteras. El análisis se realizó mediante la propuesta del Discurso del Sujeto Colectivo. Resultados: la experiencia ofreció a los estudiantes (ex)de intercambio una gama de oportunidades e intercambio de experiencias para la educación de enfermería. Se señaló la rica experiencia en el estudio de asignaturas en Australia, comparando la metodología de Aprendizaje Basado en Problemas con la metodología tradicional experimentada en Brasil y destacando sus efectos positivos. El intercambio proporcionó el desarrollo de habilidades técnico-científicas e interpersonales, experiencias de comparación de sistemas de salud, además de mejorar las habilidades lingüísticas y construir un compromiso ético-político-social y perspectivas profesionales de futuro. Consideraciones finales: la movilidad académica internacional contribuyó positivamente a la formación de enfermeras brasileñas, con evidencia de desarrollo personal y profesional.

Objective: to identify the contributions of international academic mobility, carried out in Australia, to the training of nurses in Brazil. Method: exploratory study with qualitative approach, conducted with eight former exchange students of the Science Without Borders program. The analysis was made by the proposal of the Collective Subject Discourse. Results: the experience offered (ex)exchange students a range of opportunities and exchange of experiences for nursing education. The rich experience in studying subjects in Australia was pointed out, comparing the Problem Based Learning methodology with the traditional methodology experienced in Brazil and highlighting its positive effects. The exchange provided the development of technical-scientific and interpersonal skills, experiences of comparing health systems, in addition to improving language skills and building an ethical-political-social commitment and future professional perspectives. Final considerations: international academic mobility contributed positively to the training of Brazilian nurses, with evidence of personal and professional development.

An Assessment Tool for Hand Surgical Education Needs and Capacity in Resource-Limited Settings.

BACKGROUND: Hand surgeons have the potential to substantially decrease the surgical disability burden in the developing world through educator trips. The Lancet Commission supports contextually driven educator trips grounded in the needs of local hosts, yet few organizations perform a comprehensive assessment of learning interests or the hosting institutions' surgical capacity before the trips. METHODS: The authors adapted the Personnel, Infrastructure, Procedures, Equipment, and Supplies questionnaire, which was modified from the World Health Organization's validated Tool for Situational Analysis to Assess Emergency and Essential Surgical Care. The authors revised each aspect of the questionnaire to reflect items pertinent to upper extremity surgery and hand trauma care. They added sections to gauge self-identified learning needs, local disease burden, operative resources, and current practices. The tool was distributed by means of Qualtrics; descriptive statistics were used to summarize data. The authors analyzed the data for all participants and performed two subgroup analyses to examine variation by regions and countries. RESULTS: The authors received 338 responses from 27 countries. There was wide variability in local surgical disease burden, learning interests, and skill level of upper extremity procedures. Although learners were most interested in learning tendon transfers and microsurgical techniques, the majority did not have adequate infrastructure at their institution to sustain capacity for microvascular procedures. CONCLUSIONS: Needs assessments can gauge how best to provide education during short-term visiting educator trips and optimize its impact in resource-limited settings. Understanding the needs, learning interests, and availability of resources of local learners is imperative to creating a sustainable global surgical workforce.

Internacionalização e adaptação de graduandas/egressas do curso de enfermagem em mobilidade acadêmica internacional / Internacionalización y adaptación de académicos/egresos de grado en enferméria en movilidad academica internacional / Internationalization and adaptation of undergraduate/graduate students of the nursing course in international academic mobility

Objetivo: Compreender o processo de adaptação e as repercussões da internacionalização para graduandos e egressos do curso de Enfermagem que vivenciaram a mobilidade acadêmica internacional. Método: Estudo qualitativo, realizado por meio de entrevistas semiestruturadas, com oito ex-intercambistas do programa brasileiro Ciência sem Fronteiras, de cursos de enfermagem de Instituições de Educação Superior de diferentes localidades brasileiras. As entrevistas foram realizadas via videoconferência, as quais foram gravadas para posterior transcrição. Os dados foram analisados pela técnica do Discurso do Sujeito Coletivo. Resultados: Emergiram cinco discursos: adaptação na Austrália; apoio ao estudante; estilos de vida e comportamento; diversidade cultural e comparação do sistema de saúde e da enfermagem entre Brasil e Austrália. As diferentes culturas possibilitaram a reflexão sobre o contexto multi e interculturais vivenciados, reforçando seus potenciais para a formação profissional e humana. Conclusão: A experiência com o intercâmbio representou um marco transformador, com impactos na vida pessoal e na formação profissional.(AU)

