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

Abstract

Background Personal logbooks are universally applied for monitoring and evaluation of surgical trainees; however, the quality and accuracy of such logbooks in low income countries (LICs) are poorly examined. Logbooks are kept by the individual trainee and detail every surgical procedure they perform and their role during the procedure. The aim of this study was to evaluate the quality of such a logbook system in Sierra Leone and to identify areas of improvement. Methods The last 100 logbook entries for students and graduates participating in a surgical task sharing training programme were compared with hospital records (HRs). The logbook entries were categorized as matching , close matching or over-reported . Moreover, HRs were checked for under-reported procedures. Semi-structured interviews were conducted with the study participants on logbook recording routines. The results were analysed using mixed effects logistic regression models. Results Three thousand one hundred sixty-nine database entries from 35 participants were analysed. Of that amount, 62.2% of the entries matched the HRs, 10.4% were close matches and 26.9% were over-reported. 20.7% of the investigated HRs were under-reported. Conclusions Information gathered from surgical logbook systems must be applied with care, and great efforts must be made to ensure that the logbook systems used provide reliable data. Based on analysis of the logbook data and interviews, focus areas are suggested to ensure reliable logbook data in LICs. Clear instructions and proper training should be provided when introducing the logbook system to the users. The importance of logging all procedures, including minor ones, should be emphasized. The logbook system should be user friendly and only as extensive as necessary. Lastly, keeping the logbooks exclusively digital is recommended, combined with sufficient IT equipment and training. Electronic supplementary material The online version of this article (10.1186/s12909-019-1647-2) contains supplementary material, which is available to authorized users.

Using Logbooks to Enhance Students’ Learning: Lessons From a Mixed-methods Study in an Undergraduate Surgical Rotation

“…A logbook was designed to mirror the activities that students were expected to do in the hospital during their clerkships period aligned to the course objectives [1,18]. These include clinical, diagnostic, procedural, and patient management skills.…”

“…They reasoned such observation to the tendency of students to overlook some cases [48]. Poor students' guidance due to clinicians' heavy workloads and busy schedules, in addition to the burden of data entry and limited opportunities to interact with patients on the learner's side may also be responsible factors [1,9,50]. Likewise, Alabbad et al (2019) have argued that senior students may benefit from logbooks more than their junior counterparts, where they tend to select cases that provide more significant learning opportunities; however, no correlation to their final course grades was observed [4].…”

“…SY6F "The logbook was structured to just "fill-in-the-blank;" we wanted more space to write freely, more freedom in writing." SY6F In consonance, Svendsen et al (2019) recommended a user-friendly logbook and warned against a bureaucratic one which involves extensive load of data entry [1]. Likewise, Jud et al (2020) was skeptic about the possibility of using logbooks appropriately to enhance students' learning unless proper guidance and supervision of students in the wards is implemented [17].…”

“…Involving enthusiastic physicians and mentors among the hospital staff in regular review and monitoring of their students' work supplemented with faculty development programs were proposed to increase the acceptability of the logbook and feasibility of the process [29,40,53]. Besides, effort should aim to improve the structure of the logbook to adjust the burden of data entry and refine rubrics to add fairness to the marking process [1,18,49].…”

“…The use of logbooks to enhance learning is well-known in the educational enterprise, including medicine, where they have numerous advantages to learners, instructors, and educational institutions [1][2][3]. Logbooks are applied in training programs based on the philosophy of the collection of evidence that learning has taken place [4,5].…”