Skip to main content
Erschienen in: World Journal of Surgery 12/2019

09.09.2019 | Original Scientific Report

Acquisition of Surgical Skills by Final-Year Medical Students in State-Owned Medical Schools of Cameroon: Are We Doing Any Good?

verfasst von: Alain Chichom-Mefire, Njel Gaby Keith, Acho Abongwa, Dickson Shey Nsagha, Marcelin Ngowe-Ngowe

Erschienen in: World Journal of Surgery | Ausgabe 12/2019

Einloggen, um Zugang zu erhalten

Abstract

Introduction

World Health Organization recommends that basic surgical care be administered at the district level. In the absence of qualified surgeons, general practitioners are sometimes proposed to bridge the gap. Medical curricula in low- and middle-income countries must be designed accordingly. The aim of this study was to assess the achievements of training of undergraduate medical students in Cameroon towards meeting this objective.

Methods

A descriptive cross-sectional study was carried out in the four state-owned medical schools in Cameroon. All students who had completed all clinical rotations were assessed with a self-administered questionnaire for their exposure and self-perceived comfort in conducting some selected basic surgical skills and procedures.

Results

A total of 304 (87.6%) students returned filled questionnaires. Their self-perceived comfort in surgical skills ranged from 25% (manual node tying) to 86% (surgical scrubbing). Adequate exposure to selected surgical procedures was 87% for repair of perineal tear complicating vaginal delivery, above 80% for caesarean section and incision and drainage of abscess, 73% for cast immobilization of extremity fracture and just above 50% for hernia repair and appendectomy. It was as low as 3% for bowel resection and anastomosis. The choice to perform extra-curricular activity for skills improvement was significantly associated with adequate exposure (p < 0.05).