Objective: To understand the adaptation process and repercussions of internationalization for undergraduate and graduate nursing students who experienced the international academic mobility. Method: This is a qualitative study based on semistructured interviews with eight students who joined the Science without Borders Brazilian Program from Higher Education Institutions from different locations in Brazil. The students were interviewed via videoconference, which were recorded for later transcription. The data were analyzed by means of the Collective Subject Discourse. Results: From the data analysis, five discourses emerged: Adaptation in Australia; Student support; Lifestyles and behavior; Cultural diversity; and Comparison of the health system and nursing between Brazil and Australia. The different cultures made it possible for students to reflect on the multicultural and intercultural contexts experienced, reinforcing their potential for professional and human training. Conclusion: The experience with an exchange program represented a milestone with positive impacts both in personal life and in professional training.(AU)

Objetivo: Comprender el proceso de adaptación y las repercusiones de la internacionalización en la formación profesional de enfermeros, a partir de la percepción de los estudiantes de pregrado y egreso de la carrera de Enfermería que han experimentado la movilidad académica internacional. Método: Estudio cualitativo, realizado a través de entrevistas semiestructuradas, con ocho ex alumnos de intercambio del programa Brasileño Ciencia sin Fronteras de cursos de enfermería en Instituciones de Educación Superior de diferentes lugares de Brasil. Las entrevistas se realizaron mediante videoconferencia, las cuales fueron grabadas para su posterior transcripción. Los datos se analizaron mediante la técnica del Discurso del sujeto Colectivo. Resultados: Del análisis de datos surgieron cinco discursos: adaptación en Australia; apoyo estudiantil; estilos de vida y comportamiento; diversidad cultural; y comparación del sistema de salud y enfermería entre Brasil y Australia. Se hizo evidente que la adaptación de los entrevistados en Australia se vio obstaculizada por el idioma. La poca participación del programa Ciencia sin Fronteras se identificó durante el proceso de adaptación de los estudiantes de intercambio en el país de destino. Las percepciones mostraron que hubo comparaciones entre diferentes culturas durante el período de intercambio, lo que permitió reflexionar sobre el contexto multicultural vivido, reforzando su potencial de formación profesional y humana. Conclusión: La experiencia con el intercambio representó un hito transformador, con impactos positivos en la vida personal y la formación profesional como enfermero.(AU)

Dupla Diplomação na Graduação em Enfermagem: Relato de Experiência no Contexto Brasil e Portugal / Double diplomation in nursing graduation in the brazil and portugal context

Objetivo: descrever a vivência de estudantes de enfermagem em um programa de dupla diplomação entre a Universidade Federal de Santa Catarina - Brasil e a Escola Superior de Enfermagem de Coimbra - Portugal. Método: Relato de experiência de duas acadêmicas de enfermagem do Estado de Santa Catarina, Brasil durante estágio curricular em Coimbra, Portugal. Resultados: O relato é composto pela vivência acadêmica nos diferentes campos de estágio como: clínica médico-cirúrgica, pediatria, saúde da mulher e obstetrícia, atenção à saúde do idoso e atenção básica em saúde. Conclusões: As experiências profissionais e pessoais vividas em Portugal mostraram-se fundamentais para a formação de profissionais confiantes e resilientes, receptivas às diversidades culturais e interessadas pela busca da excelência em enfermagem. (AU)

Objective: To describe the experience of students from Santa Catarina in the dual diploma program in the Undergraduate Nursing Course carried out by agreement between the Federal University of Santa Catarina - Brazil and the Higher Nursing School of Coimbra - Portugal. Methods: Experience report of two nursing students from the State of Santa Catarina, Brazil in the context of Coimbra, Portugal. Results: The report consists of academic experience in different internship fields, such as: medical-surgical clinic, pediatrics, women's health and obstetrics, health care for the elderly and primary health care. Conclusion: The professional and personal experiences lived during this year in Portugal proved to be fundamental to create confident and resilient professionals, receptive to cultural diversity and interested in the pursuit of excellence in nursing. (AU)

