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Strengthening pediatric surgical readiness: outcomes of a needs-directed short course for non-specialist physicians
Phillip J Hsu1,2,3, Donata Kwizera4, Faustin Ishimwe4
1Section of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Introduction:
Although the recent expansion of pediatric surgical services in Rwanda has improved patient outcomes, pediatric surgery specialists are available only at referral hospitals. Children with surgical conditions are often first evaluated by non-specialist physicians at district or regional hospitals prior to definitive transfer. Knowledge gaps exist in the initial management of pediatric surgical conditions among non-specialist physicians. This study assesses the impact of a needs-directed short course for non-specialist physicians in Rwanda.
Methods:
Nine prioritized pediatric surgical conditions were identified through an expert-led modified two-stage Delphi. Course content was created to fill knowledge gaps, determined through a needs assessment. Pediatric surgeons and local trainees delivered the course to non-specialist physicians at five district and regional hospitals. Participant reactions and knowledge were analyzed using RStudiov1.1.4, and thematic analysis was performed on free text responses.
Results:
Fifty-nine non-specialist physicians with heterogeneous experience participated. Participants rated the course highly, and self-rated knowledge and confidence increased on all conditions. Overall knowledge-based scores and initial management for all conditions improved substantially. More participants indicated that they knew how to contact a member of the pediatric surgical team after the course. Positive themes included acquisition of knowledge that was relevant to practice, effective course execution, and the interactive nature of the course. Themes for improvement centered on desire for more content and course availability.
Conclusions:
As pediatric surgical capacity improves, safe initial management is critical. A novel, needs-directed short course for non-specialist physicians appears to be an effective way to address knowledge gaps and improve the referral process through direct connection with specialists. Providing such a course on a regular basis to senior medical students and new graduates is a promising avenue to improving the provision of safe, timely pediatric surgical care.
