{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:46:25Z","timestamp":1791963985925,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009099","name":"Irish Aid","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009099","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012921","name":"Royal College of Surgeons in Ireland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Surgical training logbooks are vital for tracking trainee experience and training quality. As the College of Surgeons of East, Central and Southern Africa (COSECSA) expanded across 24 countries, its paper\u2010based system outgrew the capacity of paper logbooks. In partnership with the Royal College of Surgeons in Ireland, COSECSA developed an electronic logbook (eLogbook) to enhance data collection, trainee monitoring, and quality assessment. This study reviews its evolution using a theory of change framework to inform future surgical training needs in sub\u2010Saharan Africa and beyond.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We applied a retrospective theory of change (ToC) framework to analyze the development, implementation, and impact of the COSECSA eLogbook. Data sources included archived project records, eLogbook data, and published articles utilizing logbook data. Descriptive summaries were generated to analyze the logged surgical procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Phased rollout began in 2015 with full adoption in 2017. By the end of 2025, 1806 trainees had logged 712,118 procedures. The eLogbook facilitated training standardization across multiple countries and improved monitoring. Studies utilizing logbook data have identified disparities in procedural exposure, training gaps, and speciality\u2010specific challenges. The logbook also supported quality assurance and program improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Key challenges include limited internet access, necessitating offline functionality, and initial resistance to digital adoption mitigated through training and iterative refinements. Lessons from COSECSA informed the development of a similar logbook for the College of Anesthesiologists in East, Central, and Southern Africa (CANECSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The COSECSA eLogbook has revolutionized surgical training documentation, enabling data\u2010driven evaluation and standardization across programs. It showcases how digital tools and long\u2010term international collaboration can strengthen surgical education in low\u2010resource settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70573","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:42:12Z","timestamp":1789803732000},"page":"2937-2945","source":"Crossref","is-referenced-by-count":0,"title":["Transforming Surgical Training: The Evolution of the COSECSA eLogbook Through a Theory of Change Framework"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3657-1695","authenticated-orcid":false,"given":"Lawa","family":"Shaban","sequence":"first","affiliation":[{"name":"Institute of Global Surgery RCSI  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Brocato","sequence":"additional","affiliation":[{"name":"Institute of Global Surgery RCSI  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4163-8572","authenticated-orcid":false,"given":"Eric","family":"O'Flynn","sequence":"additional","affiliation":[{"name":"Institute of Global Surgery RCSI  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0018-9096","authenticated-orcid":false,"given":"Abebe","family":"Bekele","sequence":"additional","affiliation":[{"name":"College of Surgeons in East, Central and Southern Africa  Arusha Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Borgstein","sequence":"additional","affiliation":[{"name":"College of Surgeons in East, Central and Southern Africa  Arusha Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0956-0122","authenticated-orcid":false,"given":"Laston","family":"Chikoya","sequence":"additional","affiliation":[{"name":"College of Surgeons in East, Central and Southern Africa  Arusha Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani Pascal","family":"Uiso","sequence":"additional","affiliation":[{"name":"College of Surgeons in East, Central and Southern Africa  Arusha Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Geraghty","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Puyana","sequence":"additional","affiliation":[{"name":"Institute of Global Surgery RCSI  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2021.10.002"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ime2040025"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/upj.0000000000000676"},{"key":"e_1_2_11_5_1","unstructured":"COSECSA \u201cOur History.\u201d Webpage.2024 accessed 13\/11\/2024 https:\/\/www.cosecsa.org\/our\u2010history\/."},{"key":"e_1_2_11_6_1","unstructured":"COSECSA.Accredited Hospitals. COSECSA. 19\/05\/2026 2026 accessed 19\/05\/2026 https:\/\/www.cosecsa.org\/accredited\u2010hospitals\u20102\/."},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2021.11.003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909\u2010021\u201003012\u2010z"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.08.028"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.14245\/ns.2448838.419"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/wjs.12545"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2021.10.001"},{"issue":"1","key":"e_1_2_11_13_1","article-title":"Review of the Use of \u2018Theory of Change\u2019 International Development","volume":"83","author":"Vogel I.","year":"2012","journal-title":"DFID"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010016\u20100422\u20106"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12992\u2010018\u20100327\u2010z"},{"key":"e_1_2_11_16_1","unstructured":"Royal College of Surgeons in Ireland IoGS.RCSI\/COSECSA Collaboration Programme. 29\/07\/2025 2025 accessed 29\/07\/2025 https:\/\/www.rcsi.com\/surgery\/global\u2010surgery\/our\u2010projects\/cosecsa."},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010023\u201007164\u20105"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010020\u201005892\u20106"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010020\u201005613\u2010z"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2023.12.004"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010024\u201010960\u20102"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102015\u2010004411"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.70389\/PJS.100082"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2025.1430"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2020.08.045"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/sni.sni_83_17"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70573","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70573","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70573","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:02:33Z","timestamp":1791961353000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,19]]},"references-count":25,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/wjs.70573"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70573","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,19]]}}}