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Yamamoto T, Goto K, Kitano S, Maeshima Y, Yamada T, Azuma Y, Okumura S, Kawakubo N, Tanaka E, Obama K, Taura K, Terajima H, Tajiri T. Current insights on social media as a tool for the dissemination of research and education in surgery: a narrative review. Surg Today 2024; 54:1113-1123. [PMID: 38980332 DOI: 10.1007/s00595-024-02891-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/06/2024] [Indexed: 07/10/2024]
Abstract
The purpose of our narrative review is to summarize the utilization of social media (SoMe) platforms for research communication within the field of surgery. We searched the PubMed database for articles in the last decade that discuss the utilization of SoMe in surgery and then categorized the diverse purposes of SoMe. SoMe proved to be a powerful tool for disseminating articles. Employing strategic methods like visual abstracts enhances article citation rates, the impact factor, h-index, and Altmetric score (an emerging alternative metric that comprehensively and instantly quantifies the social impact of scientific papers). SoMe also proved valuable for surgical education, with online videos shared widely for surgical training. However, it is essential to acknowledge the associated risk of inconsistency in quality. Moreover, SoMe facilitates discussion on specific topics through hashtags or closed groups and is instrumental in recruiting surgeons, with over half of general surgery residency programs in the US efficiently leveraging these platforms to attract the attention of potential candidates. Thus, there is a wealth of evidence supporting the effective use of SoMe for surgeons. In the contemporary era where SoMe is widely utilized, surgeons should be well-versed in this evidence.
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Affiliation(s)
- Takehito Yamamoto
- Public Relations Committee, Japan Surgical Society, Tokyo, Japan.
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
- Department of Gastroenterological Surgery and Oncology, Medical Research Institute Kitano Hospital, Osaka, Japan.
| | - Kentaro Goto
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shoichi Kitano
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yurina Maeshima
- Public Relations Committee, Japan Surgical Society, Tokyo, Japan
- Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiyuki Yamada
- Public Relations Committee, Japan Surgical Society, Tokyo, Japan
- Department of Cardiovascular Surgery, Nagoya City University Midori Municipal Hospital, Nagoya, Japan
| | - Yoko Azuma
- Public Relations Committee, Japan Surgical Society, Tokyo, Japan
- Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, Tokyo, Japan
| | - Shintaro Okumura
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naonori Kawakubo
- Public Relations Committee, Japan Surgical Society, Tokyo, Japan
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Tanaka
- Department of Gastroenterological Surgery and Oncology, Medical Research Institute Kitano Hospital, Osaka, Japan
| | - Kazutaka Obama
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kojiro Taura
- Department of Gastroenterological Surgery and Oncology, Medical Research Institute Kitano Hospital, Osaka, Japan
| | - Hiroaki Terajima
- Department of Gastroenterological Surgery and Oncology, Medical Research Institute Kitano Hospital, Osaka, Japan
| | - Tatsuro Tajiri
- Public Relations Committee, Japan Surgical Society, Tokyo, Japan
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Roberts-Lewis S, Baxter H, Mein G, Quirke-McFarlane S, Leggat FJ, Garner H, Powell M, White S, Bearne L. Examining the Effectiveness of Social Media for the Dissemination of Research Evidence for Health and Social Care Practitioners: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e51418. [PMID: 38838330 PMCID: PMC11187521 DOI: 10.2196/51418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/15/2023] [Accepted: 03/18/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Social media use has potential to facilitate the rapid dissemination of research evidence to busy health and social care practitioners. OBJECTIVE This study aims to quantitatively synthesize evidence of the between- and within-group effectiveness of social media for dissemination of research evidence to health and social care practitioners. It also compared effectiveness between different social media platforms, formats, and strategies. METHODS We searched electronic databases for articles in English that were published between January 1, 2010, and January 10, 2023, and that evaluated social media interventions for disseminating research evidence to qualified, postregistration health and social care practitioners in measures of reach, engagement, direct dissemination, or impact. Screening, data extraction, and risk of bias assessments were carried out by at least 2 independent reviewers. Meta-analyses of standardized pooled effects were carried out for between- and within-group effectiveness of social media and comparisons between platforms, formats, and strategies. Certainty of evidence for outcomes was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. RESULTS In total, 50 mixed-quality articles that were heterogeneous in design and outcome were included (n=9, 18% were randomized controlled trials [RCTs]). Reach (measured in number of practitioners, impressions, or post views) was reported in 26 studies. Engagement (measured in likes or post