African Trainees Research Articles

The Impact of Colonialism on Surgical Training Structures In Africa Part 2: Surveying Current and Past Trainees

As a result of gradual independence from colonial rule over the course of the past century, Africa has developed and evolved 3 primary surgical training structures: an extracontinental colonial model, an intracontinental college-based model, and several smaller national or local models. There is consistent evidence of international brain drain of surgical trainees and an unequal continental distribution of surgeons; however there has not, to date, been an evaluation of the impact colonialism on the evolution of surgical training on the continent. This study aims to identify the etiologies and consequences of this segmentation of surgical training in Africa. This is a cross-sectional survey of the experience and perspectives of surgical training by current African trainees and graduates. A surgeon's region of residence was found to have a statistically significant positive association with that of a surgeon's training structure (P <0.001). A surgeon's professional college or structure of residency has a significantly positive association with desire to complete subspecialty training (P= 0.008). College and structure of residency also are statistically significantly associated with successful completion of subspecialty training (P<0.001). These findings provide evidence to support the concept that the segmentation of surgical training structures in Africa, which is the direct result of prior colonization, has affected the distribution of trainees and specialists across the continent and the globe. This maldistribution of African surgical trainees directly impacts patient care, as the surgeon-patient ratios in many African countries are insufficient. These inequities should be acknowledged addressed and rectified to ensure that patients in Africa receive timely and appropriate surgical care.

Impacts of human-dimensions of wildlife training on participants

ABSTRACT People who live in areas with high diversity often do not have access to training opportunities because of the gaps in critical training areas, although a wealth of opportunities are available to conservation practitioners. There is a need to offer cost-effective, strategic, evidence-based, sustainable, equitable, and adaptive capacity-building training to African conservation practitioners. Concerted training platforms could fill these gaps by providing learning opportunities while leveraging limited time and money. Forty-two African trainees participated in 13 training sessions in Windhoek, Namibia, in 2018. Surveys were administered before and after training. Sixty-six percent of participants strongly agreed that the training was applicable to their work before and after training. Our results provide insight on the importance of conservation training opportunities for mid-career wildlife managers, conservationists, and practitioners, including the need to ensure training opportunities are accessible and relevant to various people and their needs.

Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study

Introduction: Africa has many untreated neurosurgical cases due to limited access to safe, affordable, and timely care. In this study, we surveyed young African neurosurgeons and trainees to identify challenges to training and practice.Methods: African trainees and residents were surveyed online by the Young Neurosurgeons Forum from April 25th to November 30th, 2018. The survey link was distributed via social media platforms and through professional society mailing lists. Univariate and bivariate data analyses were run and a P-value < 0.05 was considered to be statistically significant.Results: 112 respondents from 20 countries participated in this study. 98 (87.5%) were male, 63 (56.3%) were from sub-Saharan Africa, and 52 (46.4%) were residents. 39 (34.8%) had regular journal club sessions at their hospital, 100 (89.3%) did not have access to cadaver dissection labs, and 62 (55.4%) had never attended a WFNS-endorsed conference. 67.0% of respondents reported limited research opportunities and 58.9% reported limited education opportunities. Lack of mentorship (P = 0.023, Phi = 0.26), lack of access to journals (P = 0.002, Phi = 0.332), and limited access to conferences (P = 0.019, Phi = 0.369) were associated with the country income category.Conclusion: This survey identified barriers to education, research, and practice among African trainees and young neurosurgeons. The findings of this study should inform future initiatives aimed at reducing the barriers faced by this group.

The role of the University of Cape Town, South Africa in the training and retention of surgeons in Sub-Saharan Africa

BackgroundSub-Saharan Africa (SSA) has a shortage of surgeon specialists. Many SSA countries lack specialty training programs but South Africa, an upper middle-income country, has several post-graduate surgical training programs. The primary objective of this study was to describe the retention rates of non-South African SSA surgical trainees from the University of Cape Town (UCT) on the African sub-continent. The secondary objective was to describe advantages and disadvantages of foreign surgical trainees on the UCT surgical training programs. MethodsThis was a two-part cross-sectional survey administered via email between June 1, 2018 and March 1, 2019 to UCT 1) surgical residents and fellows who graduated between 2007 and 2017 and whose country of origin was in SSA but outside South Africa, and 2) UCT surgical division heads. ResultsThirty out of 78 (38%) trainees responded; 83% (n = 25) were male. There was a 96% retention rate of surgical trainees in SSA, 80% (n = 24) returned to their country of origin after training, 83% (n = 25) worked in the public sector, and 90% (n = 27) in teaching hospitals. Seven out of ten surgical division heads responded. Reported advantages of SSA trainees included more junior staff (n = 5, 71%) and the establishment of SSA networks (n = 4, 57%). Disadvantages included increased training responsibilities for educators (n = 2, 29%) and fewer cases for South African trainees (n = 2, 29%). DiscussionRetention on the African sub-continent of surgeons who trained at UCT was high. SSA doctors can utilize South African post-graduate surgical training programs until their own countries increase their training capacity. The majority of trainees returned to their countries of origin, utilizing their skills in the public and academic sectors, and contributing to the teaching of more trainees. These training partnerships also contribute to knowledge-sharing and facilitate a regional network of African surgeons. Active recruitment of more female trainees is needed to ensure gender equity.

