Implementing surgical mentorship in a resource-constrained context: a mixed methods assessment of the experiences of mentees, mentors, and leaders, and lessons learned.

Autor: Alidina S; Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, MB, Boston, USA. Shehnaz_Alidina@hms.harvard.edu., Sydlowski MM; Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, MB, Boston, USA., Ahearn O; Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, MB, Boston, USA., Andualem BG; Amhara Regional Health Bureau, Federal Ministry of Health, Addis Ababa, Ethiopia., Barash D; GE Foundation, Boston, MA, USA., Bari S; Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, MB, Boston, USA., Barringer E; D-Implement, Dalberg Advisors, New York, USA., Bekele A; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Beyene AD; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Burssa DG; Federal Ministry of Health, Addis Ababa, Ethiopia., Derbew M; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Drown L; Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, MB, Boston, USA., Gulilat D; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Gultie TK; Safe Surgery 2020, Project, Jhpiego, Addis Ababa, Ethiopia., Hayirli TC; Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, MB, Boston, USA., Meara JG; Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, MB, Boston, USA.; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.; Department of Pediatrics, University of Melbourne, Melbourne, Australia., Staffa SJ; Department of Anesthesiology and Surgery, Boston Children's Hospital, Boston, MA, USA., Workineh SE; Safe Surgery 2020, Project, Jhpiego, Addis Ababa, Ethiopia., Zanial N; Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Avenue, MB, Boston, USA., Zeleke ZB; Amhara Regional Health Bureau, Federal Ministry of Health, Addis Ababa, Ethiopia., Mengistu AE; Safe Surgery 2020, Project, Jhpiego, Addis Ababa, Ethiopia., Ashengo TA; Safe Surgery 2020, Jhpiego, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: BMC medical education [BMC Med Educ] 2022 Aug 31; Vol. 22 (1), pp. 653. Date of Electronic Publication: 2022 Aug 31.
DOI: 10.1186/s12909-022-03691-2
Abstrakt: Background: A well-qualified workforce is critical to effective functioning of health systems and populations; however, skill gaps present a challenge in low-resource settings. While an emerging body of evidence suggests that mentorship can improve quality, access, and systems in African health settings by building the capacity of health providers, less is known about its implementation in surgery. We studied a novel surgical mentorship intervention as part of a safe surgery intervention (Safe Surgery 2020) in five rural Ethiopian facilities to understand factors affecting implementation of surgical mentorship in resource-constrained settings.
Methods: We designed a convergent mixed-methods study to understand the experiences of mentees, mentors, hospital leaders, and external stakeholders with the mentorship intervention. Quantitative data was collected through a survey (n = 25) and qualitative data through in-depth interviews (n = 26) in 2018 to gather information on (1) intervention characteristics including areas of mentorship, mentee-mentor relationships, and mentor characteristics, (2) organizational context including facilitators and barriers to implementation, (3) perceived impact, and (4) respondent characteristics. We analyzed the quantitative and qualitative data using frequency analysis and the constant comparison method, respectively; we integrated findings to identify themes.
Results: All mentees (100%) experienced the intervention as positive. Participants perceived impact as: safer and more frequent surgical procedures, collegial bonds between mentees and mentors, empowerment among mentees, and a culture of continuous learning. Over 70% of all mentees reported their confidence and job satisfaction increased. Supportive intervention characteristics included a systems focus, psychologically safe mentee-mentor relationships, and mentor characteristics including generosity with time and knowledge, understanding of local context, and interpersonal skills. Supportive organizational context included a receptive implementation climate. Intervention challenges included insufficient clinical training, inadequate mentor support, and inadequate dose. Organizational context challenges included resource constraints and a lack of common understanding of the intervention.
Conclusion: We offer lessons for intervention designers, policy makers, and practitioners about optimizing surgical mentorship interventions in resource-constrained settings. We attribute the intervention's success to its holistic approach, a receptive climate, and effective mentee-mentor relationships. These qualities, along with policy support and adapting the intervention through user feedback are important for successful implementation.
(© 2022. The Author(s).)
Databáze: MEDLINE
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