interactions) was evaluated in 21 studies. Direct dissemination (measured in link clicks, article views, downloads, or altmetric attention score) was analyzed in 23 studies (8 RCTs). Impact (measured in citations or measures of thinking and practice) was reported in 13 studies. Included studies almost universally indicated effects in favor of social media interventions, although effect sizes varied. Cumulative evidence indicated moderate certainty of large and moderate between-group effects of social media interventions on direct dissemination (standardized mean difference [SMD] 0.88; P=.02) and impact (SMD 0.76; P<.001). After social media interventions, cumulative evidence showed moderate certainty of large within-group effects on reach (SMD 1.99; P<.001), engagement (SMD 3.74; P<.001), and direct dissemination (SMD 0.82; P=.004) and low certainty of a small within-group effect on impacting thinking or practice (SMD 0.45; P=.02). There was also evidence for the effectiveness of using multiple social media platforms (including Twitter, subsequently rebranded X; and Facebook), images (particularly infographics), and intensive social media strategies with frequent, daily posts and involving influential others. No included studies tested the dissemination of research evidence to social care practitioners. CONCLUSIONS Social media was effective for disseminating research evidence to health care practitioners. More intense social media campaigns using specific platforms, formats, and strategies may be more effective than less intense interventions. Implications include recommendations for effective dissemination of research evidence to health care practitioners and further RCTs in this field, particularly investigating the dissemination of social care research. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022378793; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=378793. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/45684.
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Affiliation(s)
- Sarah Roberts-Lewis
- Population Health Research Institute, St George's University of London, London, United Kingdom
| | - Helen Baxter
- Bristol Population Health Science Institute, University of Bristol, Bristol, United Kingdom
- National Institute of Health and Care Research, London, United Kingdom
| | - Gill Mein
- Faculty of Health, Social Care and Education, St George's University of London, London, United Kingdom
| | | | - Fiona J Leggat
- Population Health Research Institute, St George's University of London, London, United Kingdom
| | - Hannah Garner
- Department of Physiotherapy, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Martha Powell
- National Institute of Health and Care Research, London, United Kingdom
| | - Sarah White
- Population Health Research Institute, St George's University of London, London, United Kingdom
| | - Lindsay Bearne
- Population Health Research Institute, St George's University of London, London, United Kingdom
- National Institute of Health and Care Research, London, United Kingdom
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Kirengo TO, Dossajee H, Onyango EM, Rachakonda RH, Schneider B, Sela DP, Hosseinzadeh Z, Nadeem Z, Obonyo NG. Catalysing global surgery: a meta-research study on factors affecting surgical research collaborations with Africa. Syst Rev 2024; 13:89. [PMID: 38500200 PMCID: PMC10946148 DOI: 10.1186/s13643-024-02474-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 01/28/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION In December 2019, the COVID-19 pandemic highlighted the urgent need for rapid collaboration, research, and interventions. International research collaborations foster more significant responses to rapid global changes by enabling international, multicentre research, decreasing biases, and increasing study validity while reducing overall research time and costs. However, there has been low uptake of collaborative research by African institutions and individuals. AIM To systematically review facilitating factors and challenges to collaborative surgical research studies conducted in Africa. METHODOLOGY A meta-research review using PubMed®/MEDLINE and Embase on surgical collaboration in Africa from 1st of January 2011 to 31st of September 2021 in accordance to PRISMA guidelines. Surgical studies by collaborative groups involving African authors and sites were included (55 papers). Data on the study period, geographical regions, and research scope, facilitating factors, and challenges were extracted from the studies retrieved from the search. RESULTS Most of the collaborations in Africa occurred with European institutions (76%). Of the 54 African countries, 63% (34/54) participated in surgical collaborations. The highest collaboration frequency occurred in South Africa (11%) and Nigeria (8%). However, most publications originated from Eastern Africa (43%). Leveraging synergies between high- and low- to middle-income countries (LMICs), well-defined structures, and secure data platforms facilitated collaboration. However, the underrepresentation of collaborators from LMICs was a significant challenge. CONCLUSION Available literature provides critical insights into the facilitating factors and challenges of research collaboration with Africa. However, there is a need for a detailed prospective study to explore the themes highlighted further. SYSTEMATIC REVIEW REGISTRATION PROSPERO 2022 CRD42022352115 .
