Assessment of the Adequacy of Neurosurgery Teaching Methods among Medical Students in Enugu State, Nigeria.

Background: Various educational neurosurgery teaching methods are employed across few Nigerian universities, especially Enugu state. Aims: To determine the adequacy of current neurosurgery teaching methods, factors influencing eventual choice of neurosurgery amongst final year medical students in Enugu state, Nigeria and suggest improvement methods towards best global standards. Materials and Methods: This was an online cross-sectional study conducted among final year medical students currently on Neurosurgery rotation in Enugu state, Nigeria using a validated questionnaire. Data was analyzed (inferential and deferential) using SPSS; chi-squares values were calculated. Significance was set at p value <0.05 and measures were put in place to limit bias. Results: 106 students filled and submitted the form with a response rate of 72.60%. Most respondents revealed that their universities had mandatory neurosurgery rotations. Majority affirmed that a general poor learning environment (75%) was the major obstacle to standard teaching. About 49% had interest in specializing in surgery but only 18% have interest in neurosurgery as a future sub-specialty choice. Positively, majority (90.6%) alluded to having qualified teachers, with 43.4% of them advocating for improved training of the teachers. There was a significant correlation between choice of specialty and the students' monthly income (less than N10, 000 had a p: 0.003). Other factors that were positively correlated in eventual choice as their future desired subspecialty include poor exposure to clinical neurosurgery cases (p: 0.020) and little or no exposure of students to neurosurgery research opportunities (p: 0.024). Conclusion/Recommendations: The current neurosurgical teaching methods in Enugu state are not fully optimal yet. There is a need for some improvement in current learning environment and teaching methods to improve the students' understanding of neurosurgery and eventual increased interest in final choice of neurosurgery as their desired subspecialty.

Knowledge and acceptance of COVID-19 vaccine among healthcare workers in Enugu metropolis, Enugu state, Nigeria.

Background: COVID-19 disease spread at an alarming rate, and was declared a pandemic within 5 months from the first reported case. As vaccines have become available, there was a global effort to attain about 75% herd immunity through vaccination. There is a need to address the issue of vaccine hesitancy to COVID-19 vaccines especially in places such as Sub-Saharan African countries which have a high rate of background vaccine hesitancy. Objective: To determine the knowledge and acceptance of COVID-19 vaccines among healthcare workers (HCWs) in Enugu metropolis. Methods: A cross-sectional descriptive study of 103 HCWs in Enugu metropolis was done. Data was collected using structured online Google forms. Descriptive and inferential statistics was done using SPSS, and results were summarized into percentages and associations. Results: An acceptance rate of 56.2% was obtained among HCWs in Enugu metropolis. Positive predicators of acceptance include older age (p = 0.004, X2 = 13.161), marriage (p = 0.001, X2 = 13.996), and higher average level of income (p = 0.013, X2 = 10.766) as significant correlations were found. No significant association was found between educational level, religion, denomination nor occupation, and acceptance of vaccine. The major factor responsible for refusal was fear of side-effects. Discussion: The acceptance rate of COVID-19 vaccines among HCWs is still less than optimal. This population represents the most enlightened population on health related matters, hence if acceptance rate remains merely average that in the general population is expected to be worse. There is a need to address the fear of vaccine side-effects by inculcating more open and interactive methods of information dissemination, while also addressing the misconceptions or myths surrounding COVID-19 vaccines.

The Adequacy of Hospital Response to COVID-19 Pandemic amongst Surgical Institutions in South-Eastern Nigeria.