Profiling work-related signature strengths of “Born Free” South Africans: A gender perspective

This study investigated the importance of signature strengths of South African trainees in the hospitality industry who are the “Born Free” generation, who have only lived in a democracy, and were given equal opportunities. Utilising a cross-sectional research design, we sampled hospitality industry trainees (n = 290) attending a large South African university (females = 70.3%; black = 91%; mean age = 20.59 years, SD = 3.86 years). For the data analysis we rank order scored the hospitality trainees’ key strengths, and differentiating these by gender. Results indicated the participants to rank Honesty, Love, and Fairness as most important; while Love of learning and Self-regulation were ranked least important of the strengths. Both males and females ranked Fairness highly, while the males ranked Hope as most important, and the females viewed Honesty as an important strength. Moreover, the males scored Leadership significantly higher than the females, while the females scored Forgiveness and Kindness significantly higher than the males. Recognising the signature strengths valued by the South African “Born Free” generation may be important for their self-awareness to provide superior service to guests by using their positive skills.

Surgical Training in South Africa: An Overview and Attempt to Assess the Training System from the Perspective of Foreign Trainees.

Currently, there are no objective reports evaluating the quality of the South African surgical training. The aim of this study is to evaluate the current state of surgical training in South Africa from an external impartial point of view and to rate the experience of short-term supernumerary registrars and fellows (STSRF) within the South African training system. A 29-item survey was distributed via e-mail and social media to non-South African trainees who worked in South Africa as STSRF for a period of at least 1month during the past 5years. The survey evaluated the surgical, clinical and academic training received during their elective period in a South African department. Sixty-four STSRF replied to the survey. Sixty-two percent of STSRF attended a trauma unit during their experience. For the majority of respondents, open and emergency surgical exposure, as well as experience as first surgeon, is significantly higher in the South African system, while minimally invasive and endoscopic surgery exposure is significantly less. Research project involvement is significantly less, for the STSRF, as opposed to lectures and teaching that constitute a higher percentage. No significant difference was found regarding exposure to hands-on activities. The South African system still provides excellent surgical and clinical exposure as well as teaching. However, minimally invasive surgery training and research are generally lacking for the STSRF. Exchange programs between South African and developed country institutes should be improved and encouraged in order to gain mutual benefits.

Explaining attractiveness: knowledge production and power projection in China’s policy for Africa

How is Chinese foreign policy building a positive image of China in Africa? IR literature on soft power and attractiveness abounds. This study builds on the existing works, especially contributions by Janice Bially Mattern and Ty Solomon, to account for the role of expert knowledge production in attractiveness and image-building. While the existing literature focuses on China’s media cooperation from the perspective of establishing Chinese media outlets in Africa, this article identifies an understudied aspect of China’s strategy in Africa—that of investing in human resource development and professional training programmes for African journalists. The study constructs its analysis based on a series of in-depth interviews and official document analysis. The findings suggest that Chinese-sponsored professional development programmes for African journalists are an opportunity for African trainees to be socialised in Chinese values, norms, and expert knowledge. These trainings contribute to build a positive image of China in Africa and are far more successful than material approaches including establishing Chinese media outlets across Africa.

Bioethics training programmes for Africa: evaluating professional and bioethics-related achievements of African trainees after a decade of Fogarty NIH investment.