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Affiliation(s)
- Thomas O Kirengo
- Imara Hospital, Embu, Kenya.
- Kenya Medical Association, Nairobi, Kenya.
| | - Hussein Dossajee
- MP Shah Hospital, Nairobi, Kenya
- Kenya Medical Association, Nairobi, Kenya
| | - Evans M Onyango
- Ministry of Health, Kajiado County, Kenya
- Kenya Medical Association, Nairobi, Kenya
| | - Reema H Rachakonda
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Critical Care Research Group, Brisbane, Australia
| | - Bailey Schneider
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Critical Care Research Group, Brisbane, Australia
| | - Declan P Sela
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Critical Care Research Group, Brisbane, Australia
| | - Zahra Hosseinzadeh
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Critical Care Research Group, Brisbane, Australia
| | - Zohaib Nadeem
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Critical Care Research Group, Brisbane, Australia
| | - Nchafatso G Obonyo
- Faculty of Medicine, University of Queensland, Brisbane, Australia
- Critical Care Research Group, Brisbane, Australia
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Kenya Medical Association, Nairobi, Kenya
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Handing GE, Westrum AM, Sweeney DD, Metzler IS, Schneck FX, Ching CB. Marketing yourself in social media as a global health organization: lessons to be learned. World J Urol 2023; 41:3801-3806. [PMID: 37902862 DOI: 10.1007/s00345-023-04661-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/24/2023] [Indexed: 11/01/2023] Open
Abstract
PURPOSE To evaluate whether X, formerly known as Twitter, is being used effectively to advance the goals of International Volunteers in Urology (IVUmed). How is X activity associated with end-user engagement? METHODS Monthly analytics of the X account @IVUmed were reviewed between September 2014 and November 2022 using https://analytics.twitter.com/ . Outcomes included tweets, mentions, impressions, engagements, interactions, followers, and profile visits. Statistical analysis using Mann-Whitney U test and Spearman's rank-order correlation was performed. Top tweet content between December 2020 and November 2022 was also analyzed and assigned one of seven different categories: research, workshops, mission statement, educational materials, fundraising, individual spotlight, and other. RESULTS Of @IVUmed's 1668 followers, 1334 (80.0%) were individuals. One thousand one hundred twenty-six (84.4%) individuals listed their locations with the majority (79.8%) residing in high-income countries. Tweet impressions have increased over time; they were significantly higher (p < 0.01) on average after the onset of COVID-19 in March 2020. From December 2020 to November 2022, new followers were positively correlated with tweet impressions (p < 0.01), total mentions (p < 0.01), and profile visits (p < 0.01). Profile visits were positively correlated with total tweets (p < 0.01). The content categories for monthly top tweets that proportionally garnered the most engagements were workshops (50%) and individual spotlight (29%), despite not being the most tweeted about content categories. CONCLUSION Non-profit organizations wishing to increase their web-based outreach can benefit from increased primary X activity. While not evaluated in this study, it may also improve fundraising capabilities. Nevertheless, periodic review of account activity is important to ensure engagement of the targeted audience.
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Affiliation(s)
- Greta E Handing
- Department of Student Affairs, Baylor College of Medicine, Houston, TX, USA.
