Our team is actively engaged in a wide range of research initiatives across global health and global surgery, spanning both published work and studies currently under review.
Our research projects span a wide range of global surgery and health systems topics, using both qualitative and quantitative approaches to better understand how surgical care is delivered and experienced across different settings. This work includes environmental scans and scoping reviews on surgical systems and training, as well as the development of low-cost educational simulators and ongoing studies focused on rural and Indigenous surgical access in British Columbia and beyond. Explore the research categories below for more detailed titles.
- Jedrzejko N, Margolick J, Nguyen JH, Ding M, Kisa P, Ball-Banting E, Hameed M, Joos E. A systematic review of global surgery partnerships and a proposed framework for sustainability. Canadian Journal of Surgery. 2021;64(3):E280–E288. https://doi.org/10.1503/cjs.010719
- Binda C, Adams J, Lam S, Panchendrabose K, Joharifard S, Haji F, Joos E. Defining a framework and evaluation metrics for sustainable global surgical partnerships: a modified Delphi study. Annals of Surgery. 2023 Aug 4. https://pubmed.ncbi.nlm.nih.gov/37539584/
- Salehi M, Zivkovic I, Mayronne S, Letoquart JP, Joharifard S, Joos E. The evaluation of a surgical task-sharing program in South Sudan. Surgeries. 2023. https://doi.org/10.3390/surgeries4020019
- Livergant R, Demetrick S, Cravetchi X, Kung JY, Joos E, Hawes H, Saleh A. Trauma training courses and programs in low- and lower middle-income countries: a scoping review. World Journal of Surgery. 2021 Dec. https://doi.org/10.1007/s00268-021-06283-1
- Heo K, Cheng S, Joos E, Joharifard S. Use of innovative technology in surgical training in resource-limited settings: a scoping review. Journal of Surgical Education. 2023 Dec 30. https://pubmed.ncbi.nlm.nih.gov/38161100/
- Cheng S, Heo K, Joos E, Vervoort D, Joharifard S. Barriers to accessing congenital heart surgery in resource-limited settings. World Journal for Pediatric and Congenital Heart Surgery. 2024 Jan. https://pubmed.ncbi.nlm.nih.gov/37915213/
- Vayalikunnel R, Zanotto Manoel P, Zanotto Manoel A, Jeyakumar M, Chen LQ, Jeyakumar R, Balmes P, Lalande A, MacNeill AJ, Joharifard S, Joos E. Global Surgical Education - Journal of the Association for Surgical Education. 2025 Dec 4. Planetary health courses around the world: an environmental scan. https://doi.org/10.1007/s44186-025-00416-z
- Rebello L, Livergant R, Khanbadr P, Bednarek O, Joharifard S. Simulation models for training in pediatric general, thoracic, plastic, and urologic surgery in low-resource settings: a scoping review. Journal of Pediatric Surgery. 2025 Jan 23. https://pubmed.ncbi.nlm.nih.gov/39890497/
- Livergant R, Bednarek O, Gerk Rangel A, Puhama A, Binda CK, Ackermann A, Zivkovic I, Magzoub A, Joos E, Pilkington M, Baird R, Joharifard S. Journal of Pediatric Surgery. Who’s training tomorrow’s pediatric surgeons? A global review of pediatric surgery postgraduate training programs in low- and middle-income countries. 2026 Feb 3. https://doi.org/10.1016/j.jpedsurg.2026.162993
- Zivkovic I, Lau D, Adams J, Blackman C, Livergant R, Binda C, Dorling M, Joharifard S, Joos E. Global rural and remote pre-hospital trauma systems: a scoping review. IJS Global Health. 2026 Mar. https://doi.org/10.1097/GH9.0000000000000620
- MacDonald B, Livergant R, Binda C, Luthra S, Moti M, Falk R, Ebert N, Joharifard S, Joos E. Mapping surgical services in rural British Columbia: an environmental scan. British Columbia Medical Journal. (Ongoing)
- Binda C, Livergant R, Tersago J, Jami Z, Chen LQ, Birch L, Blackman C, Chin E, Wild H, Joos E, Joharifard S. Monitoring and evaluation strategies for surgical task shifting and task sharing interventions: a scoping review. (Ongoing)
- Heo K, Greaney E, Hael J, Stunden C, Lindner A, Malik P, Rosenbaum DG, Muensterer O, Zakani S, Jacob J, Joharifard S. Iterative design and manufacturing of a 3D-printed pediatric open and laparoscopic integrated simulator for hernia repair (POLISHeR). Journal of Pediatric Surgery. 2025 Feb 10. PMID: https://pubmed.ncbi.nlm.nih.gov/40011165/
- Shum-Tim L, Desaigoudar V, Mashat A, Hsiao H, Malik PRA, Malone K, Abdalla M, Rajagopalan S, Mourad N, Bos C, Joos E, Joharifard S. Iterative design and manufacturing of a low-cost, low-fidelity simulator for cricothyroidotomy. 2025 Oct. https://pubmed.ncbi.nlm.nih.gov/41322752/
- Malik P, Hael J, Livergant R, Heo K, Shum-Tim L, Lindner A, Muensterer O, Joharifard S. Molding mastery: validation of a 3D-printed simulator for pediatric inguinal hernia repair. Journal of Pediatric Surgery. 2026 Jan. https://doi.org/10.1016/j.jpedsurg.2026.162955
