Understanding surgical education needs in Zambian residency programs from a Resident's perspective

Wang, David E.; Sultan, Darren; Ismail, Hebah; Robinson, Elizabeth; Zulu, Robert; Musowoya, Joseph; Munthali, James; Hopkins, Mary Ann; Dhage, Shubhada

doi:10.1016/j.amjsurg.2018.12.073

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…Likewise, due to the time constraints of staff surgeons, surgical education is primarily based on learning from textbooks and surgical atlases. The Moi residents have not had access to a surgical skills lab, simulation center or easy-to-access lecture halls [ 2 ]. This bilateral case conference, however, provides a venue for the Moi residents to learn from each other as well as from peers from IU.…”

Section: Discussionmentioning

confidence: 99%

“…Moi Teaching and Referral Hospital (MTRH), affiliated with MU, is one of two national referral centers and is responsible for providing care to over 24 million people in western Kenya. Like other countries in Africa, Kenya has two pathways to becoming a general surgeon: first, a Master of Medicine (MMed) pathway which requires the residents to defend a thesis and second, the College of Surgeons of East, Central and South Africa (COSECSA) fellow program which is predominantly a surgical care pathway [ 2 ]. At MU and MTRH, there are currently 12 clinical MMed and 14 COSECSA general surgery residents.…”

Section: Methodsmentioning

confidence: 99%

“…Surgical training is essential to increasing surgical capacity and improving patient care [ 1 ]. However, training varies from one region to another and is adversely affected by income inequalities between high-income countries (HICs) and low- and middle-income countries (LMICs) via differences in medical equipment, and expertise [ 2 ]. Trainees in LMICs face a shortage of trainers at teaching sites often due to the low number of trained surgeons and high demand for surgical care [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Bilateral trauma case conferences: an approach to global surgery equity through a virtual education exchange

Bhatia

Munda

Okoth³

et al. 2023

Global Surg Educ

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Purpose With increased interest in international surgical experiences, many residency programs have integrated global surgery into their training curricula. For surgical trainees in low- and middle-income countries (LMICs), physical exchange can be costly, and laws in high-income countries (HICs) prevent LMIC trainees from practicing surgery while on visiting rotations. To enrich the educational experience of trainees in both settings, we established a monthly virtual trauma conference between surgery training programs. Methods General surgery teams from two public institutions, a public university with two surgical training programs in Kenya and a public university with two level I trauma centers in the United States, meet monthly to discuss complex and interesting trauma patients. A trainee from each institution presents a clinical case vignette and supplements the case with pertinent peer-reviewed literature. The attendees then answer a series of multiple-choice questions like those found on surgery board exams. Results Monthly case conferences began in September 2017 with an average of 24 trainees and consultant surgeons. Case discussions serve to stimulate dialogue on patient presentation and management, highlighting cost-conscious, high-quality care and the need to adapt practice patterns to meet resource constraints and provide culturally appropriate care. Conclusion Our 5-year experience with this virtual case conference has created a unique and robust surgical education experience for trainees and surgeons who have withstood the effects of the pandemic. These case conferences have not only strengthened the camaraderie between our departments, but also promoted equity in global surgery education and prioritized the learning of trainees from both settings.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bilateral trauma case conferences: an approach to global surgery equity through a virtual education exchange

Bhatia

Munda

Okoth³

et al. 2023

Global Surg Educ

View full text Add to dashboard Cite

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“…Their findings were in keeping with this study regarding the reported problems of the training programme. Available literature indicated that trainees from LRRs believe that they perform high volume of surgical operations but with minimum supervision and less exposure to specialized procedures [ 22 , 23 ]. They also highlighted dissatisfaction of trainees regarding acquired cognitive and affective skills during their training [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Needs assessment study of postgraduate surgical education in Sudan: Trainees perspective

