Measuring the impact of medical education in resource limited settings: A scoping review

The Lancet Commission on Global Surgery identified workforce training as a key area of investment to improve access to essential surgical care. Many non-governmental organizations and universities have attempted to contribute to training and upskilling of providers in resource limited settings through educational programs. However, there are no widely agreed upon metrics for measuring the long-term success of these programs. A scoping review was conducted to assess varying methods used to measure impact, with a specific interest in patient-level impact. This scoping review was conducted in four databases (PubMed, Scopus, Embase, and Web of Science) following the PRISMA-ScR guidelines. The database search retrieved 1504 articles, of which 32 were included that quantitatively evaluated impact of medical education programs. Of the 32 articles, 6 measured patient-level impact defined by increased patient volumes after the education program or improved outcomes (decreased complications and mortality rates). The remaining 26 articles focused on provider-level impact primarily defined by skill acquisition and retention, as well as career advancement as a result of increased training. Provider-level impact was mostly assessed within 12 months of the program while patient-level impact was assessed longer after the program. There is a need to improve and standardize tools for measuring the impact of medical education. Patient impact should be the primary metric to evaluate the effectiveness of an educational program, and future tools should consider the long-term impact of training on the whole surgical workforce as opposed to a singular specialty.