- Yeung R, Kwon DS, Mashat A, Banga A, Livergant R, Tam R, Joharifard S. Design and validation of a low-cost modular simulator for training in neonatal laparotomy and jejunoileal atresia repair. Journal of Pediatric Surgery. 2026 Jan. https://pubmed.ncbi.nlm.nih.gov/40812412/
- Binda C, Adams J, Vayalikunnel R, Joharifard S, Joos E. Creating concise reference videos for a surgical training program in low-resource settings. (Ongoing)
- Livergant R, Fraulin G, Stefanyk K, Binda C, Maleki S, Joharifard S, Hillier T, Joos E. Postoperative morbidity and mortality in pediatric Indigenous populations: a scoping review and meta-analysis. Pediatric Surgery International. 2023 Feb 16. https://pubmed.ncbi.nlm.nih.gov/36795335/
- Livergant R, Stefanyk K, Binda C, Fraulin G, Maleki S, Sibbeston S, Joharifard S, Hillier T, Joos E. Post-operative outcomes in Indigenous patients in North America and Oceania: a systematic review and meta-analysis. PLOS Global Health. 2023 Aug 16. https://pubmed.ncbi.nlm.nih.gov/37585444/
- Qualitative Research on Indigenous Surgery Access in British Columbia (Ongoing)
Sustainable Global Surgical Partnerships
Partnerships between high-resourced and low-resourced settings are often created to address the burden of unmet surgical need. Reflecting on the negative, unintended consequences of asymmetrical partnerships, global surgery community members have proposed frameworks and best practices to promote sustainable engagement between partners, though these frameworks lack consensus. This project proposes a cohesive, consensus-driven framework with accompanying evaluation metrics to guide sustainability in GSPs.
We present the first framework for building sustainable GSPs using the input of experts from all World Health Organization regions. We hope this tool will help the global surgery community to find noncolonial solutions to addressing the gap in access to quality surgical care in low-resource settings. Read the full study published in Annals of Surgery (2024).
Additionally, broader work in global health research has examined how to address inequities in international research collaborations. Through a review of existing literature and a series of workshops, Morton et al. (2021) discussed equitable authorship and the responsibilities of academic journals in evaluating research conducted across high- and low-resource settings. Based on these discussions, guidance was developed for both authors and journal editors to promote fairer research practices. One key recommendation is that studies conducted in low- or middle-income countries through collaborations with high-income institutions include structured reflexivity statements that describe how partnerships, contributions, and authorship decisions were determined.
Access the documents below:
Featured Publications
Global Surgery Interest and Engagement in Canadian Thoracic Surgery Practice
Thoracic pathologies pose a substantial health burden in low- and middle-income countries. Compounding the high incidence of these conditions, a global shortage and unequal distribution of surgical professionals exacerbate morbidity, mortality, and disability-adjusted life years in these regions. Global thoracic surgery aims to address these disparities. This study explores the interest, engagement, and perceived importance of global surgical care among Canadian thoracic surgeons.
VitalSurg: Outcomes From a Surgical Task-Shifting Training Program in a Humanitarian Context
The Vital Surgery Training Program (VitalSurg) is a task-shifting initiative designed to build local surgical capacity in surgical deserts by training generalist doctors to perform essential procedures. Implemented in partnership with Médecins Sans Frontières (MSF), the program has undergone 2 pilot iterations in South Sudan. This study evaluates the second iteration, which reflects a refined curriculum and integrated assessment strategy informed by lessons learned from the first iteration. This study sought to examine the feasibility, effectiveness, and adaptability of competency-based surgical training embedded within humanitarian clinical care.
International Consensus on Global Surgery Learning Objectives and Competencies
As global surgery emerges as an academic field, there is a growing need for consensus-driven learning objectives to guide education and training. Existing curricula vary widely and lack multidisciplinary input. This study aimed to achieve international consensus on core learning objectives for global surgery education.