Patel N, Leusink A Leusink, Singh N, Koto M Z, Luvhengo T
Department of Paediatric Surgery, University of the Witwatersrand, Johannesburg, South Africa.
Department of Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
S Afr J Surg. 2018 Jun;56(2):10-14.
Surgical training varies significantly amongst universities within the same country. This trend is reflected in South Africa and provides an opportunity for innovation to improve the quality of general surgical training.
To assess the perceptions of South African general surgery registrars regarding surgical training.
A prospective descriptive study was performed by means of a confidential questionnaire distributed to general surgical registrars at all eight training centers in South Africa. Participants were asked to give comments regarding adequacy of formal academic teaching, level of supervision during surgical procedures, exposure to and training in minimally invasive surgery (MIS), and preparation for examinations. Descriptive statistics were generated with Microsoft Excel. Ethics clearance was obtained from the University of the Witwatersrand Human Research Ethics Committee.
Of 200 questionnaires distributed 105 (52.5%) were returned. 44% (105/241) of all registrars from six training institutions participated. 89.5% (94/105) of respondents reported that they attended less than six hours of formal academic teaching per week and 71.4% (75/105) indicated that their institution offered less than six hours of formal academic teaching per week. 76.2% (80/105) of respondents regarded lack of protected academic time as the greatest obstacle to their surgical training and 95.2% (99/105) reported that clinical responsibilities prevented them from attending formal academic teaching regularly. Overall, only 31.4% (33/105), 41.9% (44/105) and 37.1% (39/105) were satisfied with the amount of formal academic teaching, level of supervision during theatre procedures and exposure to minimally invasive surgery respectively. Lack of resources and lack of appropriate skills were identified as a hindrance to MIS training by 47.6% (50/105) and 28.6% (30/105) of respondents respectively.
Surgical registrars are dissatisfied with the amount of formal academic teaching and protected academic time, level of supervision in theatre and their exposure to MIS. These challenges compromise trainees' ability to practice independently after qualification. Numerous interventions are necessary and possible to address these challenges.
在同一个国家内，各大学之间的外科培训差异显著。这种趋势在南非也有所体现，这为创新提供了契机，以提高普通外科培训的质量。
评估南非普通外科住院医师对外科培训的看法。
通过向南非所有八个培训中心的普通外科住院医师发放保密问卷进行前瞻性描述性研究。参与者被要求就正规学术教学的充分性、手术过程中的监督水平、微创手术（MIS）的接触和培训以及考试准备情况发表意见。使用微软Excel生成描述性统计数据。获得了威特沃特斯兰德大学人类研究伦理委员会的伦理批准。
在发放的200份问卷中，回收了105份（52.5%）。来自六个培训机构的所有住院医师中有44%（105/241）参与了调查。89.5%（94/105）的受访者报告称，他们每周参加的正规学术教学少于6小时，71.4%（75/105）表示他们所在机构每周提供的正规学术教学少于6小时。76.2%（80/105）的受访者认为缺乏受保护的学术时间是他们外科培训的最大障碍，95.2%（99/105）报告称临床职责使他们无法定期参加正规学术教学。总体而言，分别只有31.4%（33/105）、41.9%（44/105）和37.1%（39/105）的受访者对正规学术教学的量、手术过程中的监督水平和微创手术的接触程度感到满意。分别有47.6%（50/105）和28.6%（30/105）的受访者认为资源短缺和缺乏适当技能是微创培训的障碍。
外科住院医师对正规学术教学的量、受保护的学术时间、手术中的监督水平以及他们接触微创手术的情况不满意。这些挑战损害了受训者毕业后独立执业的能力。需要并有可能采取多种干预措施来应对这些挑战。
