ALL-SAFE Grabs Grand Prize for Laparoscopic Surgical Training 19 Jan 2023 “We started out as a small group of rebels,” says Dr David Jeffcoach, co-team lead for ALL-SAFE, the Grand Prize winning team of the Global Surgical Training Challenge. His team, co-led by Dr Grace Kim, worked with team members in Ethiopia, Cameroon, Kenya, and the United States to create surgical training modules to teach surgeons laparoscopic surgical skills to treat ectopic pregnancy. They chose ectopic pregnancy because it is the leading cause of maternal death, and a significant contributor to infertility in women. Women in sub-Saharan Africa have an increased risk of ectopic pregnancy, with little or no access to minimally invasive, laparoscopic interventions. ALL-SAFE has since created more modules to teach this minimally invasive approach to treating a variety of conditions, including Meckel’s Diverticulum, Appendicitis and Penetrating Thoracoabdominal Trauma. Dr David Jeffcoach, co-team lead of Grand Prize winner ALL-SAFE Since the start of the Challenge in 2020, the team has grown from a core group to up to 30 people in five countries with technical, surgical, and education expertise. “During the course of this Challenge we have grown, and I’m really proud of how we have worked together,” adds Dr Jeffcoach, who is director of the general surgery residency program at Soddo Christian Hospital in Ethiopia. The ALL-SAFE team set out to develop unique training modules that taught laparoscopic skills without the investment needed to have a full, high-tech simulator suite. Working across different countries allowed Dr Jeffcoach and his team to adapt the modules to a variety of low resource environments. “When you’re looking for low resource ways to build things, you need to have those pieces of equipment or materials available as broadly as possible,” he says. A Three-Pronged Approach The Challenge asked teams to create the open-source modules with didactic, cognitive and built-in self-assessment elements. ALL-SAFE designed their training modules to teach laparoscopic skills to surgeons who had experience with open procedures. Learners must complete each element successfully before moving on to the next. Surgeons who know the techniques from the open perspective have been using ALL-SAFE to learn from the laparoscopic perspective. This gives them the opportunity to perform the procedures in their practice. The self-assessment insures they are performing the procedures correctly, and that they are improving critical techniques, such as suturing. “Self assessment is key,” says Dr Grace Kim, a general surgeon at University of Michigan Health. She has a specialty in minimally invasive surgery. “Our platform allows learners to assess how they’re doing. It also features peer review.” “Self-assessment allows us to scale because it removes the bottleneck of needing a mentor to stand over you,” adds Dr Jeffcoach. What’s Next for ALL-SAFE ALL-SAFE is already receiving requests from surgeons in other specialties. “We built the platform in such a way that you can add on to it for a variety of clinical specialties. Surgeons have a hunger to do laparoscopy because they know it’s better for patients. But they currently don’t have the resources to do the training to get there,” says Dr Jeffcoach. The team is planning a module to guide learners in the placement of laparoscopic trocars. As the ALL-SAFE team tries to assemble a complete toolkit for laparoscopic surgery, Dr Kim and Dr Jeffcoach felt that a module dedicated to this critical skill set was necessary for success. “Trocar placement is performed in all laparoscopic surgeries, and its correct placement is critical for a safe operation for the patient,” says Dr Kim. ALL-SAFE plans to use the $700,000 Grand Prize to scale to other countries and other specialties. They plan to partner with universities, hospitals and medical centers to deploy the modules. “We need to get it out there in a way that’s effective and that will positively impact clinical outcomes,” says Dr Jeffcoach. “The whole goal is to make these minimally invasive surgical procedures accessible to patients in sub-Saharan Africa and around the globe,” says Dr Kim. Learn more Meet the team and learn what inspired them Explore the ALL-SAFE modules on Appropedia Learn how to get involved with SELF: Surgical Education Learners Forum
