ArticleWorld journal of surgery2026
Transforming Surgical Training: The Evolution of the COSECSA eLogbook Through a Theory of Change Framework.
Article in World journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Transforming Surgical Training: The Evolution of the COSECSA eLogbook Through a Theory of Change Framework.World journal of surgery · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
introductionSurgical 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-based 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-Saharan Africa and beyond.
methodsWe 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.
resultsPhased 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-specific challenges. The logbook also supported quality assurance and program improvement. DISCUSSION: 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).
conclusionThe COSECSA eLogbook has revolutionized surgical training documentation, enabling data-driven evaluation and standardization across programs. It showcases how digital tools and long-term international collaboration can strengthen surgical education in low-resource settings.
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