Okoli Chinedu, Nwanna-Nzewunwa Obieze, Onyinyechukwu Adaeze Arua, Etukokwu Ekene, Okoli Chinenye
General Surgery, Institute for African Research, Innovation, and Education, Port Harcourt, NGA.
General Surgery, MaineHealth, Portland, USA.
Cureus. 2024 Sep 8;16(9):e68923. doi: 10.7759/cureus.68923. eCollection 2024 Sep.
Aim Cardiothoracic surgery has the potential to improve care in resource-deprived countries like Nigeria. This study analyzes the barriers to training in cardiothoracic surgery and gaps in the existing curriculum from a cardiothoracic surgery trainee perspective. Methods An online nationwide mixed-method cross-sectional survey was conducted. The participants were from a pool of senior residents in cardiothoracic surgery. A five-point Likert scale was utilized to rate and evaluate their training experiences. The motivations for choosing cardiothoracic surgery, gaps in the training curriculum, perceived barriers, and facilitators in their training programs were also assessed. The survey included closed and open-ended questions to capture quantitative data and qualitative insights. The quantitative data were analyzed using SPSS 21 (Armonk, NY: IBM Corp), while the qualitative data were analyzed using MAXQDA 24 (Berlin, Germany: VERBI Software). Results Sixteen senior cardiothoracic surgery residents completed the survey. Thematic grouping identified several key barriers, such as low case volume, lack of infrastructure and equipment, and reduced trainee autonomy during cases. The significant deficiencies in the existing curriculum are the absence of clear minimum competencies, lack of local and international collaboration, and robust cardiac training. In low-resource settings like Nigeria, government participation and improved funding, increased collaboration between local and international programs, and establishment of regional centers may offer solutions and successful implementation of cardiothoracic surgery training and improve access to surgical care. Conclusion Cardiothoracic trainees are highly interested in their training despite several barriers. Increased funding, collaboration, and infrastructure development will help improve the training experience.
目的 心胸外科手术有潜力改善像尼日利亚这样资源匮乏国家的医疗服务。本研究从一名心胸外科住院医师的角度分析了心胸外科手术培训的障碍以及现有课程中的差距。方法 开展了一项全国性的在线混合方法横断面调查。参与者来自心胸外科的高级住院医师群体。采用五点李克特量表对他们的培训经历进行评分和评估。还评估了他们选择心胸外科手术的动机、培训课程中的差距、感知到的障碍以及培训项目中的促进因素。该调查包括封闭式和开放式问题，以获取定量数据和定性见解。定量数据使用SPSS 21（纽约州阿蒙克：IBM公司）进行分析，而定性数据使用MAXQDA 24（德国柏林：VERBI软件）进行分析。结果 16名心胸外科高级住院医师完成了调查。主题分组确定了几个关键障碍，如病例数量少、缺乏基础设施和设备以及手术过程中住院医师自主权降低。现有课程的重大缺陷包括缺乏明确的最低能力要求、缺乏本地和国际合作以及强大的心脏培训。在像尼日利亚这样的低资源环境中，政府参与和资金改善、本地和国际项目之间加强合作以及建立区域中心可能会为心胸外科手术培训提供解决方案并成功实施，同时改善手术治疗的可及性。结论 尽管存在诸多障碍，心胸外科住院医师对他们的培训仍高度感兴趣。增加资金、合作和基础设施发展将有助于改善培训体验。