Objetivo: Describir la experiencia de los estudiantes de Santa Catarina en el programa de doble diploma en el Curso de Pregrado de Enfermería realizado por acuerdo entre la Universidad Federal de Santa Catarina - Brasil y la Escuela Superior de Enfermería de Coimbra - Portugal. Métodos: Informe de dos estudiantes de enfermería del estado de Santa Catarina, Brasil en el contexto de Coimbra, Portugal. Resultados: El informe consta de la experiencia académica en diferentes campos de prácticas, tales como: clínica médico-quirúrgica, pediatría, salud de la mujer y obstetricia, atención de la salud del anciano y atención primaria de salud. Conclusión: Las experiencias profesionales y personales vividas durante este año en Portugal demostraron ser fundamentales para crear profesionales seguros y resistentes, receptivos a la diversidad cultural e interesados en la búsqueda de la excelencia en enfermería. (AU)

North-South surgical training partnerships: a systematic review.

Background: Fostering the success of surgical trainees from low- and middle-income countries (LMICs) plausibly addresses the existing workforce deficit in a sustainable manner, but it is unclear whether and how these trainees are targeted as strategic learners for educational exchanges. The purpose of this review was to assess the quality and outcomes of existing literature on exchanges of surgical trainees between high-income countries (HICs) and LMICs. Methods: We conducted a systematic review of reported instances of surgical training exchanges between HICs and LMICs. After database searching, 2 independent reviewers evaluated titles, abstracts and manuscripts. Selected studies were critically appraised with the use the Critical Assessment Skills Programme Qualitative Checklist and analyzed for trainee level, institutions, countries and subspecialties, as well as reported outcomes of the exchange. Results: Twenty-eight reports met the inclusion criteria and were analyzed. Most publications (18 [64%]) detailed North-to-South exchanges; 1 exchange was bidirectional. General surgery was the most common discipline identified, with 9 other subspecialties described involving learners at all phases of training. Reports were generally of good quality, although outcomes were reported variably, and most authors failed to acknowledge the ethical implications of their study. Conclusion: The articles identified described a variety of surgical exchanges across disciplines, learner types and host/home countries. Few of the exchanges prioritized the learning of surgical trainees from LMICs. There is an increasing need to formalize these exchanges via clear goals and objectives, as well as to prioritize the proper matching of educational goals with local clinical needs. Level of evidence: V - Evidence from systematic reviews of descriptive and qualitative studies.

Contexte: Le soutien à la réussite des chirurgiens en formation des pays à revenu faible ou moyen (PRFM) pourrait concrètement aider à remédier au manque d'effectifs actuel de façon durable. On ignore toutefois si ces apprenants sont ciblés par les programmes d'échanges en tant que candidats stratégiques et quelles sont les méthodes de recrutement employées. La présente revue vise à évaluer la qualité et les résultats des publications sur les échanges entre pays à revenu élevé (PRE) et PRFM auxquels participent des chirurgiens en formation. Méthodes: Nous avons procédé à une revue systématique des cas rapportés d'échanges étudiants en chirurgie entre PRE et PRFM. Après une recherche dans les bases de données, 2 évaluateurs indépendants ont passé en revue les titres, les résumés et les manuscrits retenus. Les études sélectionnées ont fait l'objet d'une évaluation critique d'après la liste de contrôle pour la recherche qualitative CASP (Critical Assessment Skills Programme Qualitative Checklist); les critères d'analyse comprenaient le niveau de scolarité des apprenants, les établissements, les pays et les surspécialités, ainsi que les résultats rapportés pour l'échange. Résultats: Au total, 28 rapports répondaient aux critères d'inclusion et ont donc été analysés. La plupart d'entre eux (18 [64%]) traitaient d'échanges du nord au sud; un échange était bidirectionnel. La chirurgie générale était la discipline la plus souvent recensée; on a aussi décrit la participation d'apprenants à différentes étapes de leur formation pour 9 autres surspécialités. Les rapports étaient en général de bonne qualité, mais la présentation des résultats variait, et la majorité des auteurs ont omis de rendre compte des considérations éthiques de leur étude. Conclusion: Les articles évalués décrivaient des échanges étudiants en chirurgie se rapportant à une multitude de disciplines, de types d'apprenants et de pays d'origine et d'accueil. Peu de programmes d'échanges priorisaient l'apprentissage des chirurgiens en formation issus des PRFM. Il est de plus en plus pressant de baliser les échanges étudiants en établissant des buts et des objectifs clairs, et de faire une priorité de la juste correspondance des objectifs pédagogiques et des besoins cliniques locaux. Niveau de preuve: V ­ Preuve issue de revues systématiques d'études descriptives et qualitatives.

