Peer Teaching Across Borders: A Reverse-teaching Pilot Between Low-and-middle Income Countries (LMIC) And High-income Countries (HIC) Trainees

Peer Teaching Across Borders: A Reverse-teaching Pilot Between Low-and-middle Income Countries (LMIC) And High-income Countries (HIC) Trainees

Ashmita Khatri , Sampada Sapkota, Meliska Malla, Suyog Raj Gautam, Prapti Lakhey, Bishow Bekhyat Karki, Mahmoud Loubani
KIST Medical College and Teaching Hospital, Lalitpur, Nepal; Devdaha Medical College & Research Institute, Butwal, Nepal; Chitwan Medical College, Bharatpur, Bharatpur, Nepal; KIST Medical College & Teaching Hospital, Lalitpur, Lalitpur, Nepal; Nepal Medical College Pvt. Ltd, Kathmandu, Nepal; Leeds Teaching Hospital NHS Trust, Leeds, United Kingdom; Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom

Introduction: The KNOT Campaign began as a way to elevate knot-tying skills for medical students in LMIC, using virtual teaching led by mentors from high-income countries. This pilot study expanded the campaign by exploring a reverse-teaching model, where trained medical students from LMIC led knot-tying sessions for HIC-based medical students.

Aim: To evaluate the effectiveness of LMIC-led knot-tying training for medical students in HIC.

Methodology: A pre-post interventional quantitative study was conducted involving four UK-based Foundation Year 1 trainees. Participants received training in five knot-tying techniques from four Nepal-based 3rd/4th-year medical students, supported by additional mentors. Training was done using a cup and thread. Pre/post surveys were shared online and analysed using SPSS.

Result: All four participants had no prior formal surgical skills training. Participants demonstrated increase in self-reported confidence across all knot-tying techniques; Reef Knot increased by +3.0, Single-Handed Knot (+3.25), Double-Handed Knot (+3.5), Tying at Depth (+3.0), and Instrument Tying (+1.75); p=0.068–0.18. All rated the trainers as very effective and all participants felt entirely comfortable learning from someone trained in a different healthcare system. Peer collaboration and the LMIC-HIC paired teaching model were rated as extremely helpful by all participants.

Conclusion: The campaign showed that LMIC-trained peer educators can effectively teach knot-tying to HIC trainees, with all participants improving their skills. The fully positive response to this LMIC-HIC model shows how knowledge can be shared both ways and supports the long-term goal of building sustainable surgical education worldwide.

Keywords: Peer Teaching, Surgical Training