The factors that least affected career choice were related to knowledge of anesthesiology and the role of. Anaesthesiology of the University of KwaZulu-Natal, for assistance with data interpretation and analysis and editing a poster. Tonya Esterhuizen and Mr Stephen van der Linde, formerly of the Department of Biostatistics at the University of KwaZulu-Natal.
BACKGROUND
STATEMENT OF THE PROBLEM
Research Hypothesis
Research Questions
PURPOSE OF THE RESEARCH
SPECIFIC OBJECTIVES OF THE RESEARCH
This study can provide insights that can be used to strengthen the educational process and promote anesthesiology as a career, thereby improving recruitment to the specialty. To follow up on whether this choice would be anesthesiology after completing the rotation. To determine if and how the perception of the specialty changed after the completion of the rotation.
ASSUMPTION UNDERLYING THE STUDY
OPERATIONAL DEFINITIONS USED IN THE STUDY
SCOPE OF THE STUDY
CHAPTER II: LITERATURE REVIEW
- INTRODUCTION
- PURPOSE OF THE LITERATURE REVIEW
- SCOPE OF LITERATURE REVIEW
- LITERATURE REVIEWED
- Anaesthesiology as a career choice
- Intern training in anaesthesiology
In 1980, none of the 54 undergraduates in the Nigerian study chose anesthesiology as their first choice.7 This was due to insufficient exposure. Between 1981 and 1982, undergraduate students completing a 4-week clinical internship in anesthesiology at the University of Michigan completed a survey.8 Results. Anesthesiology was not considered by any Israeli medical students, but by 12.9% of students in the American program.
CHAPTER III: METHODS
- INTRODUCTION
- TYPE OF RESEARCH
- STUDY DESIGN
- TARGET POPULATION
- STUDY POPULATION
- DATA SOURCES
- Measurement instruments
- Data Collection Techniques
- VARIABLES
- MEASURES TO ENSURE VALIDITY
- Internal (face validity)
- Reduction of bias
- External
- LIMITATIONS
- STATISTICAL ANALYSIS
- Descriptive statistics
- Analytic statistics
- Ethical Considerations
- Institutional Ethical Review Board
- Permissions
The second part of the questionnaire was completed at the end of the anesthesiology rotation – approximately two months in duration. A focus group discussion was conducted with a group of practitioners prior to the actual study period and formulation of the final questionnaire. Undergraduate training recall bias was reduced by administering the first questionnaire at the start of the rotation and the second part at the end of the rotation.
Questionnaires were anonymous but the first and second parts of the questionnaire were linked using the internal number. The survey was conducted in theater by a member of the Department of Anesthesiology and this may have caused interns to feel intimidated when they completed the questionnaire. A similar questionnaire about interns in South Africa has not been carried out before and therefore validation of the questionnaire was difficult.
Frequency tables and bar graphs will be used to describe categorical variables, while the mean and standard. Fischer's exact test was used to test associations between demographic profiles and specialty choice. Trainee numbers were used to correlate pre- and post-rotation responses, but these were removed after the data were entered into the database so that all trainee numbers were disconnected.
Dissemination of the study findings and any resulting publications will be through the University of KwaZulu-Natal and the Department of Anesthesiology.
CHAPTER IV: RESULTS
- INTRODUCTION
- DEMOGRAPHIC PROFILE
- PRIOR EXPOSURE TO ANAESTHESIOLOGY
- SPECIALTY CHOICE (pre rotation)
- SPECIALTY CHOICE (post rotation)
- SUMMARY
Thirty-two interns completed the questionnaire at the beginning of the rotation and five of these interns did not complete the questionnaire at the end of the rotation (Table 1). Five of the thirty-two interns earned a bachelor's degree before entering medical school. There were 4 graduates from the University of the Free State and 3 from the Walter Sisulu University.
Two were University of Cape Town graduates and 2 qualified outside South Africa. When asked whether the time spent in Anesthesiology was necessary or unnecessary, all 13 trainees who responded answered that the time was necessary. In the questionnaire at the beginning of the rotation interns were asked to list three possible options for a choice of specialty according to preference.
The demographic profile of the 12 trainees who chose Anesthesiology as one of their top 3 career choices is set out below (Table 5). There was a mix of first and second year interns who rotated through Anesthesiology during the year. To assess the strength of each factor in influencing career choice, the rating was given for each factor by all the trainees.
The lowest ranked factors were: home conditions, specialty status, advice from friends, advice from parents or relatives, and interest before medical school. The integration of the different disciplines in medicine and the intellectual content of anesthesiology were seen as important. Trainees also noticed that they had a better understanding of the specialty and the role of the anesthesiologist.
CHAPTER V: DISCUSSION
INTRODUCTION
FINDINGS
- Demographic profile
- Prior exposure to Anaesthesiology
- Specialty choice (pre rotation)
- Specialty choice (post rotation)
Postgraduate enrollment in medical school is not common in South Africa, so most of the trainees in the study were under the age of thirty. The choice of profession in this group of interns shows a marked predominance of women in the sample (81/3%). This is common in the UK, Australia, South Africa, New Zealand, Japan, China and Russia.