| | | | | | - Ian S Metzler
- IVUmed, Austin, TX, USA
- Department of Urology, Oregon Health and Science University, Portland, OR, USA
| | - Francis X Schneck
- IVUmed, Austin, TX, USA
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Christina B Ching
- IVUmed, Austin, TX, USA
- Department of Pediatric Urology, Nationwide Children's Hospital, Columbus, OH, USA
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Bhatia MB, Munda B, Okoth P, Carpenter KL, Jenkins P, Keung CH, Hunter-Squires JL, Saruni SI, Simons CJ. Bilateral trauma case conferences: an approach to global surgery equity through a virtual education exchange. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2023; 2:47. [PMID: 38013866 PMCID: PMC10069354 DOI: 10.1007/s44186-023-00126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 03/18/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
Purpose With increased interest in international surgical experiences, many residency programs have integrated global surgery into their training curricula. For surgical trainees in low- and middle-income countries (LMICs), physical exchange can be costly, and laws in high-income countries (HICs) prevent LMIC trainees from practicing surgery while on visiting rotations. To enrich the educational experience of trainees in both settings, we established a monthly virtual trauma conference between surgery training programs. Methods General surgery teams from two public institutions, a public university with two surgical training programs in Kenya and a public university with two level I trauma centers in the United States, meet monthly to discuss complex and interesting trauma patients. A trainee from each institution presents a clinical case vignette and supplements the case with pertinent peer-reviewed literature. The attendees then answer a series of multiple-choice questions like those found on surgery board exams. Results Monthly case conferences began in September 2017 with an average of 24 trainees and consultant surgeons. Case discussions serve to stimulate dialogue on patient presentation and management, highlighting cost-conscious, high-quality care and the need to adapt practice patterns to meet resource constraints and provide culturally appropriate care. Conclusion Our 5-year experience with this virtual case conference has created a unique and robust surgical education experience for trainees and surgeons who have withstood the effects of the pandemic. These case conferences have not only strengthened the camaraderie between our departments, but also promoted equity in global surgery education and prioritized the learning of trainees from both settings.
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Affiliation(s)
- Manisha B. Bhatia
- Department of Surgery, Indiana University, 545 Barnhill Drive, Emerson Hall 125, Indianapolis, IN 46202 USA
| | - Beryl Munda
- Department of Anaesthesia and Surgery, Moi University, Eldoret, Kenya
| | - Philip Okoth
- Department of Surgery, Siaya County Referral Hospital, Siaya, Kenya
| | - Kyle L. Carpenter
- Department of Surgery, Indiana University, 545 Barnhill Drive, Emerson Hall 125, Indianapolis, IN 46202 USA
| | - Peter Jenkins
- Department of Surgery, Indiana University, 545 Barnhill Drive, Emerson Hall 125, Indianapolis, IN 46202 USA
| | - Connie H. Keung
- Department of Surgery, Indiana University, 545 Barnhill Drive, Emerson Hall 125, Indianapolis, IN 46202 USA
| | - JoAnna L. Hunter-Squires
- Department of Surgery, Indiana University, 545 Barnhill Drive, Emerson Hall 125, Indianapolis, IN 46202 USA
- Department of Anaesthesia and Surgery, Moi University, Eldoret, Kenya
| | | | - Clark J. Simons
- Department of Surgery, Indiana University, 545 Barnhill Drive, Emerson Hall 125, Indianapolis, IN 46202 USA
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Shaikh HJ, Brodell BJ, Soin SP. "Social media perceptions of hip fractures: A two-year cross-sectional analysis". Injury 2023; 54:1176-1179. [PMID: 36803921 DOI: 10.1016/j.injury.2023.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND The outcomes of hip fracture rely heavily on subjective pain relief, and social media provides a remarkable lens to examine the patient experience. METHODS A search of public posts on Instagram and Twitter was performed over a 2 -year period, selected through use of the following hashtags: #hipfracture, #hipfracturerecovery, and #hipfracturerepair. A categorical classification system was used for media format (picture or video), perspective, timing, tone, and content. Post-popularity (number of likes) and geographic location were also recorded. RESULTS Of the Instagram posts analyzed, 50.6% were made by patients. The most common content included in Instagram posts was rehabilitation and or educational posts on hip fracture. Amongst the Twitter posts analyzed, 66% of posts were made by professional organizations. Frequently referenced themes included education, and posts produced by the hospital or surgeon. Of Facebook posts analyzed, 62.8% of posts were produced by businesses. CONCLUSION Social media analysis is a powerful tool for evaluating characteristics important to patients. Instagram was used more by patients and focused on rehabilitation. Twitter posts were more frequently made by professional organizations and tended to be educational. Lastly, Facebook posts were made primarily by businesses and focused on marketing.