Acute care surgery, trauma and disaster relief: a clinical exchange between the University of British Columbia and the Mexican Red Cross.

Background: Our objective was to establish a sustainable educational partnership and clinical exchange between the trauma services at Vancouver General Hospital (VGH) and the Mexican Red Cross hospital in Mexico City (Hospital Central de la Cruz Roja [HCCR] Polanco). Methods: In 2017, a general surgery resident in postgraduate year 4 travelled from VGH to HCCR Polanco for the initial exchange, followed by a trauma fellow. The surgical case volumes in a month at VGH and a month at HCCR Polanco were compared. At the end of the exchange, a 36-item Likert style questionnaire was administered to the Mexican surgeons and residents who interacted with the Canadian resident and fellow during the exchange. Results: The most commonly performed procedures on the VGH acute care surgery service were laparoscopic cholecystectomy (35%) and laparoscopic appendectomy (17%). The most commonly performed procedures on the VGH trauma service were chest tube insertions (24%) and tracheostomies (24%). The most commonly performed procedures at HCCR Polanco were surgery for penetrating abdominal trauma (19%) and extremity trauma (13%). The survey results indicated that the costs of travel and accommodation were obstacles to future exchanges. All survey respondents wanted to continue collaborating with Canadians on clinical and research endeavours, felt that hosting Canadian residents was a valuable experience and felt that visiting VGH would also be valuable. Conclusion: Canadian surgical trainees gained valuable exposure to operative trauma during the exchange. The mix of operations performed at VGH and HCCR Polanco was vastly different; therefore, the exchange broadened the trainees' surgical experience. There was a unanimously positive response to the exchange among the Mexican survey respondents. This exchange is part of a long-term collaboration between our surgical centres.

Contexte: Notre objectif était d'établir un partenariat pédagogique et un échange clinique durables entre les services de traumatologie de l'Hôpital général de Vancouver (VGH) et de l'hôpital de la Croix-Rouge mexicaine à Mexico (Hospital Central de la Cruz Roja [HCCR] Polanco). Méthodes: En 2017, un résident R4 en chirurgie générale du VGH s'est rendu au HCCR Polanco pour l'échange inaugural; un fellow en traumatologie l'a suivi peu après. Les volumes de cas de chirurgie par mois dans les 2 hôpitaux ont été comparés. À la fin de l'échange, les chirurgiens et les résidents mexicains qui ont interagi avec le résident et le fellow canadiens ont répondu à un questionnaire en 36 points s'apparentant à l'échelle de Likert. Résultats: Les interventions les plus fréquemment effectuées au service chirurgical d'urgence du VGH étaient la cholécystectomie laparoscopique (35 %) et l'appendicectomie laparoscopique (17 %); au service de traumatologie, les plus fréquentes étaient l'insertion d'un drain thoracique (24 %) et la trachéotomie (24 %). Au HCCR Polanco, les interventions chirurgicales les plus courantes étaient la chirurgie pour un traumatisme abdominal pénétrant (19 %) et un traumatisme aux extrémités (13 %). Les résultats du questionnaire suggèrent que les coûts associés aux déplacements et à l'hébergement seraient un obstacle pour les échanges futurs. Cela dit, tous les répondants ont dit vouloir poursuivre leur collaboration avec les Canadiens dans des projets cliniques et de recherche, considérer que l'accueil de résidents canadiens était une expérience profitable et qu'ils gagneraient à se rendre eux-mêmes au VGH. Conclusion: Durant l'échange, les chirurgiens en formation canadiens ont reçu une exposition précieuse à la chirurgie traumatologique. Puisque la nature et la fréquence relative des opérations effectuées au VGH étaient très différentes de celles observées au HCCR Polanco, l'échange a contribué à diversifier l'expérience chirurgicale des apprenants. Tous les répondants mexicains au questionnaire avaient une expérience positive de l'échange. Le programme fait partie d'une collaboration à long terme entre les 2 centres chirurgicaux.

Global Surgery Electives: A Strategy to Improve Care to Domestic Underserved Populations?

