Browsing by Author "Mugabi, Patrick"

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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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    Case Report: Swallowed toothbrush in the stomach of a 56 year female at St Mary’s Hospital Lacor, Uganda [version 1; referees: 1 approved with reservations, 1 not approved]
    (AAS Open Research, 2018) Amone, Derrick; Okot, Christopher; Mugabi, Patrick; Okello, Tom Richard; Ogwang, David Martin
    Toothbrush swallowing is a rare occurrence. Toothbrush swallowing presents a risk of impaction and perforation along the gastrointestinal tract. This case report describes a 56 year old female that presented to the emergency unit of St Mary’s Hospital Lacor with a 1 day history of chest pain after a toothbrush was pushed down her throat by a traditional healer who was managing her for pharyngitis. The chest pain was associated with difficulty in breathing. She also reported dull abdominal pain. There was no history of vomiting or drooling of saliva. On examination, we found that she was in pain and had respiratory distress with a respiratory rate of 32 breath/ min and was using accessory muscles. There was no oedema, aneamia or jaundice. Blood pressure of 120/80 mmHg and pulse rate of 87 beats/ min. The abdominal findings were normal, but ultrasound scan suggested that the toothbrush was in the stomach. The plain erect abdominal x-ray was inconclusive. She was admitted to the ward for conservative management. After 2 weeks we decided to do exploratory laparotomy and we found the toothbrush in the stomach, that we removed and closed the abdomen in layers. Post-operatively the patient recovered uneventfully on the ward. Toothbrush swallowing is a rare occurrence. The commonest foreign bodies ingested by adults are bones, spoons and dentures. Toothbrush ingestion occurs commonly among patients with psychiatric conditions like bulimia or anorexia nervosa, schizophrenia and bezoar. Most swallowed toothbrushes have been found in the esophagus or the stomach of affected patients. Most people who swallowed their toothbrushes did so entirely without erotic intent, as with this case where the patient had the brush pushed down her throat by a traditional healer. This is the first case of toothbrush swallowing in this hospital.
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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.