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Affiliation(s)
- Hashim Jf Shaikh
- Department of Orthopaedic Surgery and Physical Performance, University of Rochester, 601 Elmwood Ave, Rochester, New York 14620, United States.
| | - Bs James Brodell
- Department of Orthopaedic Surgery and Physical Performance, University of Rochester, 601 Elmwood Ave, Rochester, New York 14620, United States
| | - Sandeep P Soin
- Department of Orthopaedic Surgery and Physical Performance, University of Rochester, 601 Elmwood Ave, Rochester, New York 14620, United States
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Castro-Varela A, Luc JGY, Vervoort D. Social media and global cardiovascular disparities. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:3-4. [PMID: 36711183 PMCID: PMC9707863 DOI: 10.1093/ehjdh/ztaa019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 12/29/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Alejandra Castro-Varela
- Escuela de Medicine y Ciencias de la Salud, Tecnologico de Monterrey, Av. Ignacio Morones Prieto 3000, 64710 Monterrey, Nuevo Leon, Mexico
| | - Jessica G Y Luc
- Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, 2329 West Mall, V6T 1Z4 Vancouver, British Columbia, Canada
| | - Dominique Vervoort
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
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Keil EJ, Navarro SM, Shaikh H, Yao LE, Tuttle TM. Social Media Perceptions of Surgical Cancer Care in the Era of COVID-19: A Global Cross-Sectional Study. JCO Glob Oncol 2020; 6:1306-1311. [PMID: 32795195 PMCID: PMC7456316 DOI: 10.1200/go.20.00326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The rapid dissemination of information through social media renders a profound lens to evaluate perceptions of emerging topics, especially in the context of a global pandemic. The primary objective of this cross-sectional study was to elucidate trends on social media in the setting of surgical cancer care affected by the COVID-19 pandemic across the globe. METHODS A public search of Twitter from April 1 to 30, 2020, was conducted, which yielded 996 posts related to COVID-19 and cancer. Two authors (E.J.K. and H.S.) individually reviewed all posts and recorded the post category, engagement, author category, and geographic location. Data were then analyzed through descriptive analyses. Only English-language posts were included, and any noncancer- or non-COVID–related posts were excluded from the analysis. RESULTS A total of 734 unique authors from 26 different countries wrote 996 relevant posts that averaged 12.0 likes, 4.7 retweets, and 0.5 hashtags per post. Only 2.3% (23 of 996) of posts included a video. Authors of the included tweets most frequently were friends and families of patients (183; 18.4%), academic institutions or organizations (182; 18.3%), and physicians (138; 13.9%). Topics of importance were cancellations of surgeries (299; 40.1%), COVID-19 education (211; 121.2%), and research studies (93; 9.3%). The United Kingdom and the United States made up 81.5% of the cohort, followed by Canada (6.6%) and India (2.4%). Of posts where a specific type of surgery was identified (196), the most common type mentioned was breast cancer (50; 25.5%), followed by lung cancer (37; 18.9%) and urologic cancer (22; 11.2%). CONCLUSION This analysis provides insight into the resulting impacts of COVID-19 on the global discussion of surgical cancer care.
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Affiliation(s)
- Evan J Keil
- Department of Surgery, University of Minnesota, Minneapolis, MN
| | | | - Hashim Shaikh
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Lilian E Yao
- Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Todd M Tuttle
- Department of Surgery, University of Minnesota, Minneapolis, MN
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Abstract
Introduction In the 5 months since it began, the COVID-19 pandemic has placed extraordinary demands on health systems around the world including surgery. Competing health objectives and resource redeployment threaten to retard the scale-up of surgical services in low- and middle-income countries where access to safe, affordable and timely care is low. The key aspiration of the Lancet Commission on global surgery was promotion of resilience in surgical systems. The current pandemic provides an opportunity to stress-test those systems and identify fault-lines that may not be easily apparent outside of times of crisis. Methods We endeavoured to explore vulnerable points in surgical systems learning from the experience of past outbreaks, using examples from the current pandemic, and make recommendations for future health emergencies. The 6-component framework for surgical systems planning was used to categorise the effects of COVID-19 on surgical systems, with a particular focus on low- and middle-income countries. Key vulnerabilities were identified and recommendations were made for the current pandemic and for the future. Results Multiple stress points were identified throughout all of the 6 components of surgical systems. The impact is expected to be highest in the workforce, service delivery and infrastructure domains. Innovative new technologies should be employed to allow consistent, high-quality surgical care to continue even in times of crisis. Conclusions If robust progress towards global surgery goals for 2030 is to continue, the stress points identified should be reinforced. An ongoing process of reappraisal and fortification will keep surgical systems in low- and middle-income countries responsive to “old threats and new challenges”. Multiple opportunities exist to help realise the dream of surgical systems resilient to external shocks.
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