Evidence map›Paper›PMID 38037034›Full record

ArticleBMC medical education2023

A national perspective on exposure to essential surgical procedures among medical trainees in Nigeria: a cross-sectional survey and recommendations.

Paul Tunde KingPriest, Barnabas Tobi Alayande, Emmanuel Walong Clement, Mustapha Muhammed, Joy Ohejem Egbiri, Miracle Shanabo, Etinosa Kevin Osayande, Abiodun Ayomide Atunrase, Jamiu Israel Abubakar, Daniel Chukwuma Eze and 11 more

Open access · goldAbstract read
In one paragraph

Article in BMC medical education, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.4field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. North-South Divide in the Distribution of Medical Schools in Nigeria: A Tale of Internal Inequity.Nigerian medical journal : journal of the Nigeria Medical Association
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 18 institutions in 3 countries.

Paul Tunde KingPriest *Surgical Equity and Research Hub, Jos, Nigeria.
Barnabas Tobi Alayande *Surgical Equity and Research Hub, Jos, Nigeria. dr.alayande@gmail.com.
Emmanuel Walong ClementUniversity of Jos, Jos, Nigeria.
Mustapha MuhammedUsman Danfodio University, Sokoto, Nigeria.
Joy Ohejem EgbiriBenue State University, Makurdi, Nigeria.
Miracle ShanaboBingham University Teaching Hospital, Jos, Nigeria.
Etinosa Kevin OsayandeUniversity of Benin, Benin, Nigeria.
Abiodun Ayomide AtunraseAfe Babalola University, Ado-Ekiti, Nigeria.
Jamiu Israel AbubakarUniversity of Nigeria, Nsukka, Nigeria.
Daniel Chukwuma EzeUniversity of Ibadan, Ibadan, Nigeria.
Stephen AdekoyaOlabisi Onabanjo University, Sagamu, Nigeria.
Gideon Bulus ChiromaGombe State University, Gombe, Nigeria.
Onosegbe Moses AikhuomogbeAmbrose Alli University, Ekpoma, Nigeria.
Fatima Shuwa GailaUniversity of Maiduguri, Maiduguri, Nigeria.
Dennis YagaKaduna State University, Kaduna, Nigeria.
Nomsu Noble ThomasMadonna University, Elele, Nigeria.
Chukwudi Anthony ChukwuntaEnugu State University of Technology, Enugu, Nigeria.
Matthew T HeyCenter for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
Callum ForbesCenter for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
Robert R RivielloCenter for Equity in Global Surgery, University of Global Health Equity, Kigali, Rwanda.
Bashiru O IsmailaUniversity of Jos, Jos, Nigeria.
Harvard University · USAfe Babalola University · NGAmbrose Alli University · NGBenue State University · NGBingham University · NGEnugu State University of Science and Technology · NGGombe State University · NGJos University Teaching Hospital · NGKaduna State University · NGMadonna University · NGOlabisi Onabanjo University · NGUniversity of Benin · NGUniversity of Global Health Equity · RWUniversity of Ibadan · NGUniversity of Jos · NGUniversity of Maiduguri · NGUniversity of Nigeria · NGUsmanu Danfodiyo University · NG

Funding

Partnership for Global Health Research Training Program (Renewal)-Supplement for OBSSR, NCI, NCI-AIDS and NIDCDD43TW010543 · FIC · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Wafaie W Fawzi, DAVIDSON HOWES HAMER · 2017 to 2026
$12.1M
FIC NIH HHS D43 TW010543
6 · The paper itself

Abstract

backgroundIn sub-Saharan Africa, recent graduates from medical school provide more direct surgical and procedural care to patients than their counterparts from the Global North. Nigeria has no nationally representative data on the procedures performed by trainees before graduation from medical school and their confidence in performing these procedures upon graduation has also not been evaluated.

methodsWe performed an internet-based, cross-sectional survey of recent medical school graduates from 15 accredited Federal, State, and private Nigerian medical schools spanning six geopolitical zones. Essential surgical procedures, bedside interventions and three Bellwether procedures were incorporated into the survey. Self-reported confidence immediately after graduation was calculated and compared using cumulative confidence scores with subgroup analysis of results by type and location of institution. Qualitative analysis of free text recommendations by participants was performed using the constant comparative method in grounded theory.

resultsFour hundred ninety-nine recent graduates from 6 geopolitical zones participated, representing 15 out of a total of 44 medical schools in Nigeria. Male to female ratio was 2:1, and most respondents (59%) graduated from Federal institutions. Students had greatest practical mean exposure to bedside procedures like intravenous access and passing urethral foley catheters and were most confident performing these. Less than 23% had performed over 10 of any of the assessed procedures. They had least exposures to chest tube insertion (0.24/person), caesarean Sect. (0.12/person), and laparotomy (0.09/person). Recent graduates from Federal institutions had less procedural exposure in urethral catheterization (p < 0.001), reduction (p = 0.035), and debridement (p < 0.035). Respondents that studied in the underserved North-East and North-West performed the highest median number of procedures prior to graduation. Cumulative confidence scores were low across all graduates (maximum 25/60), but highest in graduates from Northern Nigeria and private institutions. Graduates recommended prioritizing medical students over senior trainees, using simulation-based training and constructive individualized non-toxic feedback from faculty.

conclusionNigerian medical students have poor exposure to procedures and low confidence in performing basic procedures after graduation. More attention should be placed on training for essential surgeries and procedures in medical schools.

Indexed as

Students, MedicalCross-Sectional StudiesFemaleHumansMaleNigeriaSchools, MedicalSurveys and QuestionnairesConfidenceGeopolitical zonesNigerian medical graduatesProcedural exposureProcedures

Identifiers

PMID38037034
PMCPMC10691202
OpenAlexW4389193021

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.