Kheirelseid,

Magzoub,

Ahmed

et al. 2023

PLoS ONE

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Introduction Global interest has increased in improving the quality and increasing the number of graduates from surgical training programmes in countries with limited resources. Needs assessment of stakeholders in the training programmes represent the backbone of such process. The aim of this study was to assess the surgical training in Sudan from trainees’ perspective in order to inform training delivery. Methods We adopted mixed methods design using focus group discussion for qualitative data collection and questionnaire survey for quantitative data. NVivo 20 Pro was used to organize qualitative data and SPSS 24.0 was used for quantitative data analysis. Results Thematic analysis of qualitative data identified three themes. Trainees were overall satisfied that they will make good surgeons after completion of the programme. They identified case volume and collaborations with colleagues as the main strengths of the programme and lacking clear objectives for each year of training and academic activities as the main weaknesses. They suggested motivation of trainers and utilization of online resources and meeting platforms as solutions to improve supervision and academic activities during training. Conclusion The gaps in training and their suggested solutions highlighted by trainees in this study should form the base for reforming the surgical training in Sudan and countries with similar circumstances.

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“…Hence, by increasing individual providers' self‐efficacy we would anticipate improvement in team performance as the individual is able to effectively communicate the goals and needs of the team. SBT using basic models and team role play promises to be efficacious and of value for residents in training in LMICs who may be working in circumstances where direct observation and supervision are not readily available 28 . SBT and additional training modalities are critical to continue lowering rates of maternal and fetal morbidity and mortality around the globe.…”

Section: Discussionmentioning

confidence: 99%

Changing the landscape of obstetric resident education in low‐ and middle‐income countries using simulation‐based training

Meza

Bianco

Herrarte

et al. 2021

Intl J Gynecology & Obste

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Objective To evaluate simulation‐based training (SBT) in low‐ and‐middle‐income countries (LMIC) and the long‐term retention of knowledge and self‐efficacy. Methods We conducted an SBT course on the management of postpartum hemorrhage (PPH), shoulder dystocia (SD), and maternal cardiac arrest (MCA) in three government teaching hospitals in Guatemala. We evaluated changes in knowledge and self‐efficacy using a multiple‐choice questionnaire for 46 obstetrics/gynecology residents. A paired Student's t test was used to analyze changes at 1 week and 6 months after the SBT. Results There was an increase in scores in clinical knowledge of MCA (p < 0. 001, 95% confidence interval [CI] 0.81–1.49) and SD (p < 0.001, 95% CI 0.41–1.02) 1 week after SBT, and a statistically insignificant increase in PPH scores (p = 0.617, 95% CI −0.96 to 0.60). This increase in scores was maintained after 6 months for MCA (p < 0.001, 95% CI 0.69–1.53), SD (p = 0.02 95% CI 0.07–0.85), and PPH (p = 0.04, 95% CI 0.01–1.26). For MCA and SD, the levels of self‐efficacy were increased 1 week following training (p < 0.001, 95% CI 0.83–2.30 and p = 0.008, 95% CI 0.60–3.92, respectively), and at 6 months (p < 0.001, 95% CI 0.79–2.42 and p = 0.006, 95% CI 0.66–3.81, respectively). There was a slight increase in PPH self‐efficacy scores 1 week after SBT (p = 0.73, 95% CI −6.05 to 4.41), maintained after 6 months (p = 0.38, 95% CI −6.85 to 2.85). Conclusion SBT was found to be an effective and feasible method to increase short‐ and long‐term clinical knowledge and self‐efficacy of obstetric emergencies in LMIC.

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Understanding surgical education needs in Zambian residency programs from a Resident's perspective

Cited by 7 publications

References 8 publications

Bilateral trauma case conferences: an approach to global surgery equity through a virtual education exchange

Bilateral trauma case conferences: an approach to global surgery equity through a virtual education exchange

Needs assessment study of postgraduate surgical education in Sudan: Trainees perspective

Changing the landscape of obstetric resident education in low‐ and middle‐income countries using simulation‐based training

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