Implementation and Learning Outcomes of the SURGhub Digital Surgical Training Platform

An implementation-effectiveness study evaluated the United Nations Global Surgery Learning Hub (SURGhub) using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to examine reach, equity, and learning outcomes in surgical continuing professional development. The cross-sectional analysis covered 112 courses delivered between June 2023 and July 2025, combined with an uncontrolled paired analysis of knowledge acquisition among learners.

The platform documented 32,014 course enrolments from healthcare practitioners in 195 countries. Weighted mean learner progression was 29.0%, and the overall weighted mean completion rate was 23.1%. Completion was higher among courses with shorter mean enrolment-to-completion intervals (34.0%) compared to courses with longer intervals (13.8%). Course acceptability was high among completers responding to the survey, with a mean score of 4.57 on a 5-point scale.

In an uncontrolled paired evaluation using a linear mixed-effects model with random intercepts for courses (1,928 paired observations across 33 courses), learners achieved a mean assessment score increase of 33.4 percentage points (95% confidence interval = 29.8–37.1), with course-level improvements ranging between 15.3 and 54.4 percentage points. Analysis of platform equity showed that while learners represented both high-income and low- and middle-income settings, content providers were geographically concentrated in high-income countries. The authors concluded that low-bandwidth, open-access platforms can support surgical education at scale, noting that course completion metrics should be contextualized alongside broader engagement markers and that future work should examine long-term clinical impact, retention, and content generation from low- and middle-income countries.