Investigator(s)
| Submitter |
Santiram Dhakal KGUMSB and JDWNRH Santiram Dhakal 
|
| Principal Investigator |
Santiram Dhakal KGUMSB and JDWNRH Santiram Dhakal
|
Title(s) and abstract
| Scientific title | The Role of Surgical Camps in Medical Education: Developing a Novel Assessment Framework in Bhutan |
| Public title | Surgical Camp Educational Environment Measure (SCEEM), a modified STEEM (Surgical Theater Educational Environment Measures) for use in surgical camps. |
| Background | Surgical camps are a common medical initiative in Bhutan, organized by specialist departments from Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) and regional medical centers. While the benefits to patients are well-recognized1,2, the potential advantages for trainee surgeons are less systematically understood. For young surgeons—both residents and recent graduates—these surgical camps represent critical opportunities for professional development. They offer invaluable hands-on experience, particularly when the learning environment is supportive and structured. These medical professionals eagerly anticipate such camps as platforms for skill enhancement and practical training. The concept of local capacity building and surgical skill transfer is a fundamental aspect of these medical missions. In Bhutan, as in many parts of the world, surgical camps often involve expatriate surgeons collaborating with local medical professionals to perform complex procedures. This knowledge exchange is crucial for advancing surgical expertise in resource-constrained settings. Traditionally, the success of surgical camps has been measured narrowly—primarily through the number of surgeries performed and complication rates. 10-14 However, this approach overlooks a critical dimension: the educational value and skill transfer that occurs during these interventions. The Surgical Theatre Educational Environment Measure (STEEM), a validated 40-item questionnaire designed to assess educational environments in established surgical institutes, provides a comprehensive evaluation tool. 5,9 Yet, no equivalent instrument exists for assessing educational quality in surgical camp settings. This study aims to address this gap by creating a specialized assessment framework so that we can better understand and optimize the educational potential of surgical camps, ultimately improving surgical training and patient care. The study will provide a robust, evidence-based framework for understanding and improving educational methodologies in surgical training contexts, with a focus on creating mo |
| Objectives | 1. Examine the limitations of STEEM in surgical camp contexts. 2. Develop and propose a modified assessment tool to assess the educational environment in surgical camps. 3. Propose a more holistic approach to evaluating surgical camp success that encompasses both clinical outcomes and educational impact. |
| Study Methods | This observational study will evaluate and enhance educational assessment in surgical training camps through a systematic, multi-phase approach. The research will involve: Phase 1. Conducting a prospective analysis of the Surgical Training Educational Environment Measure (STEEM) questionnaire (Appendix 1) to assess its current effectiveness and relevance in surgical camp settings. Open-ended questions, added to the STEEM, will reveal participants’ experiences (please see Figure 1) that may not have been captured by the STEEM, and will reveal irrelevant items in the STEEM. Phase 2. Developing a tailored, modified questionnaire specifically adapted for surgical camp environments, termed the 'Surgical Camp Educational Environment Measure' (SCEEM). This instrument will be meticulously crafted to capture the unique educational dynamics of surgical training camps. Phase 3. Implementing the refined SCEEM questionnaire among targeted participants in surgical training environments, ensuring comprehensive and contextually appropriate data collection. Phase 4. Performing an in-depth qualitative analysis of trainee feedback to provide nuanced insights into the educational experience, pedagogical challenges, and potential areas of improvement in surgical training camps. Phase 5. Dissemination of potential areas of improvement in surgical training camps to the hospital and governmental authorities and to visiting surgical volunteer organisations such as Interplast. |
| Expected outcomes and use of results | Specific patient and community benefits: Enhanced supervision and hands-on surgical training will result in more confident and reliable surgeons, who in turn will deliver superior service and positive clinical outcomes. The community served by these skilled surgeons will benefit greatly, as competent medical professionals provide care to them, their families, and friends. With an increase in surgeons possessing strong hands-on skills, the people of Bhutan will ultimately enjoy improved surgical care. Feedback and dissemination of the results: The results and conclusions from this study will be shared with all departments that conduct surgical camps to ensure they are educationally enriching, not solely focused on case clearance. If the new tool, SCEEM, is found to be more appropriate for surgical camps, it will be promoted in collaboration with hospital administration and camp leaders. Should SCEEM prove more applicable than STEEM, it will be recommended for use in surgical camps outside Bhutan and published in renowned journals. Implications for policy and practice: As more clinically successful surgical camps are planned and conducted to improve community outreach, evaluating their educational impact will provide valuable feedback on overall performance. This feedback will enable better planning for a holistic approach to future surgical camps. |
| Keywords | SCEEM, STEEM, surgical camp, learning environment |
Research Details
| Student research | No |
| Start Date | 01-Oct-2025 |
| End Date | 31-Mar-2026 |
| Key Implementing Institution | Jigme Dorji Wangchuck National Referral Hospital |
| Multi-country research | No |
| Nationwide research | Yes |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Other (Surgical learning environment) |
| Involves human subjects | Yes |
| Intervention Evaluation Research | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |