Delivering low-intensity psychological interventions in low- and middle-income countries: A systematic review and meta-ethnographic synthesis of lay health workers' experiences.

Perioperative management represents a core competency for physicians entering clinical practice and encompasses a broad range of cognitive and procedural responsibilities across the continuum of surgical care [–]. These include preoperative evaluation and diagnostic assessment, surgical planning, risk stratification, and perioperative medication management, as well as patient communication and informed consent [, –]. Intraoperatively, perioperative competence involves adherence to principles of asepsis, correct sterile gowning and behavior in the operating room, and an understanding of surgical workflows [, ]. Postoperatively, it extends to wound management, monitoring for complications, coordination of follow-up care, and interprofessional communication [, , ]. Although some elements of perioperative management are traditionally associated with surgical specialties, many of these competencies are inherently multidisciplinary and essential for physicians across disciplines, including internal medicine, anesthesiology, emergency medicine, and primary care, where perioperative assessment, medication reconciliation, postoperative monitoring, and patient counseling are routinely required [–, ]. Despite their relevance, perioperative knowledge and skills are encountered inconsistently during undergraduate medical education, [–] often depending on clinical rotations, local teaching culture, and opportunity rather than structured, longitudinal curricula. Elective courses are frequently used to address gaps in undergraduate medical education, particularly in procedural and practice-oriented domains where content may be insufficiently represented or taught in a fragmented manner across disciplines []. However, their evaluation often focuses on short-term satisfaction or on their effectiveness in recruiting students into specific specialties. Such a narrow focus risks overlooking broader educational functions of electives, including the development of professional identity, strengthening of self-efficacy for early clinical responsibilities, and support of informed career decision-making. Importantly, exposure that enables students to critically appraise a specialty and make informed decisions for or against it after structured experience may represent an equally valuable educational outcome. The educational design of the elective emphasized collaborative case-based learning, supervised clinical participation, and guided reflection, approaches consistent with social constructivist learning theory, which views learning as the construction of knowledge through authentic participation and interaction with more experienced clinicians []. In addition, Self-Determination Theory proposes that educational environments supporting learners’ needs for autonomy, competence, and relatedness foster autonomous motivation and facilitate the internalization of learning [, ]. These educational concepts informed the design of the elective and provide a theoretical framework for interpreting the observed educational outcomes.