Conclusion

Overall, the mastery of practical surgical skills and basic surgical interventions by final-year medical students in Cameroon is insufficient. There is need to reinforce the training and assessment by creating the conditions for an appropriate exposure of medical students during surgical rotations.
Literatur
1.
Zurück zum Zitat Stevermer JJ, Supattanasiri GJ, Williamson H (2001) A survey of general surgeons in rural Missouri: potential for rapid decrease in work force. J Rural Health 17:59–62CrossRef Stevermer JJ, Supattanasiri GJ, Williamson H (2001) A survey of general surgeons in rural Missouri: potential for rapid decrease in work force. J Rural Health 17:59–62CrossRef
2.
Zurück zum Zitat Meara JG, Leather AJM, Hagander L et al (2015) Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 386:569–624CrossRef Meara JG, Leather AJM, Hagander L et al (2015) Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 386:569–624CrossRef
3.
Zurück zum Zitat Liu JH, Etzioni DA, O’Connell JB et al (2004) The increasing workload of general surgery. Arch Surg 139:423–428CrossRef Liu JH, Etzioni DA, O’Connell JB et al (2004) The increasing workload of general surgery. Arch Surg 139:423–428CrossRef
4.
Zurück zum Zitat Chichom MA, Mbome NV, Verla V et al (2017) A retrospective one-year estimation of the volume and nature of surgical and anaesthetic services delivered to the populations of the Fako Division of the South-West Region of Cameroon: an urgent call for action. World J Surg 41:660–671. https://doi.org/10.1007/s00268-016-3775-8 CrossRef Chichom MA, Mbome NV, Verla V et al (2017) A retrospective one-year estimation of the volume and nature of surgical and anaesthetic services delivered to the populations of the Fako Division of the South-West Region of Cameroon: an urgent call for action. World J Surg 41:660–671. https://​doi.​org/​10.​1007/​s00268-016-3775-8 CrossRef
8.
Zurück zum Zitat Lavy C, Tindall A, Steinlechner C et al (2007) Surgery in Malawi—a national survey of activity in rural and urban hospitals. Ann R Coll Surg Engl 89:722–724CrossRef Lavy C, Tindall A, Steinlechner C et al (2007) Surgery in Malawi—a national survey of activity in rural and urban hospitals. Ann R Coll Surg Engl 89:722–724CrossRef
9.
Zurück zum Zitat Loutfi A, Pickering JL (1993) The spectrum of surgery in Ethiopia. Can J Surg 36:91–95PubMed Loutfi A, Pickering JL (1993) The spectrum of surgery in Ethiopia. Can J Surg 36:91–95PubMed
10.
Zurück zum Zitat World Health Organization (2003) Surgical care at the district hospital. WHO, Geneva World Health Organization (2003) Surgical care at the district hospital. WHO, Geneva
11.
Zurück zum Zitat Dimick JB, Cowan JJ, Colletti LM et al (2004) Hospital teaching status and outcomes of complex surgical procedures in the United States. Arch Surg 139:137–141CrossRef Dimick JB, Cowan JJ, Colletti LM et al (2004) Hospital teaching status and outcomes of complex surgical procedures in the United States. Arch Surg 139:137–141CrossRef
13.
Zurück zum Zitat Rose J, Weiser TG, Hider P et al (2015) Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health Estimate. Lancet Glob Health 3(Suppl 2):S13–S20CrossRef Rose J, Weiser TG, Hider P et al (2015) Estimated need for surgery worldwide based on prevalence of diseases: a modelling strategy for the WHO Global Health Estimate. Lancet Glob Health 3(Suppl 2):S13–S20CrossRef
14.
Zurück zum Zitat Bergström S, McPake B, Pereira C, et al (2015) Chapter 7: Workforce innovations to expand the capacity for surgical services. In: Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN (eds) Essential surgery: disease control priorities, third edition (volume 1). The International Bank for Reconstruction and Development/The World Bank, Washington, DC Bergström S, McPake B, Pereira C, et al (2015) Chapter 7: Workforce innovations to expand the capacity for surgical services. In: Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN (eds) Essential surgery: disease control priorities, third edition (volume 1). The International Bank for Reconstruction and Development/The World Bank, Washington, DC
15.
Zurück zum Zitat Thompson MJ, Lynge DC, Larson EH et al (2005) Characterizing the general surgery workforce in rural America. Arch Surg 140:74–79CrossRef Thompson MJ, Lynge DC, Larson EH et al (2005) Characterizing the general surgery workforce in rural America. Arch Surg 140:74–79CrossRef
16.
Zurück zum Zitat Nancy L, Harvey T, Nancy A et al (2005) Does having cesarean section capability make a difference to a small rural maternity service? Can Fam Physician 51:1238–1239 Nancy L, Harvey T, Nancy A et al (2005) Does having cesarean section capability make a difference to a small rural maternity service? Can Fam Physician 51:1238–1239
17.
Zurück zum Zitat Humber N, Frecker T (2008) Delivery models of rural surgical services in British Columbia (1996–2005): Are general practitioner–surgeons still part of the picture? Can J Surg 51:173–178PubMedPubMedCentral Humber N, Frecker T (2008) Delivery models of rural surgical services in British Columbia (1996–2005): Are general practitioner–surgeons still part of the picture? Can J Surg 51:173–178PubMedPubMedCentral