ObjectivesOur primary aim was to evaluate the impact of US National Institutes of Health (NIH)-funded bioethics training programmes (Fogarty bioethics training programmes, FBTPs) that trained individuals from Africa over the programme's first 10 years to examine changes between pretraining and post-training in individual achievement and to document any associations between individual, training programme and post-training accomplishments.DesignWe surveyed trainees from the 10 bioethics programmes funded by NIH Fogarty International Center from 2000 to 2011 that included African trainees. McNemar's and Wilcoxon signed rank-sum tests were used to analyse pre–post levels of general and bioethics-related professional achievement. Likelihood of specific post-training achievement outcomes was measured using logistic regression including demographic, pretraining and intratraining variables.Setting10 different FBTPs that trained individuals from Africa from 2000 to 2011.ParticipantsOf 253 eligible respondents, 171 completed the survey (response rate 67.6%).Primary outcome measuresPre–post comparisons of professional achievement indicators (eg, serving in leadership roles, teaching, publishing manuscripts); likelihood of specific post-training achievement outcomes.ResultsPost-training, respondents were significantly more likely to report serving in a leadership role, being an investigator on a research grant, serving on international committees, serving as a mentor, and publishing manuscripts than at pretraining. Post-training, significantly greater numbers of respondents reported bioethics-related achievements including being a bioethics instructor, serving on an Institutional Review Board (IRB), being an investigator on a bioethics grant and publishing bioethics-related manuscripts than pretraining. Controlling for other factors, there were no significant differences by gender in the post-training success of these participants in terms of leadership roles, being instructors, investigators on grants and holding IRB roles.ConclusionsAfrican trainees who participated in FBTPs reported significantly higher levels of professional achievement after training. There was no single factor—either demographic, related to a trainee's professional background, or in programme design—that consistently predicted greater levels of post-training achievement.

Implementation of the Medical Education Partnership Initiative

The Medical Education Partnership Initiative (MEPI) is contributing to the transformation of medical training in Africa. In this paper, medical students present their perspective on how MEPI initiatives have influenced five key areas related to African medical trainees: educational infrastructure, information technology, community-based training, scientific research, and professional outlook and goals. They propose three new areas of focus that could further assist MEPI in bettering medical training in Africa.

From Pentecostalism to politics: mass literacy and community development in late colonial Northern Ghana

This article takes as its starting point a strike among African trainee literacy workers in the Northern Territories of the Gold Coast (now Ghana) in 1952. While the existing literature tends to concentrate on the tensions and contradictions in British colonial education policy, this article uses the strike to investigate how these agendas were experienced by, and engendered opposition from, literacy workers on the ground. It argues that, in their efforts to link mass literacy to community development, and to secure legitimacy for their campaigns, colonial officials depended heavily upon the authority of chiefs. This strategy backfired because it ignored both shorterterm instances of chiefly venality, and the longer history of colonial taxation and labour demands which had been enforced on Northern peoples through chiefs. The African trainees went on strike because they were astute in recognising how different forms of educational provision fitted into the re‐ordering of local, regional and national power relations as the Gold Coast approached Independence.

South Africa’s transition from apartheid: The role of professional closure in the experiences of black chartered accountants

As apartheid gave way to political freedom in South Africa in the last quarter of the 20th century, chartered accounting firms began to hire black South African trainees for the first time. The study examines the oral histories of black chartered accountants within the context of social closure theory and South Africa’s changing political and ideological landscape. The evidence indicates that processes of professional closure and credentialing excluded the majority population from the ranks of the profession on basis of race and class throughout the period 1976–2000.

The Relationship Between Intelligence and Attitudes in a Bilingual Society: The Case of White South Africa

Abstract The relationship between attitudes and intelligence in a sample of white South African teacher trainees was examined. The results indicate that Afrikaans speakers were significantly higher than English speakers on most factors of conservatism and religiosity. The attitudinal patterns of the more conservative Afrikaans speakers were different from the attitudinal patterns of the more liberal English speakers. No conclusions could be reached, however, regarding the connection between attitudes and intelligence. Language was found to mediate conservative attitudes, and these attitudes, and not language, were the critical variables interrelated with intelligence.

International efforts in family planning training.

Worldwide population stabilization must be achieved to avert the economic and ecologic dangers which will result from excessive population growth. Health professionals from several black African nations 2 predominantly black institutions and the United States Agency for International Development have joined in a common training effort to prepare personnel to deal with the unique aspects of family planning relating to Blacks. Meharry Medical College through its Maternal Child Health/Family Planning Center and health professionals from Africa are promoting massive educational efforts for both the provider and the consumer. 6 nurses and a physician were sent to the Center from Kenya for training in family planning teaching after Kenya adopted an offical population policy. Since then many African trainees have attended the Center. Future educational efforts are dependent upon the availability of adequate clinical outlets such as those at the John Andrew Memorial Hospital in Tuskegee Alabama. The shortage of doctors in Kenya has partially been alleviated through the training of nurses in the practice of family planning. Making full use of the nurse practitioner is important in raising the level of maternal and child health.