The Effectiveness and Challenges of E-learning in Surgical Training in Low- and Middle-Income Countries: A Systematic Review
E-learning encompasses the use of electronic media, online tools, and technologies in education and has been shown to be generally effective and satisfying for students, compared to traditional methods such as didactic lectures. Within surgical education, there is growing demand for e-learning platforms in low- and middle-income countries (LMICs). A systematic review was conducted to evaluate the effectiveness and challenges of e-learning for surgical trainees in LMICs. Out of 87 studies, five studies met the inclusion criteria and reported either neutral or positive improvements in cognitive and procedural skills, compared to baselines or controls for surgical trainees in LMICs. Using a qualitative synthesis approach, the researchers identified common challenges and barriers, such as low bandwidth, limited connectivity, and poor surgical details, which led to poor knowledge synthesis. This suggests that more emphasis needs to be placed on developing a strong online foundation that could be easily accessed and is user-friendly and intuitive, especially in LMICs. However, the research was limited by the lack of literature surrounding surgical e-learning interventions in LMICs and more research is required in this area.