BACKGROUND: In the United States, a shortage of general surgeons exists, primarily in rural, poor, and minority communities. Identification of strategies that increase resident interest in underserved regions provides valuable information in understanding and addressing this shortage. In particular, surgical experience abroad exposes residents to practice in low-resource and rural settings. As residency programs increasingly offer global surgery electives, we explore whether the presence of an international surgical rotation affects graduates' future practice patterns in underserved communities domestically. METHODS: We surveyed general surgery residency graduates at a single academic institution. Those who finished general surgery residency from 2001 to 2018 were included. Participant demographics, current practice demographics, and perceptions related to global surgery and underserved populations were collected. Respondents were stratified based on whether they did ("after") or did not ("before") have the opportunity to participate in the Kijabe rotation (started in 2011), defined by graduation year. RESULTS: Out of 119 eligible program graduates, 64 (53.7%) completed the survey, and 33 (51.6%) of the respondents graduated following the implementation of the Kijabe rotation. Two participants defined their primary current practice location as international. Fifteen (45.5%) in the "After" group indicated an interest in working with underserved populations following residency, compared to 5 (17.8%) of the "Before" group (P = 0.074). Furthermore, 20 (60.6%) respondents in the "After" group expressed interest in working with underserved populations even if it meant making less money. In the "Before" group, only 13 (46.4%) responded similarly (P = 0.268). Eleven (9.2%) residents rotated at Kijabe. Those who participated in the Kijabe rotation reported an uninsured rate of 36.7% for their current patient population, compared to rate of 13.9% in those who did not rotate there (P = 0.22). CONCLUSIONS: At a single institution, our results suggest that participation in an international surgical rotation in a resource-constrained setting may be associated with increased care for underserved populations in future clinical practice. These results could be due to self-selection of residents who prioritize global surgery as part of their residency experience, or due to increased exposure to underserved patients through global surgery.

The 2019 Austrian-Swiss-German Traveling Fellowship.

The Austrian-Swiss-German (ASG) Traveling Fellowship was established over 40 years ago as an annual exchange program between the English-speaking countries of the United States, Great Britain, and Canada and the German-speaking countries of Austria, Germany, and Switzerland. In 2019, 4 German-speaking consultant orthopaedic surgeons represented their national societies in this unique and prestigious fellowship program: Karlmeinrad Giesinger from the St. Gallen Hospital, sponsored by the Swiss Society of Orthopaedics and Traumatology; Boris Michael Holzapfel from the Julius-Maximilians University in Wuerzburg, and Georgi Wassilew from the Greifswald Medical University, both sponsored by the German Society for Orthopaedics and Traumatology; and Martin Thaler from the Medical University of Innsbruck, sponsored by the Austrian Orthopaedic Association. This article describes the 2019 ASG Traveling Fellowship.

Clinical Observership Opportunities in North America for International Orthopaedic Surgeons.

BACKGROUND: Although efforts have been made to address the inequities of surgical care globally, to our knowledge, there has been no comprehensive analysis of orthopaedic clinical observerships in North America that are available for international surgeons. METHODS: Two investigators performed a systematic online search to identify orthopaedic clinical observerships that are available in the United States and Canada for international surgeons. Variables such as host type, geographic location of host site, program type, eligibility criteria, subspecialty focus, application and participation fees, availability of funding, duration of observership, and the quality of online information that is available based on an online content (OC) score were collected. RESULTS: Of the 113 available observership sponsors in North America, 36 (32%) were professional-society-based, 69 (61%) were academic/institution-based, and 8 (7%) were private-practice-based. Most observerships were located in the U.S. (n = 85) and, of these, the Northeast was the most common U.S. region (n = 29, p = 0.008). Of the observerships with a focus, pediatrics was the most frequent orthopaedic subspecialty (p < 0.0001), followed by spine and trauma. Professional-society-sponsored observerships offered funding to international surgeons more often than academic/institution-based and privately sponsored programs (p < 0.0001). The average OC score for the entire cohort was 2.35 and was similar among the 3 host types (p = 0.954). The program structure and requirements such as applicant eligibility, application and participation fees, and duration of observership varied widely. CONCLUSIONS: There are opportunities for international orthopaedic surgeons to participate in clinical observerships in North America. Given the greater funding support and lack of fees for professional-society-sponsored observerships, these observerships may pose fewer financial barriers for surgeons from low and middle-income countries (LMICs). The quality of online information was similar among the 3 different host types and can be improved. CLINICAL RELEVANCE: The relevance and impact of a clinical observership experience in North America for a practicing orthopaedic surgeon from an LMIC need to be explored further.

