Evaluation of a surgical task sharing training programme's logbook system in Sierra Leone

Area of Science:

• Medical Education
• Surgical Training
• Health Systems Research

Background:

• Personal logbooks are standard for monitoring surgical trainees but their accuracy in low-income countries (LICs) is under-examined.
• Logbooks document procedures performed by trainees and their roles.

Purpose of the Study:

• To evaluate the quality and accuracy of a surgical logbook system in Sierra Leone.
• To identify areas for improvement in logbook data reliability in LICs.

Main Methods:

• Compared 100 logbook entries per participant with hospital records (HRs).
• Categorized entries as matching, close matching, or over-reported; checked HRs for under-reported procedures.
• Conducted semi-structured interviews to understand recording routines; analyzed data using mixed effects logistic regression.

Main Results:

• Analyzed 3,169 entries from 35 participants.
• 62.2% of logbook entries matched HRs, 10.4% were close matches, and 26.9% were over-reported.
• 20.7% of hospital records were found to be under-reported.

Conclusions:

• Surgical logbook data in LICs requires careful interpretation due to potential inaccuracies.
• Recommendations include clear instructions, user training, emphasizing logging all procedures, user-friendly digital systems, and adequate IT support.
• Implementing these improvements is crucial for ensuring reliable data from logbook systems in LICs.