The Gap between Surgical Resident and Faculty Surgeons Concerning Operating Theatre Teaching: Report from Addis Ababa, Ethiopia.

Background: In a continent like Africa where the number of surgeons is alarmingly few, training of a large number of residents is the way forward. However, sudden expansion in the number of trainees in an existing teaching environment may bring the quality of the most fundamental education i.e. operation room teaching into question.
Method: We wanted to investigate the different perceptions of our surgeons-under-training and faculty concerning preoperative preparation, intra operative teaching and postoperative feedback. A validated questionnaire was administered to our surgical residents and faculty at the Addis Ababa University, School of Medicine, Department of Surgery. Results were analyzed with 2- sample t tests, comparing Likert scores. Findings were significant if the p value was < 0.05.
Results: Forty residents (15 second year, 15 third years and 10 final years) and 30 faculty members completed the survey. With respect to preoperative preparation, faculty were significantly more likely to claim that residents’ preparation in terms of reading is low (3.77 vs 2.45; p=0.001) and anatomy review (3.73 vs 2.34; p=0.001) before the procedure. There was a very significant difference with regards to intra-operative teaching activities, i.e teaching of the operative steps (2.60 vs 3.79; p=0.048), instrument handling (2.30 vs 3.72; p=0.002), and surgical technique (2.23 vs 3.83; p= 0.001). Residents’ perception of the effort of the faculty to act as a teacher in the operating room was significantly lower compared to the faculty (2.13 vs 3.94; p=0.002). Postoperatively, significant differences were found in perceptions of positive feedback (2.48 vs 3.86; p=0.01) and feedback on areas to improve (1.85 vs 3.34; p=0.001).
Conclusion: There is a universal agreement on the need to improve the current residency training. However, the difference between resident and faculty in the teaching-learning process is alarmingly significant. As there is no substitute for the intra-operative training of residents, every effort must be made to not to trade off number of graduates with quality and competence of surgeons-under-training.