Comparison of surgical skill acquisition by UK surgical trainees and Sierra Leonean associate clinicians in a task-sharing programme. Issue 2 (24th December 2018)

• Record Type: Journal Article
• Authors: Liu, B; Hunt, L M; Lonsdale, R J; Narula, H S; Mansaray, A F; Bundu, I; Bolkan, H A
• Is Part Of: BJS open. Volume 3:Issue 2(2019)
• Page Start: 218
• Page End: 223
• Publication Date: 2018-12-24
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs5.50122
• Languages: English
• ISSNs: 2474-9842

Abstract

Abstract: Background: Task-sharing in surgery is well established, with associate clinicians performing successful surgery in many countries. Little is known about the process of surgical skill acquisition by associate clinicians, or whether this differs from that of doctors. Methods: A blinded experimental study compared surgical skill acquisition by Sierra Leonean associate clinicians enrolled in an essential and emergency surgery training programme with that of a matched group of UK surgical trainees. After identical instruction, practice time and with identities disguised, trainees were videoed performing simulated surgery. Trainees were marked on 12 performance parameters and five behaviour characteristics using validated tools and qualitative comment. Results: The Sierra Leonean group comprised 19 associate clinicians and one doctor; the UK group comprised 20 doctors in their first 5 years of training. The UK group had significantly more surgical and postgraduate experience than the Sierra Leonean group. The Sierra Leonean trainees outperformed the UK trainees on three of the 12 performance parameters and four of the five behaviour characteristics. UK trainees did not outperform Sierra Leonean trainees on any parameter or characteristic. Qualitative differences in learning style were observed. Conclusion: Sierra Leonean associate clinicians demonstrated equal or superior skill in all objective parameters tested, despite having less experience than the UK doctors. Graphical Abstract: An experimental study, using standard assessment tools, compared surgical skill acquisition by Sierra Leonean trainee associate clinicians and UK surgical trainees. The Sierra Leonean trainees matched or outperformed the UK trainees in all parameters. Qualitative differences in learning styles were observed. UK Trainees were not better