Using telemedicine to teach paediatric surgery in resource-limited countries

Halstedian method of surgical training has been the mainstay of surgical education for many decades. Onsite knowledge sources in surgery have traditionally been textbooks, which are often a number of years out of date or teaching rounds with a Professor or senior colleague that enables a small number of trainees to benefit from. Congresses have been a good way of learning new developments in the field, but they often require travelling and are very costly. We have identified web-based education as a means of linking experts with trainees, regardless of their geographic location and often without requiring any substantial capital. Web meetings have been running on a weekly basis from University of Cape Town, Division of Paediatric Surgery since 2010. This enabled speakers from Australia to Venezuela, across the globe share their expertise with individuals and paediatric surgical teams both in resource limited and developed countries. Attendance to meetings has grown significantly as the users become more familiar with the meeting software and also internet connection and availability of bandwidth increased. Adobe Connect® has been the main platform we used with its functions, including camera and video transmission, sharing of presentations, and ease of creating polls to encourage participant enrolment. Recordings are also made available and viewed over 300 times/month through the website www.surgicalskills.co.za. Other applications using the same platform has been explored which included transfer of hands on surgical skills, such as laparoscopy, burns surgery and fibre optic endoscopy as well as conducting administrative meetings for professional societies. Web meetings have added another dimension to surgical education. This will likely grow more in the future, and transform peer to peer knowledge transfer into a global environment.