AMPATH Surgical App

Designing a surgical training module to train clinicians who are expected to perform open appendectomies 

Team Lead: Dr. JoAnna Hunter-Squires
Lead Institution: AMPATH

Team Countries: Kenya, United States, England

Team ASAP (AMPATH Surgical App) is designing a surgical module that provides a surgical training module to train clinicians who are expected to perform open appendectomies in primary and secondary health facilities throughout the world. 

The Discovery Award will allow the team to develop a mobile application that will guide the learner through the evaluation and management of lower right quadrant pain, indicative of appendicitis. Using mobile technology the learner will be able to apply these skills immediately, or ASAP (as soon as possible).

“Surgery is our universal culture and language as surgeons,” says Dr. JoAnna Hunter-Squires in regards to this global collaboration. “The passion for surgical education and patient outcomes is the same no matter what country you are in.”

An open appendectomy is a common procedure around the world. But in many LMICs, particularly in rural or district healthcare facilities, the lack of surgeons means the procedure is often performed by general practitioners who graduated from medical school but have no formal surgical training. Morbidity related to appendicitis is three times higher in sub-Saharan African countries compared to high-income countries. 

An open appendectomy requires familiarity with the anatomy of the right lower abdominal quadrant, knowledge of the procedural steps, and several basic surgical skills. Failing to perform these steps competently can lead to devastating consequences for patients. 

The AMPATH team is creating a model to teach the necessary appendectomy skills that will allow district hospital general practitioners to perform this procedure safely and effectively, thereby reducing the morbidity associated with a lack of access to this procedure and complications of improperly performed appendectomies. 

“If we can solve this problem, we believe we can apply similar models to other common surgical procedures,” says Dr JoAnna Hunter-Squires, who is leading the team with members in Kenya, England and the United States. 

A mobile app will leverage best practices for structuring a skills curriculum to teach psychomotor skills. The module will also use cognitive task analysis (CTA) as a foundation for the curriculum and artificial intelligence feedback.

“By combining different approaches and enhancing them with mental imagery, supported by our app-based curriculum, we believe learners will perform as well as they would with traditional simulation, but at much lower cost and with higher reproducibility,” says Dr Hunter-Squires. “The AMPATH Surgical App will not focus on psychomotor skill acquisition alone, just as surgical practice does not rely solely upon the technical component.”