BackgroundPreoperative anxiety is a common occurrence in patients awaiting surgery. Preoperative anxiety adversely affects anaesthesia and surgical process and increases the risk of postoperative complications. Level of anxiety in patients awaiting surgical procedures in Rwanda is not well known or documented. Objective To assess preoperative anxiety and associated factors of patients awaiting surgery at a teaching hospital in Kigali. Methods A cross-sectional study design was adopted. A convenience sampling method was used to recruit 151 adult patients, and the instrument entitled "Pre-operative Intrusive Thoughts Inventory (PITI)" anxiety scale was used to assess anxiety. Descriptive and inferential statistics were used to analyse data. ResultsNearly three quarters (72.8%) of participants had a high level of clinically significant preoperative anxiety. Patients awaiting orthopaedic surgery were 10 times more likely to have clinically significant pre-operative anxiety (OR 10.22; 95%; CI 1.144 -91.304; P= 0.037), whereas participants with impending Cesarean (OR: 0.03; 95% CI-0.002-0.568; P=0.018), and older participants had decreased pre-operative anxiety levels (OR: 0.22; 95% CI 0.075 -0.650; P=0.006). ConclusionPatients awaiting surgery had clinically significant pre-operative anxiety level (72.8%) associated with age, medical diagnosis and type of surgical intervention. A preoperative intervention incorporating individual characteristics is needed to reduce preoperative anxiety.

BackgroundTo continue delivering the courses despite school closure during the covid-19 pandemic, the University of Rwanda abruptly shifted its teaching from traditional physical to online teaching. This was the compulsory medium of teaching during the lockdown period. This sudden change did not allow for adequate preparation for students. ObjectivesTo assess the preparation of learners to use the e-learning platform, and to explore the factors that enabled or inhibited learners’ use of the e-learning platform. MethodThis was a cross-sectional quantitative research design study done between June and July 2020. An online questionnaire was sent to all students registered in the College of Medicine and Health Sciences for the academic year 2019-2020. ResultsA total of 446 students completed the questionnaire. Students reported not being adequately oriented and unprepared to effectively use e-learning. Students were motivated to use e-learning when the learning objectives were clear, interactive, with engaging materials. Inadequate e-learning infrastructure, limited access to internet connectivity and inadequate devices were identified as the strongest barriers of using e-learning. ConclusionThe covid-19 pandemic has brought a transformational opportunity to embrace a blended learning approach. To sustain such a transformation, proper and timely planning and strategies need to be invested. Rwanda J Med Health Sci 2022;5(1):99-112

Background: Clinical experiences allow nursing students to apply theoretical knowledge into practice hence socialize with their future professional roles and responsibilities. This is a report of observations made by thirteen perioperative nursing students in the first cohort of Master of sciences in nursing training program during their practicum in selected Rwandan Referral Hospitals aimed at improving students' learning outcomes in future. Methods: Teams of four to five students were allocated to the operating theatres in three selected referral and teaching hospitals in Rwanda for thirteen weeks. At the end of their clinical placement, they wrote clinical reports that highlighted their observations informed by theoretical knowledge of perioperative nursing care using a structure, process and outcome format. These reports focused on the strengths and challenges observed. Results: Students were able to translate theoretical knowledge gained in class to clinical practice. Although the hospitals provided good learning opportunities in relation to the number of patients attended to and the various surgical treatments provided, the existing infrastructures, and care delivery systems, still need improvement. Conclusions: Hospital structure and processes helped the students to achieve their clinical learning objectives. Fostering strong collaboration of Universities, Hospitals and Ministry of Health will promote specialization in the emerging field of perioperative nursing in Rwanda.

Nurses within a surgical team play such a fundamental role in the success of a surgery that they require specific training for the purpose. However, in Rwanda, there has been a severe scarcity of perioperative nurses. This article describes the collaborative effort for perioperative nursing training by the University of Rwanda (UR) and the Ministry of Health (MOH) with the Human Resources for Health (HRH) Program and a consortium of American Universities. The goal of the HRH program has been to build up the capacities of health professionals both in academia and clinical settings so as to address the shortage of qualified staff. In that regard, the UR in 2015 started a Masters program in nursing in eight specialties, of which one was perioperative nursing. The aim of this paper is to highlight the training process, success, and challenges of perioperative nursing training in Rwanda. The training has so far been successful, with the 19 nurses who completed the program working now in academic and clinical teaching institutions. Students in the program have also increased their number of research publications in peer-reviewed journals and international conference presentations. The UR and its partners are investing in the sustainability and excellence of this program. Using the import-of-experts approach to train Rwandans within their country, the program addresses the scarcity of specialists in various disciplines within the nursing profession. As a consequence,  countries where the lack of specialized nurses poses challenges may adopt this partnership strategy. Rwanda J Med Health Sci 2021;4(1):185-196

BackgroundSurgery cancellation is a challenging and costly event resulting in operating theatre inefficiency and psychological and financial problems for the patients and their families. This study aimed to find out the incidence and reasons for surgical cancellation at a Rwandan hospital.MethodsA retrospective study was conducted on 736 patients’ files obtained from theatre registry lists of surgical operations done from January to March 2017. The American Association of Perioperative Nurses (AORN) checklist for documenting cancelled surgical cases was used to establish the rate and reasons for cancellation. Data were analyzed using frequency and percentage descriptive statistics.ResultsOut of the 736 surgeries booked, 179 (24.3%) were cancelled as follows: Orthopedic and general surgeries (28.2%) respectively, gynecology and obstetrics (27.4%), urology surgeries (15.5%), maxillofacial surgeries (15.9%), ENT (15.6%) and plastic surgeries (13.3%). Time constrain/long list (19.6%), acute change in medical status (10.6%), non-turn-up of the patient (8.4%), and abnormal lab findings (7.8%) were the most prevalent reasons.ConclusionThe surgical cancellation rate at the study hospital was 24%, increasing with the number of patients booked and the type of surgical procedure. A prospective study is required to gain more insight into the reason for cancellations, mostly amenable to mitigation measures.Rwanda J Med Health Sci 2021;4(3):379-386