By Anna Casey, Brighton and Sussex Medical School
Introduction: the IAOMS podcast
The International Association of Oral and Maxillofacial Surgeons (IAOMS) is an international organisation, whose mission is “to improve the quality and safety of health care worldwide through the advancement of patient care, education and research in oral and maxillofacial surgery”. They provide education, training, networking and career development opportunities to oral and maxillofacial surgeons and trainees, as well as hosting various events throughout the year.
First airing on October 28th, 2019, the IAOMS podcast releases weekly episodes every Monday. This review looks at season 3, episode 3, with Dr Steven Roser, which was aired on September 28th, 2020.
I chose this episode to review because a key topic is the global role of oral and maxillofacial surgery (OMS), and international cooperation between higher- and lower-resource settings. Dr Roser discusses the Covid-19 Community and Healthcare Facility Checklists developed by a team including himself and the team at Emory University, as well as some lessons from the pandemic and ‘words of wisdom’ for the future. These are freely available on the IAOMS website, and will soon be translated for more accessible distribution.
Covid-19 Community and Healthcare Facility Checklists represent a consolidated resource for healthcare and community settings to enable safe activity during the Covid-19 pandemic
Users can update the resources to enable fast integration of new information, and these checklists are freely available online
The checklists will be translated into several languages aiming to be completed in September 2021, which will also involve surveys to allow more validated assessment of usefulness
Lessons from Covid-19 include: resilience, the importance of social interaction, advances in technological involvement in education and a need to learn to see and develop opportunities in crisis
Covid-19 has triggered an increased awareness of the importance of a global outlook, and maxillofacial surgery is part of this: two areas of particular focus are trauma and cleft surgery
Covid-19 Community and Healthcare Facility Checklists
What are they?
These checklists are designed “to provide a wide range of COVID-19 preparedness and management resources to public health officials, physicians, administrators, public information officers, community leaders, and school district managers”. They are freely available online (box.com link), and are structured in a way that allows context-dependent customisation. There is a survey that users can complete to give an idea of how useful the checklists are and help develop future versions.
Why were they developed?
Emory University’s medical school has a peri-operative global surgery group (the Emory Global Perioperative Alliance), and has a yearly one-month student-run elective surgical outreach programme in Haiti for medical students. For numerous reasons, this was cancelled in 2020, and the students helped develop these checklists instead. Dr Roser commented, “In dealing with millennials, they never think locally, they’re always thinking globally!” – highlighting that the focus was on the global application of these resources from the beginning, and the importance of involving students with a global outlook in such projects.
Initially, these checklists were aimed at the healthcare setting, but it became apparent that there was a need for lay communities to have access to quality, collated information – as healthcare workers tended to have better access to information. Thus, there are two sections to these checklists: one for community settings, one for healthcare facilities. The former use lots of graphics and visuals to make the messaging as clear as possible and keep the resource accessible. Areas of positive feedback are the checklists’ usefulness, ease of access and free distribution.
Where are they going?
Initially shared with the local community and G4 alliance of which the IAOMS Foundation is a member, and now available on the IAOMS website, the checklists received generally good feedback and some constructive critique to tailor its use to lower-resource settings. They have been edited to better fit these settings, and the group has now received funding to translate to Spanish, French, Portuguese and Arabic. Future ambitions include using survey results on these translated versions in order to provide a more validated method of assessing usefulness, and facilitate a continuous, iterative improvement process. The expected main audience is the community, as these settings tend to have less access to validated information, especially in a centralised format than healthcare settings. An especially important element is the presentation of guidance, which must appeal to people and not be seen as “scare tactics”, thus alienating the groups this resource is aiming to help. As Dr Roser is from the United States, there was also discussion of the overlapping strategies to manage Covid-19 and seasonal influenza infections, in which case these checklists could have wider usefulness.
Oral and Maxillofacial Surgery - a Global Perspective
Global role of OMS
The second half of the episode was a wider discussion of the global role of OMS, as well as the impact of the Covid-19 pandemic. Key lessons Dr Roser commented on from the Covid-19 pandemic included resilience, the need for social contact, and the technological learning curve that has changed the mainstream approach to medical and other education. He highlighted an opportunity to grow from challenges, and to “forgive imperfections” whilst learning from mistakes.
Dr Roser observed that the pandemic has forced a more global outlook on healthcare, and suggested that IAOMS, as one of the few global subspecialty platforms already has “the things that money can’t buy”, such as collaboration, communication and strong international leadership.
Future areas of focus
In terms of the future of OMS, Dr Rosen suggested 2 areas of focus: trauma and cleft surgery. Injuries are in the top 3 causes of death between the ages of 5 and 44 (1), with maxillofacial trauma a major contributor. This is a key area of focus to meet the global burden of disease and he suggests that IAOMS can be a leader in this area. Offering an example from one of the Haiti outreach program, he reflects on the impact of jaw trauma – a relatively “easy fix”, which if neglected, leads to disability impacting on workforce, earnings and family.
The second area of focus Dr Rosen suggests is cleft surgery, highlighting the 2015 Lancet commission on Global Surgery (2) which highlighted cleft surgery as an ‘important procedure potentially needing specialist support’ – a ‘can do’ procedure. He shares that there are several published standards such as those from SmileTrain (3), and suggests that OMS could do so as well.
These areas of focus could be achieved with international leadership such as that at the IAOMS foundation, and organisation of people and groups. Another key factors is resources such as funding for these organisations.
To wrap up, this is a great episode of a valuable podcast for anyone interested in OMS. All the episodes can be found on the IAOMS website, and are also on a number of different podcast platforms. Check them out, as each episode has a different focus interview with a surgeon, and will certainly expand your awareness of OMS issues.