Evaluation of a surgical task sharing training programme\u2019s logbook system in Sierra Leone

Ø V Svendsen,A J Van Duinen,Ø Salvesen,C Helgerud,P M George,H A Bolkan

doi:10.1186/s12909-019-1647-2

Ø V Svendsen, A J Van Duinen + Show 4 more

Open Access

https://doi.org/10.1186/s12909-019-1647-2

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Abstract

BackgroundPersonal logbooks are universally applied for monitoring and evaluation of surgical trainees; however, the quality and accuracy of such logbooks in low income countries (LICs) are poorly examined. Logbooks are kept by the individual trainee and detail every surgical procedure they perform and their role during the procedure. The aim of this study was to evaluate the quality of such a logbook system in Sierra Leone and to identify areas of improvement.MethodsThe last 100 logbook entries for students and graduates participating in a surgical task sharing training programme were compared with hospital records (HRs). The logbook entries were categorized as matching, close matching or over-reported. Moreover, HRs were checked for under-reported procedures. Semi-structured interviews were conducted with the study participants on logbook recording routines. The results were analysed using mixed effects logistic regression models.ResultsThree thousand one hundred sixty-nine database entries from 35 participants were analysed. Of that amount, 62.2% of the entries matched the HRs, 10.4% were close matches and 26.9% were over-reported. 20.7% of the investigated HRs were under-reported.ConclusionsInformation gathered from surgical logbook systems must be applied with care, and great efforts must be made to ensure that the logbook systems used provide reliable data. Based on analysis of the logbook data and interviews, focus areas are suggested to ensure reliable logbook data in LICs. Clear instructions and proper training should be provided when introducing the logbook system to the users. The importance of logging all procedures, including minor ones, should be emphasized. The logbook system should be user friendly and only as extensive as necessary. Lastly, keeping the logbooks exclusively digital is recommended, combined with sufficient IT equipment and training.

Highlights

Personal logbooks are universally applied for monitoring and evaluation of surgical trainees; the quality and accuracy of such logbooks in low income countries (LICs) are poorly examined
For the remainder of this article, students refers to participants in the first 2 years of training, interns refers to participants during the one-year internship, while graduates refers to participants that have completed both the first 2 years of training and the internship year of the programme
Of the 3169 database entries cross-checked against the Hospital record (HR), 813 were missing associated Personal logbook (PL) entries

Summary

Introduction

Personal logbooks are universally applied for monitoring and evaluation of surgical trainees; the quality and accuracy of such logbooks in low income countries (LICs) are poorly examined. Logbooks are kept by the individual trainee and detail every surgical procedure they perform and their role during the procedure. 6% of the 313 million surgical procedures annually performed worldwide occur in the poorest countries, and 143 million additional procedures. One of the main barriers to the expansion of surgical capacity in low income countries (LICs) is the shortage of human resources [3]. In LICs, where trainer resources are limited, monitoring the progress during the training in these programmes is, of great importance to assure that the trainees gain the required skills and experience [5]

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