Making educational content open access can save lives

Most people in the world cannot access safe, affordable surgical care when they need it. This results in death and disability at a scale that is hard to comprehend, including an estimated 17 million preventable deaths each year.

While there is no shortage of people and institutions willing to work towards finding solutions, the provision of safe surgery is complex, with many moving parts. 

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There is no quick fix – no vaccination, no medicine and no policy change will, on its own, significantly alleviate the burden of surgical disease or provide greater access to surgical care. Provision of safe surgical care requires staff, equipment, infrastructure, systems and political support. So how can we make a difference? 

We are really proud to be part of an initiative that is giving individuals and institutions, in both low- and high-resource settings, a simple way to make an impact. That is, making educational content available open access to the world, through a trusted online platform. This sounds so simple, but it provides an answer to a significant problem. 

One of the greatest challenges in the provision of surgery worldwide is the insufficient number of surgical providers – surgeons, anaesthetists, obstetricians and perioperative nurses. Yet, it’s often difficult for training programmes in low-resource settings to scale up, due to a lack of access to appropriate training material. 

Through the United Nations Global Surgery Learning Hub (SURGhub), we are working with the global surgery community to address this need. We provide access to high-quality surgical, anaesthetic, obstetric and perioperative nursing training resources appropriate to low-resource contexts, making them available through an innovative open access online platform. 

Life-saving content

SURGhub was launched in June 2023 and, as of October 2024, is being used in more than 178 countries, including in every conflict zone in the world: in Ukraine, Palestine, Israel, Lebanon, Myanmar, Yemen, Sudan and beyond. More than 8,000 learners are enrolled – potentially just the tip of the iceberg – and their feedback is overwhelmingly positive. Ultimately, education saves lives.

SURGhub works because it actively fosters a diffused, global sense of ownership. The project is led by committees of volunteer clinicians, nurses, educators and technologists from all over the world, supported by a project team from the Global Surgery Foundation, the United Nations Institute for Training and Research and RCSI University of Medicine and Health Sciences. SURGhub is funded by the Johnson & Johnson Foundation.

Content is provided for free by numerous academic, professional and non-governmental bodies from both high- and low-resource settings, and reviewed by a panel of more than 200 volunteer experts from across the globe. It is a product of the global surgical community, for the global surgical community. 

Both resources designed specifically for low-resource settings and those designed for high-resource settings are regarded as valuable by low-resource setting surgical learners, research shows. However, content produced specifically for low-resource settings particularly resonates because it is more likely to focus on the pathologies, treatments and tools that learners see and have access to. The most accessed course on SURGhub to date, “Surgical Foundations”, was produced by the College of Surgeons of east, central and southern Africa.

A global outlook

Making high-quality, trusted content available is a good start, but is not enough. Most content on SURGhub is in English, so usage is correspondingly concentrated in countries where English is spoken, with India, Ethiopia and Nigeria having the greatest number of learners. That is why translation is the next frontier.

SURGhub is not the only open access education platform making medical content globally available. We thank OPENPediatrics and Open Critical Care, to name but two, for blazing a trail for us.

For us, in a health sciences university, we know that education saves lives. It also improves living conditions, drives economic opportunities, reduces inequality and underpins all of the progress that the UN Sustainable Development Goals (SDGs) are striving for.

So, wherever you are, and in whatever academic field, can we ask that you consider whether the content available to learners in your institution might benefit others in lower-resource settings? Educational content produced for one learner group can often be of significant value for other learner groups, which might not have been considered. Giving permission for content to be hosted on a trusted, visible, easy-to-use open access platform potentially greatly multiplies the impact. Does a mechanism exist for your content in your field to be shared in this way? If it doesn’t, who might create it? If not you, if not us, then who?

Ines Perić is education project manager and Eric O’Flynn is programme director for education, training and advocacy, both at the Institute of Global Surgery at RCSI University of Medicine and Health Sciences. SURGhub has been shortlisted in the Technological or Digital Innovation of the Year category in the 2024 THE Awards. A full list of nominees can be found here. The awards will be presented at a ceremony in Birmingham on 28 November 2024.

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