More time should be spent reflecting on work related to ISTCs. After any on-the-ground experiences within an ISTC, there should be an open meeting to reflect on what worked well and what did not, as well as other lessons learned. These lessons from previous experiences can be applied to future work to improve efficacy. Integral to this process is the involvement of local stakeholders, such as surgeons, nurses, and other healthcare providers, who can provide constructive feedback on the elements of the partnership that are going well and those that are not. For example, Human Resources for Health in Rwanda has gained valuable insight from introspective reflection of their program’s growth . Additionally, many participants had also reported that people who would consider becoming involved in ISTCs remain unaware of their options for participation. Reflection meetings could not only improve collaborations, but could increase the number of participants, which could help advance global surgery efforts .