Background: The novel corona virus (COVID-19) was first diagnosed in Wuhan, China in December 2019. The healthcare specifically, departments of surgery in Southeastern Nigeria, are making modifications to cope and plan for the pandemic. Objectives: To evaluate how well surgical institutions in Southeastern Nigeria are prepared for the anticipated influx of Covid-19 patients, existing patients and to determine the adequacy of hospital provision of essential supplies and awareness creation. Materials and Methods: A cross-sectional online study of two hundred and one (201) surgery resident doctors in surgical institutions in South-eastern Nigeria was conducted. Questionnaires were designed and distributed using online platforms. The data obtained was analyzed using the Statistical Package for the Social Sciences (SPSS). Significance was set at P < 0.05. Consent was obtained from all respondents. Results: A total of 201 surgery resident doctors filled and submitted their questionnaires, response rate of 71.5%, out of which 50.1% agreed that hospital response to Covid-19 pandemic was inadequate, 78.3% agreed that the Personal Protective Equipment (PPEs) provided by hospitals were inadequate while about 53.8% agreed that the hospital workforce was poor and inadequate and incapable of adapting to the unstable workforce during the pandemic. About 46.2% agreed that the hospitals were conducting an adequate creation of awareness with regards to the pandemic while 25% agreed that the hospital compliance with the CDC (Center for disease control) preventive protocols/guidelines in surgical institutions were adequate.There was a statistically significant association (P = 0.019 (< 0.05); X2= 5.517) between hospital type and provision of adequate Personal protective equipment for surgical procedures. Only 19% of the government hospital employees felt that adequate amount of PPEs were provided compared to 41% of private hospital employees. Conclusion: The results from this study show that the hospital response to Covid-19 pandemic and awareness creation amongst surgical institutions in Southeastern Nigeria are inadequate. Recommendations: The government should equip the health sector by providing the necessary amenities to adequately combat the challenges of surgical practice in the Covid-19 pandemic.

Impact of Virtual Resources and Effect of COVID-19 Pandemic on Plastic Surgery Residency and Training among Residents in Southern Nigeria.

Background: Despite the increased usage of virtual, nonphysical resources for medical education during the coronavirus disease-2019 (COVID-19) pandemic, plastic surgical training still suffered adversely in some aspects. Objectives: The aim of this study was to explore the overall impact of virtual resources and effect of the COVID-19 pandemic on plastic surgery training among residents in Southern Nigeria. Materials and Methods: This was a cross-sectional study conducted among senior plastic surgery residents in southern Nigeria using a well-structured online questionnaire carried out over a 3-month period. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software program, version 25.0. Measures were taken to significantly minimise response, answer order, and other survey research errors/bias. A pilot study was done. Consent was obtained from all participants. Results: A total of 29 plastic surgery residents completed the questionnaire. Mean age was 35.15 years with standard deviation of 6.31. The response rate was 72.5%. According to a majority of the residents, there were no significant changes in the frequency of burn, hand, and facial injury cases during the pandemic; training courses on plastic surgery (44.3%) and operative cases decreased (48.3%), whereas there was a significant increase in intraoperative teaching (27.6%) as well as simulations and conferences (41.4%). Majority of the respondents also alluded to the significant financial and psychological impacts of the pandemic on residents and a significant decline in cases with general anaesthesia as compared with cases with local anaesthesia. Conclusion: The COVID-19 pandemic has caused a mixture of significant positive and negative changes in the plastic surgery training of residents.

Factors Affecting the Acquisition of Basic Surgical Skills among Surgery Interns in Teaching Hospitals in Southeast, Nigeria.

Background: Upon graduation from medical school, doctors in Nigeria undergo a compulsory internship program which includes rotation through four core specialties: Internal medicine, Obstetrics and Gynaecology, Paediatrics and Surgery. Interns are expected to acquire basic surgical skills during their rotation in surgery. Objectives: To identify the factors that affect the acquisition of basic surgical skills by surgery interns (house officers) during their one-year internship program in teaching hospitals in Southeast Nigeria. Materials and Methods: A total of 73 surgery interns were sampled using a descriptive cross-sectional, epidemiological survey that employed self-administered Google forms. The semi-structured questionnaire was electronically distributed to interns currently in surgery rotations in their internship program in South-east, Nigeria. The data was analyzed using IBM's Statistical Package for Social Sciences (SPSS) version 22 and presented in tables and charts. Consent was obtained from all respondents and measures were put in place to limit different forms of bias. Results: The most important factors that negatively affected the acquisition of surgical skills by interns were fatigue from overwork (55.4%), poor mentorship (47.3%) and inadequate skill training courses (44.6%). There were no statistically significant correlations amongst the factors that affected the acquisition of basic surgical skills by house officers. Conclusion: Some of the major limitations to acquisition of surgical skills by house officers that have undergone the surgery rotation were identified to be the workload, poor mentorship and inadequate structured skill training courses. Recommendation: Provision of better work conditions to limit work fatigue and improve learning. The training of house officers undergoing their surgery rotation should be supplemented by periodic assessment and mentorship programs by senior doctor to improve the acquisition of basic surgical skills by house officers.