Experiences of University College Hospital, Ibadan surgical residents in audit and research

Abstract

An online monthly seminar was started in April 2021 for surgical residents at the College of Medicine University of Ibadan by a faculty of alumni based in the United Kingdom. The surgical residents felt the seminars will make them better clinicians, fill gaps in their training and find out about Gold Standards of care. Moodle learning management system was used to manage course materials, communication, feedback, online surveys, and interaction with trainees. Seventy-two residents registered, but only about 30 were core attendees. All recorded lectures were placed on You Tube https://www.youtube.com/playlist?list=PLXzLiMlwy2sjLAacZLav58h7aj7qXZaWZ. Topics were multispecialty and determined by the residents.

At the same time, an audit-and-research group (ARG) was formed, with eight residents joining. This number has risen to 14. The ARG was a response to a survey assessing residents’ experiences in research and audit. Thirty-seven surgical residents, with an average age of 34.3 years, completed the questionnaire. Forty-three per cent were senior residents and 84% were males. Forty-three percent were general surgery residents, 16% orthopaedics and 11% in urology, 8% in neurosurgery and 8% in paediatric surgery, The rest were from plastic, ENT and cardiothoracic surgery. The median number of years from graduation was 9 years with an inter-quartile range of 7–11 years.

Sixty-five per cent of residents had not done any audit since graduation, and only 24% had completed an audit cycle. All residents agreed that surgeons should do audits, and all agreed that it was good for clinical practice. Ninety-five per cent agreed that surgeons should do a least an audit annually, however, only 68% of residents indicated that they would like to do an audit. Eighty-one per cent of residents had never presented an audit or research work, oral or poster, at a national or international meeting, and 65% have never been an author in a peer-reviewed article. Ninety-seven per cent indicated that they would like to take part in a study.

The six top reasons given for poor audit and research outputs by the residents were (multiple answers allowed):

1. Not knowing where to start by 60% of surgical residents
2. No support for it by 46%
3. No source of funding by 38%
4. Audit and research is not a culture in their environment by 38%
5. No opportunities by 24%.
6. No suitable role models by 16%

After completion of training, 76% of residents indicated that they wanted to work in a teaching hospital.

In two and half years since its formation, the ARG has completed a qualitative study on clinical learning environments (OP05) and an audit on the use of WHO surgical safety checklists in theatre (OP06). These were supervised by both a local faculty and a UK-based alumnus. These have generated two oral and one poster presentations at international conferences.