Brief report: Global health initiatives and breast oncology capacity-building in Africa.

INTRODUCTION: Global health initiatives provide exciting opportunities for capacity-building in low- and middle-income countries but data regarding how African clinicians characterize the most effective partnerships are lacking. METHODS: We surveyed attendees at two "Breast Cancer in Africa" symposia sponsored through a surgeon-led global breast cancer research collaborative. Respondents ranked their preferences for needs from American global health partnerships. RESULTS: 399 African attendees responded (170 at the 2017 Ghana conference; 229 at the 2018 Ethiopia conference). Physicians comprised 41.1% of respondents; nurses 20.1% and medical students 27.6%. Ancillary hospital staff comprised the remaining 11.2%. Among clinicians, 75.7% ranked educational/training programs or donation of medical supplies as the highest-priority needs compared to only 20.4% ranking direct monetary support as the highest-priority need (P < 0.0001). CONCLUSIONS: Our survey study found that African clinicians prioritize training programs and donation of medical/hospital supplies above direct monetary support as their highest-value needs from global health initiatives.

Collaboration in Outreach: The Kumasi, Ghana, Model.

Hand surgery does not have to be expensive. Substituting evidence-based field sterility for main operating room sterility and using wide-awake, local anesthesia, no tourniquet (WALANT) surgery instead of sedation makes hand surgery much more affordable worldwide. This article explains how North Americans collaborated with Ghanaian hand surgeons and therapists to establish more affordable hand care in Kumasi. It describes how multiple nonprofit organizations collaborate to create trans-Atlantic Webinars and a reverse fellowship program to share hand surgery and therapy knowledge between North American and Ghanaian hand care providers.

Global Hand Surgery: Initiatives that Work (The Touching Hands Project): Why, When, and How!

The Touching Hands Project was initiated as part of the American Society for Surgery of the Hand (ASSH) outreach effort in 2014. The project has expanded rapidly and has become a pillar along with education, research, clinical practice (patient care), and organizational excellence. This article explains the background behind The Touching Hands Project that leads to a groundswell of support for ASSH's commitment to outreach from the leadership, membership, and corporate members. The Touching Hands Project in collaboration with organizations with similar missions has greatly expanded hand care across the globe by focusing on education, patient care, surgery, and rehabilitation.

Intercâmbio Acadêmico Internacional na Pós-Graduação em Enfermagem: Relato de Experiência / International Academic Exchange in Nursing Graduate Studies: Experience Report

Objetivo: descrever a experiência discente acerca da mobilidade internacional acadêmica em um programa de intercâmbio em Havana - Cuba, na área de pós-graduação em enfermagem. Método: relato de experiência acerca das vivências acadêmicas e pessoais, decorridas durante as atividades realizadas no intercâmbio acadêmico entra Brasil e Cuba entre setembro e outubro de 2018. Resultados: a experiência possibilitou a aquisição de conhecimentos científicos ampliados à enfermagem no âmbito da pós-graduação e a formação de vínculos acadêmicos, propiciando o aperfeiçoamento na formação acadêmica, sócio-crítico-cultural e pessoal, a partir da inter-relação teoria-prática. Isso contribui para formação de habilidades interpessoais e profissionais permeadas por aspectos influenciadores e humanista ao cuidado de enfermagem e para o processo de internacionalização do curso de enfermagem. Conclusão: a experiência do intercâmbio acadêmico internacional contribui para o amadurecimento pessoal, científico e profissional e este relato visa incentivar os estudantes a idealizarem tal possibilidade que agrega novos saberes acadêmicos.

Objective: describe the student experience about international academic mobility in a postgraduate nursing exchange program in Havana - Cuba. Method: experience report about the academic and personal experiences, which took place during the activities carried out in the academic exchange between Brazil and Cuba, from September to October 2018. Results: the experience made possible the acquisition of expanded scientific knowledge to nursing in the post- graduation and the formation of academic bonds, providing the improvement in the academic, socio-critical-cultural and personal formation, from the theory-practice interrelationship. Contributing to the formation of interpersonal and professional skills permeated by influential and humanistic aspects of nursing care and the internationalization process of the nursing course. Conclusion: the experience of international academic exchange contributes to personal, scientific and professional maturation and this report aims to encourage students to idealize such a possibility that adds new academic knowledge.