A national perspective on exposure to essential surgical procedures among medical trainees in Nigeria: a cross-sectional survey and recommendations.

Autor: KingPriest PT; Surgical Equity and Research Hub, Jos, Nigeria.; The Global Health Network, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK., Alayande BT; Surgical Equity and Research Hub, Jos, Nigeria. dr.alayande@gmail.com.; Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda. dr.alayande@gmail.com.; Harvard TH Chan School of Public Health, Boston, USA. dr.alayande@gmail.com., Clement EW; University of Jos, Jos, Nigeria., Muhammed M; Usman Danfodio University, Sokoto, Nigeria., Egbiri JO; Benue State University, Makurdi, Nigeria., Shanabo M; Bingham University Teaching Hospital, Jos, Nigeria., Osayande EK; University of Benin, Benin, Nigeria., Atunrase AA; Afe Babalola University, Ado-Ekiti, Nigeria., Abubakar JI; University of Nigeria, Nsukka, Nigeria., Eze DC; University of Ibadan, Ibadan, Nigeria., Adekoya S; Olabisi Onabanjo University, Sagamu, Nigeria., Chiroma GB; Gombe State University, Gombe, Nigeria., Aikhuomogbe OM; Ambrose Alli University, Ekpoma, Nigeria., Gaila FS; University of Maiduguri, Maiduguri, Nigeria., Yaga D; Kaduna State University, Kaduna, Nigeria., Thomas NN; Madonna University, Elele, Nigeria., Chukwunta CA; Enugu State University of Technology, Enugu, Nigeria., Hey MT; Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.; Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA., Forbes C; Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.; Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA., Riviello RR; Center for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.; Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA., Ismaila BO; University of Jos, Jos, Nigeria.; Jos University Teaching Hospital, Jos, Nigeria.
Jazyk: angličtina
Zdroj: BMC medical education [BMC Med Educ] 2023 Nov 30; Vol. 23 (1), pp. 913. Date of Electronic Publication: 2023 Nov 30.
DOI: 10.1186/s12909-023-04847-4
Abstrakt: Background: In sub-Saharan Africa, recent graduates from medical school provide more direct surgical and procedural care to patients than their counterparts from the Global North. Nigeria has no nationally representative data on the procedures performed by trainees before graduation from medical school and their confidence in performing these procedures upon graduation has also not been evaluated.
Methods: We performed an internet-based, cross-sectional survey of recent medical school graduates from 15 accredited Federal, State, and private Nigerian medical schools spanning six geopolitical zones. Essential surgical procedures, bedside interventions and three Bellwether procedures were incorporated into the survey. Self-reported confidence immediately after graduation was calculated and compared using cumulative confidence scores with subgroup analysis of results by type and location of institution. Qualitative analysis of free text recommendations by participants was performed using the constant comparative method in grounded theory.
Results: Four hundred ninety-nine recent graduates from 6 geopolitical zones participated, representing 15 out of a total of 44 medical schools in Nigeria. Male to female ratio was 2:1, and most respondents (59%) graduated from Federal institutions. Students had greatest practical mean exposure to bedside procedures like intravenous access and passing urethral foley catheters and were most confident performing these. Less than 23% had performed over 10 of any of the assessed procedures. They had least exposures to chest tube insertion (0.24/person), caesarean Sect. (0.12/person), and laparotomy (0.09/person). Recent graduates from Federal institutions had less procedural exposure in urethral catheterization (p < 0.001), reduction (p = 0.035), and debridement (p < 0.035). Respondents that studied in the underserved North-East and North-West performed the highest median number of procedures prior to graduation. Cumulative confidence scores were low across all graduates (maximum 25/60), but highest in graduates from Northern Nigeria and private institutions. Graduates recommended prioritizing medical students over senior trainees, using simulation-based training and constructive individualized non-toxic feedback from faculty.
Conclusion: Nigerian medical students have poor exposure to procedures and low confidence in performing basic procedures after graduation. More attention should be placed on training for essential surgeries and procedures in medical schools.
(© 2023. The Author(s).)
Databáze: MEDLINE
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