Much needs to be done to change the perception of the anesthesiologist in the eyes of the public and the younger medical staff. In the post-rotation questionnaire, interns were again asked about their top 3 choices for a thesis. A comparison was made with a choice of Anesthesiology as one of the top three choices in the pre-rotation questionnaire with a yes answer in the post-rotation questionnaire.
There was a trend towards more interns choosing Anesthesiology with 16 in the post-rotation questionnaire as opposed to 12 pre-rotation. As in the pre-rotation questionnaire, interns were asked to motivate why they chose Anesthesiology or not. The top 5 factors influencing career choice were similar to those ranked in the pre-rotation questionnaire, except for two factors.
This only serves to confirm that there is very limited knowledge of Anesthesiology and the Anesthesiologist in the general public and among medical students.
BIAS AND LIMITATIONS
- Selection bias
- Information bias
- Limitations
At the end of the questionnaire, trainees were asked in an open-ended question whether the two-month rotation had changed their perception of anesthesiology. It may be that this improved perception of the specialty translates into more trainees choosing Anesthesiology. Their ability to accurately complete that part of the questionnaire would have been dependent on them remembering details of their undergraduate education.
An attempt to reduce this was made by asking trainees about the bachelor's degree on the first day of the Anesthesiology rotation. The questionnaire was administered by a staff member from the Anesthesiology Department and this may have intimidated trainees when completing the questionnaire. This may have limited the time to complete the questionnaire, meaning the answers may not have been thought through long enough.
A similar questionnaire had not been carried out locally before and it was therefore difficult to validate the questionnaire. Before the study, King Edward VIII Hospital was designated as a regional hospital because it was a tertiary hospital and therefore may have employed fewer interns. A few interns may not have been present at the orientation at the beginning of each block and were therefore not recruited into the study.
As the first part of the questionnaire was a pre-rotation questionnaire, the opportunity for recruitment into the study would only have been at the beginning of the rotation.
CHAPTER VI: RECOMMENDATIONS AND CONCLUSIONS
- INTRODUCTION
- CONCLUSIONS
- RECOMMENDATIONS
- RECOMMENDATION FOR FURTHER STUDY
The profile of trainees in this center may differ from those in other centers within the Ethekwini metropolitan area and even more so from trainees in other areas in the province and country. Anesthesiology and the role of the anesthesiologist prior to medical school and during the bachelor's degree program. This implies that there is very limited knowledge about anesthesiology and the anesthesiologist among the general public and among medical students.
A longer and more focused rotation in Anesthesiology should be included in the undergraduate curriculum. Both undergraduate and postgraduate training programs should be designed with a firm emphasis on the challenges of the increasing female predominance in the medical workforce. This can be done through public education in health care institutions and through the media.
Medical students also need more information about a career in Anesthesiology and more exposure to the. Interns should be followed up after community service to determine whether their intention to enter a specialty actually translates into them applying for training positions afterward. A study of physicians already in training positions could be conducted to determine their motivations for choosing the specialty.
In South Africa, there may be different perceptions among patients in the public and private sectors and in different social and economic classes.
Attitudes toward anesthesiology residency among medical students in the American and Israeli programs at the Sackler Faculty of Medicine, Tel Aviv University. Medical and Dental Professions Board - Health Professions Council of South Africa: Logbook for Internship Training.
ADDENDA
- Approval from the Postgraduate Education Committee
- Ethical Approval
- Permission from King Edward VIII Hospital
- Questionnaires
- Information Document
- Informed Consent
Study Title: The Effect of Undergraduate Curriculum and Anesthesiology Trainee Rotation on Career Choice of Trainees at King Edward VIII Hospital, Durban in 2009. You are invited to participate in a research project on the training of anesthesiology trainees at King Edward VIII Hospital, Durban. We would like to assess trainees' perceptions of undergraduate and in-house training in anesthesiology at King Edward VIII Hospital, Durban in 2009.
The study is being carried out by researchers at the King Edward VIII Hospital and the University of KwaZulu Natal, Department of Anesthesiology. Anesthesiology at King Edward VIII Hospital, Dr L Cronje, at the orientation to your 2 month rotation. You will also be asked to complete a questionnaire at the end of your 2 month rotation in Anesthesiology.
By participating in this survey, you will help us better understand trainees' perceptions of their training in anesthesiology and the factors that influence career choices. This means that you have the right to change your mind about participating in the study and to stop being so. If you wish to leave the study or have any questions, please contact Dr. Justin Reddy at or through the University of KwaZulu-Natal, Department of Anesthesiology at.
We would like to invite you to participate in a research project entitled: The Effect of Undergraduate Curriculum and Anesthesiology Trainee Rotation on Trainee Career Choice Making at King Edward VIII Hospital, Durban in 2009.