18.
Zurück zum Zitat Solanki K, Pisesky A, Frecker P (2013) Basic surgical skills training in United Kingdom foundation year doctors: can we do more? Int J Surg 11:529–534CrossRef Solanki K, Pisesky A, Frecker P (2013) Basic surgical skills training in United Kingdom foundation year doctors: can we do more? Int J Surg 11:529–534CrossRef
19.
Zurück zum Zitat Davis CR, Toll EC, Bates AS et al (2014) Surgical and procedural skills training at medical school - a national review. Int J Surg 12:877–882CrossRef Davis CR, Toll EC, Bates AS et al (2014) Surgical and procedural skills training at medical school - a national review. Int J Surg 12:877–882CrossRef
20.
Zurück zum Zitat Helenius I, Sinisaari I, Hirvensalo E et al (2002) Surgical procedure skills of graduating medical students: effects of sex, working, and research experience. J Surg Res 102:178–184CrossRef Helenius I, Sinisaari I, Hirvensalo E et al (2002) Surgical procedure skills of graduating medical students: effects of sex, working, and research experience. J Surg Res 102:178–184CrossRef
21.
Zurück zum Zitat Rajan P, Menon A, Crofts T (2011) Teaching corner-“lumps and bumps”: a practical guide to minor surgery for the core surgical trainee. Malawi Med J 23:65–68CrossRef Rajan P, Menon A, Crofts T (2011) Teaching corner-“lumps and bumps”: a practical guide to minor surgery for the core surgical trainee. Malawi Med J 23:65–68CrossRef
22.
Zurück zum Zitat Augestad KM, Revhaug A, Vonen B et al (2008) The one-stop trial: does electronic referral and booking by the general practitioner (GPs) to outpatient day case surgery reduce waiting time and costs? A randomized controlled trial protocol. BMC Surg 8:14CrossRef Augestad KM, Revhaug A, Vonen B et al (2008) The one-stop trial: does electronic referral and booking by the general practitioner (GPs) to outpatient day case surgery reduce waiting time and costs? A randomized controlled trial protocol. BMC Surg 8:14CrossRef
23.
Zurück zum Zitat Adamu A, Maigatari M, Lawal K et al (2010) Waiting time for emergency abdominal surgery in Zaria, Nigeria. Afr Health Sci 10:46–53PubMedPubMedCentral Adamu A, Maigatari M, Lawal K et al (2010) Waiting time for emergency abdominal surgery in Zaria, Nigeria. Afr Health Sci 10:46–53PubMedPubMedCentral
26.
Zurück zum Zitat Weiser TG, Regenbogen SE, Thompson KD et al (2008) An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 372:139–144CrossRef Weiser TG, Regenbogen SE, Thompson KD et al (2008) An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 372:139–144CrossRef
27.
Zurück zum Zitat Löfgren J, Kadobera D, Forsberg BC et al (2015) Surgery in district hospitals in rural Uganda-indications, interventions, and outcomes. Lancet 385(Suppl 2):S18CrossRef Löfgren J, Kadobera D, Forsberg BC et al (2015) Surgery in district hospitals in rural Uganda-indications, interventions, and outcomes. Lancet 385(Suppl 2):S18CrossRef
28.
Zurück zum Zitat Fingerhut A, Hay JM, Millat B et al (1998) General and gastrointestinal tract surgery in France. Arch Surg 133:568–574CrossRef Fingerhut A, Hay JM, Millat B et al (1998) General and gastrointestinal tract surgery in France. Arch Surg 133:568–574CrossRef
29.
Zurück zum Zitat Ali A, Subhi Y, Ringsted C et al (2015) Gender differences in the acquisition of surgical skills: a systematic review. Surg Endosc 29:3065–3073CrossRef Ali A, Subhi Y, Ringsted C et al (2015) Gender differences in the acquisition of surgical skills: a systematic review. Surg Endosc 29:3065–3073CrossRef
30.
Zurück zum Zitat Burgos CM, Josephson A (2014) Gender differences in the learning and teaching of surgery: a literature review. Int J Med Educ 5:110–124CrossRef Burgos CM, Josephson A (2014) Gender differences in the learning and teaching of surgery: a literature review. Int J Med Educ 5:110–124CrossRef
31.
Zurück zum Zitat Scott IM, Matejcek AN, Gowans MC et al (2008) Choosing a career in surgery: factors that influence Canadian medical students’ interest in pursuing a surgical career. Can J Surg 51:371–377PubMedPubMedCentral Scott IM, Matejcek AN, Gowans MC et al (2008) Choosing a career in surgery: factors that influence Canadian medical students’ interest in pursuing a surgical career. Can J Surg 51:371–377PubMedPubMedCentral
Metadaten
Titel
Acquisition of Surgical Skills by Final-Year Medical Students in State-Owned Medical Schools of Cameroon: Are We Doing Any Good?
verfasst von
Alain Chichom-Mefire
Njel Gaby Keith
Acho Abongwa
Dickson Shey Nsagha
Marcelin Ngowe-Ngowe
Publikationsdatum
09.09.2019
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 12/2019
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05163-z

Weitere Artikel der Ausgabe 12/2019

World Journal of Surgery 12/2019 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.