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Arthur Johnson

My research examines how surgical care performs when healthcare systems are placed under extreme pressure, from mass casualty incidents and disasters in the Nordic region to prolonged resource constraints in low- and middle-income countries.

I combine active clinical practice with systems-level research to generate knowledge that can be directly applied in practice and that strengthens surgical care when demands are at their highest.

Surgery under strain — preparedness, access, and outcomes in challenging environments

Surgical care rests on a fragile chain: a well-trained surgeon, a functioning surrounding system, and a continuous pipeline of new surgeons in training. This chain is tested as soon as conditions become atypical: a mass casualty incident, a fire disaster, a humanitarian deployment, or the everyday reality of a healthcare system with too few surgeons and too many patients. My research investigates how this chain holds under such conditions, and which concrete measures can make it more resilient. A central aim is to produce findings that clinicians, healthcare systems, and decision-makers can act upon.

My research

My research revolves around three interconnected areas where this chain is most clearly tested:

  • Preparedness for mass casualty incidents and disasters. This is the focus of my doctoral work at Linköping University. It includes adapting the U.S. military KSA framework (Knowledge–Skills–Abilities) for measuring surgical preparedness to the Swedish KVÃ… procedure coding system, comparing preparedness among general surgeons at university and county hospitals, and evaluating a scenario-based educational intervention on mass casualty incidents for Swedish medical students.
  • Burn care under strain, studied at both system and clinical levels. At the system level, this includes a Nordic mixed-methods study of preparedness for mass burn casualty incidents, involving burn centers, trauma centers, and regional hospitals. At the clinical level, it includes research on risk factors for wound infection in children with scald injuries, conducted in collaboration with the Burn Centre at Linköping University Hospital.
  • Surgical care in low- and middle-income countries. This includes research on the development of the caesarean section rate as a practical indicator of access to surgical care, as well as a research program on outcomes in breast cancer among women living with HIV. The work is based on field research conducted as a Fogarty Global Health Fellow at Princess Marina Hospital and the Botswana Baylor Children’s Clinical Centre of Excellence in Gaborone.

A unifying principle across all three areas is that surgical research creates the greatest value when it remains closely connected to the operating theatre and the systems that surround it.