title: Promoting quality of care in disaster response: A survey of core surgical competencies.
abstract: BACKGROUND
  Recent humanitarian crises have led to a call for professionalization of the humanitarian field, but core competencies for the delivery of surgical care have yet to be established. The objective of this study was to survey surgeons with experience in disaster response to identify surgical competencies required to be effective in these settings.
  
  
  METHODS
  An online survey elucidating demographic information, scope of practice, and previous experience in global health and disaster response was transmitted to surgeons from a variety of surgical societies and nongovernmental organizations. Participants were provided with a list of 111 operative procedures and were asked to identify those deemed essential to the toolset of a frontline surgeon in disaster response via a Likert scale. Responses from personnel with experience in disaster response were contrasted with those from nonexperienced participants.
  
  
  RESULTS
  A total of 147 surgeons completed the survey. Participants held citizenship in 22 countries, were licensed in 30 countries, and practiced in >20 countries. Most respondents (56%) had previous experience in humanitarian response. The majority agreed or strongly agreed that formal training (54%), past humanitarian response (94%), and past global health experiences (80%) provided adequate preparation. The most commonly deemed important procedures included control of intraabdominal hemorrhage (99%), abdominal packing for trauma (99%), and wound debridement (99%). Procedures deemed important by experienced personnel spanned multiple specialties.
  
  
  CONCLUSIONS
  This study addressed specifically surgical competencies in disaster response. We provide a list of operative procedures that should set the stage for further structured education programs.
authors.affiliation: Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Surgeons OverSeas (SOS), New York, NY. Electronic address: evan.wong@mail.mcgill.ca.
authors.forename: Evan G
authors.initials: EG
authors.lastname: Wong
authors.affiliation: Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Tarek
authors.initials: T
authors.lastname: Razek
authors.affiliation: Emergencies and Recovery, International Operations, Canadian Red Cross, Ottawa, Ontario, Canada.
authors.forename: Hossam
authors.initials: H
authors.lastname: Elsharkawi
authors.affiliation: Department of Surgery, Stanford University School of Medicine, Stanford, CA.
authors.forename: Sherry M
authors.initials: SM
authors.lastname: Wren
authors.affiliation: Surgeons OverSeas (SOS), New York, NY; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Surgery, Columbia University, New York, NY.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
authors.affiliation: International Trauma Surgery, Queen Mary & Barts School of Medicine and Dentistry, University of London, London, UK.
authors.forename: Christos
authors.initials: C
authors.lastname: Giannou
authors.affiliation: Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Kosar A
authors.initials: KA
authors.lastname: Khwaja
authors.affiliation: Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Andrew
authors.initials: A
authors.lastname: Beckett
authors.affiliation: Centre for Global Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Dan L
authors.initials: DL
authors.lastname: Deckelbaum
mesh_terms: D000328:Adult; D000368:Aged; D000533:Altruism; D002983:Clinical Competence / Q000592:standards*; D004189:Disaster Planning / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008493:Medical Missions / Q000592:standards*; D008875:Middle Aged; D011787:Quality of Health Care; D013514:Surgical Procedures, Operative / Q000592:standards*