Do South African anaesthesiology graduates consider themselves fit for purpose? A longitudinal study

Abstract

This quantitative, descriptive study included recent national anaesthesiology graduates. Each participant scored their own preparedness for competences deemed appropriate by national experts via an electronic survey at two separate time intervals. Nine meta-competences (i.e. Medical Expert, Communicator, Collaborator, Leader, Health Advocate, Scholar, Professional, Context Awareness and Humaneness) together with 101 component enabling competences, were assessed. Participants scored their preparedness for each competence using a 4-point Likert scale (1 -completely unprepared; 2 -somewhat prepared; 3 -prepared; 4 -completely prepared). During analysis, competences scored as 1 and 2 were considered as unprepared and competences scored as 3 and 4 as prepared. Scores given at the time of graduation were compared with those given after 12 months' experience. Results:The overall response rate was 79%. At graduation, graduates felt prepared for seven of the nine meta-competences (i.e. Medical Expert, Collaborator, Communicator, Professional, Scholar, Context Awareness and Humaneness), and felt unprepared for the Leader and Health Advocate meta-competences. After 12 months, graduates felt prepared for all nine meta-competences but perceptions of preparedness for 14% (14 of 101) of the enabling competences had declined. Conclusion:At graduation, South African anaesthesiology graduates consider themselves unprepared for the meta-competences of Leader and Health Advocate, both comprising predominantly non-technical skills (NTS). The graduates' perceptions at the time of graduation suggest that they are not fully prepared and may, therefore, not yet be fit for purpose as specialists. Graduates' selfassessment longitudinally reflects that their perceptions of being fit for purpose change after a period of time and with specialist experience.

The leadership gap: is there a crisis of leadership in anaesthesiology?

“…These skills have often been referred to as the 'hidden curriculum' -the skills, knowledge and attitudes expected of clinicians in a sociocultural sense, both by society and their own profession. 2 Kalafatis et al 3 undertook a survey among South African specialists at the completion of their training and again one year after graduation. They found a perceived deficit in leadership and health advocacy skills which improved during the first year of practice.…”

“…In general, followers like their leaders to be accessible, to listen to them and to 'lead by example' by seeking to understand their stresses and frustrations. 15 As Kalafatis et al 3 noted, these skills are 'non-technical' skills involving emotional intelligence, communication, cooperation and negotiation. Crucially, leaders must not only know their colleagues and charges but also know themselves and their own likely biases.…”

“…Kalafatis et al 3 show us that we have a long way to go in developing leadership and advocacy training for all graduates of specialist programmes. We must follow Bennett's advice given at the beginning of this article and develop systems that create the leaders of tomorrow, for us to truly be great leaders ourselves.…”