Browsing by Author "Ghee, Hwang"

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    Assessment of surgical skills training: A call for quality improvement for educators in low- and middle-income countries
    (East and Central African Journal of Surgery, 2019) Okello, Tom Richard; Mugabi, Patrick; Ghee, Hwang; Michelle, Sutter; Lett, Ronald
    We read with keen interest the article by Tom R. Okello and colleagues on the assessment of their final-year medical students after Essential Surgical Skills training.1 We commend the authors, the training institution, and their partners for their contributions to surgical training in the region. In their article, the authors noted the need to evaluate the effectiveness of such training programmes in terms of skills acquisition and confidence among the trainees. Using a selfadministered questionnaire, they demonstrated an improvement in the trainees’ pretraining and posttraining confidence in performing a variety of essential surgical skills. Whereas confidence is required for performing surgical procedures, it is also important to assess that the taught skills have actually been acquired by the trainees in the first place. However, no measure of the actual skills acquisition was undertaken. Selfreported assessments as used in this article tend to be subjective and are prone to a number of biases. Moreover, there was no mention of the validity or reliability of the questionnaire used for assessment. The need to assess medical skills training courses cannot be overemphasized. However, such assessment needs to be conducted in an objective manner using reliable, valid, and widely accepted tools.2 Over the years, the evolution of the assessment of surgical skills training has led to development of several tools. Examples include objective structured clinical examination (OSCE), the mini-clinical evaluation exercise (mini-CEX), the System for Improving and Measuring Procedural Learning (SIMPL), and the Objective Structured Assessment of Technical Skills (OSATS), among others
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    Evaluation of surgical skills training: A literature review and call to quality improvement for educators in low-and middle-income countries
    (East and Central African Journal of Surgery, 2020) Okello, Tom Richard; Mugada, Samuel M; Ghee, Hwang
    Background: Whereas surgical simulator skills training has been demonstrated to improve surgical skills, no gold-standard assessment tools exist for summative and formative evaluation of skills training. This study aimed to evaluate the most commonly used skills evaluation methods to determine which are most appropriate in our setting. Methods: This literature review examined the tools most used to evaluate surgical skills courses in terms of competency transfer to trainees. Many tools were evaluated: objective structured clinical examination (OSCE), the mini-Clinical Evaluation Exercise (Mini-CEX), objective structured assessment of technical skills (OSATS), the mini-Peer Assessment Tool (mini-PAT), procedure-based assessment (PBA), Surgical Direct Observation of Procedural Skills [S-DOPS], and precourse–postcourse surveys. Results: Precourse–postcourse tools had the highest reliability coefficient (0.92). Depending on the design, this tool is capable of measuring learner confidence, comfort levels, and competency, in terms of the performance of the taught skills; it can also be used to test for improvements and practice of such skills before and after training and skills acquisition. Conclusions: The precourse–postcourse self-assessment method is a reliable tool for assessing improvements in self-confidence, comfort levels, and surgical skills competency. The other available tools are most appropriate for continuous assessment in clinical clerkship and formal examination settings.
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    Student self-assessment after Essential Surgical Skills training for final-year medical students at Gulu University, northern Uganda
    (East And Central African Journal of Surgery, 2018) Okello, Tom Richard; Mugabi, Patrick; Ghee, Hwang; Michelle, Sutter; Lett, Ronald
    Background Medical practice depends on a set of essential clinical and surgical skills, yet inadequate attention is given to training these skills in medical school. This study aimed to evaluate the effect of Essential Surgical Skills® (ESS) training on self-report comfort levels in performing surgical skills among final-year medical students at Gulu University in Gulu, Uganda. Methods This study analysed 5 years’ worth of pre- and post-course ESS self-evaluation questionnaires completed by final-year medical students attending Gulu University between 2013 and 2017. Pre- and post-course results were compared using Student’s t-test. ESS elements covered over the 5-day course were: surgery fundamentals; respiratory and anaesthesia skills; and skills related to gastrointestinal, obstetric, and orthopaedic surgery. Results There was a significant improvement in the students’ level of comfort related to all ESS components when pre- and post-course questionnaire responses were compared (P < 0.001). Conclusions Medical schools should emphasize training of essential clinical and surgical skills because these give medical students the confidence and proficiency needed in clinical practice.