UDSspace Collection:

THE NEED FOR HANDS-ON TRAINING AND SUPERVISION FOR ENTRY-LEVEL PHYSICIANS IN A COUNTRY WITH LOW SURGICAL STAFFING DENSITY: A NATIONWIDE SURVEY IN GHANA

2026-06-09T15:15:34Z

Title: THE NEED FOR HANDS-ON TRAINING AND SUPERVISION FOR ENTRY-LEVEL PHYSICIANS IN A COUNTRY WITH LOW SURGICAL STAFFING DENSITY: A NATIONWIDE SURVEY IN GHANA Authors: Kang, M. J.; Ngissah, R. K. S; Buunaaim, A. D. B.; Baidoo, R.; Odei‑Ansong, F.; Wordui, T.; Adjepong‑Tandoh, E. K.; Baidoo, P. K.; Aggrey‑Orleans, J. E. K. Abstract: Background Despite the largely unmet need, relatively few medical school graduates enrol in surgical residency and fewer surgical specialists work rurally in low and middle income countries. Surgical housemanship is the only formal training for medical graduates who will become the main surgical care providers in underserved areas. This study aimed to evaluate Ghanaian surgical housemanship (internship) and its impact on independent medical practice. Methods A nationwide questionnaire survey of surgical trainees from seven teaching or regional level hospitals ascertained the experience and self confidence levels for 35 training objectives set by the Medical and Dental Council of Ghana, and suggestions to improve surgical training quality. Results Of 310 respondents, 59.7% experienced ≤ 10 cases for each topic, and 24.8% reported self confidence as ≤ 2 points (out of 5). More than 90% of respondents experienced ≤ 10 cases for gastric, colorectal and liver cancer management. Teaching hospital trainees had lower proportions of those experiencing > 10 cases (36.6% versus 43.7%) and reporting self confidence ≥ 4 (46.5% versus 55.8%), respectively, compared with those from regional/other level hospitals. 40% of respondents were not confident about their surgical skills, and 70.5% requested better supervised and practical surgical skills training. The proportion of respondents who reported limited supervision was higher among those from teaching hospitals, reported self confidence scores < 4, and experienced ≤ 10 cases for each topic. 67% of respondents were satisfied with their surgical housemanship and 75.8% perceived surgical rotation as relevant to their future work. Conclusions Most surgical trainees are concerned about their surgical skills. A structured curriculum with specific goals and better supervised surgical skills training should be established. Inclusion of regional/other level hospitals in surgical training may reduce the supervisory burden in teaching hospitals.

REDUCING THE ENVIRONMENTAL IMPACT OF SURGERY ON A GLOBAL SCALE: SYSTEMATIC REVIEW AND CO-PRIORITIZATION WITH HEALTHCARE WORKERS IN 132 COUNTRIES

2026-06-09T15:00:33Z

Title: REDUCING THE ENVIRONMENTAL IMPACT OF SURGERY ON A GLOBAL SCALE: SYSTEMATIC REVIEW AND CO-PRIORITIZATION WITH HEALTHCARE WORKERS IN 132 COUNTRIES Authors: Adisa, A.; Bahrami-Hessari, M.; Bhangu, A.; Tabiri, S.; et al. Abstract: Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co- prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion: This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.

EXPLORING GHANAIAN MEDICAL STUDENTS’ LEARNING EXPERIENCES DURING THE COVID-19 LOCKDOWN: A CASE STUDY OF THE UNIVERSITY FOR DEVELOPMENT STUDIES MEDICAL SCHOOL

2026-06-09T14:48:14Z

Title: EXPLORING GHANAIAN MEDICAL STUDENTS’ LEARNING EXPERIENCES DURING THE COVID-19 LOCKDOWN: A CASE STUDY OF THE UNIVERSITY FOR DEVELOPMENT STUDIES MEDICAL SCHOOL Authors: Amalba, A.; Amoore, B. Y.; Kpebu, S. E. A.; Abugri, B. A.; Mogre, V. Abstract: Background The COVID-19 pandemic has had a profound impact on health professions education, particularly in developing and middle-income countries. Despite the implementation of alternative educational strategies to facilitate remote learning while maintaining physical distancing, challenges persist in ensuring the effectiveness. Methods This qualitative cross-sectional study explored the learning experiences of medical students at a Ghanaian institution during the COVID-19 pandemic. Participants were drawn from four departments within the medical school, using a cluster-based sampling approach. A voluntary response sampling method was employed to recruit students, who completed self-administered online surveys containing interview questions about their educational experiences during the pandemic. Results The study identified several barriers to effective online learning, including inadequate supervision, limited access to library resources, overburdened syllabi, and interference from household responsibilities. A significant majority of participants (n=133, 67%) reported that online learning was insufficient, ineffective, and financially burdensome, undermining the development of essential competencies and skills needed for clinical practice. Conclusions Notwithstanding these challenges, nearly all participants expressed the belief that a combination of face-to-face and online learning could enhance medical education. The pandemic has accelerated the adoption of online learning in health professions, highlighting the need to address the ongoing challenges faced by students to ensure the effectiveness of this mode of instruction.

ASSESSING VENTILATION THROUGH AMBIENT CARBON DIOXIDE CONCENTRATIONS ACROSS MULTIPLE HEALTHCARE LEVELS IN GHANA

2026-06-09T14:47:20Z

Title: ASSESSING VENTILATION THROUGH AMBIENT CARBON DIOXIDE CONCENTRATIONS ACROSS MULTIPLE HEALTHCARE LEVELS IN GHANA Authors: Crews, C.; Angwaawie, P.; Abdul-Mumin, A.; Yabasin, I. B.; Attivor, E.; Dibato, J.; Coffee, M. P. Abstract: Infection prevention and control (IPC) measures safeguard primary healthcare systems, especially as the infectious disease landscape evolves due to climate and environmental change, increased global mobility, and vaccine hesitancy and inequity, which can introduce unexpected pathogens. This study explores the importance of an "always-on," low-cost IPC approach, focusing on the role of natural ventilation in health facilities, particularly in low resource settings. Ambient carbon dioxide (CO2) levels are increasingly used as a measure of ventilation effectiveness allowing for spot checks and targeted ventilation improvements. Data were collected through purposive sampling in Northern Ghana over a three-month period. Levels of CO2ppm (parts per million) were measured by a handheld device in various healthcare settings, including Community-Based Health Planning and Services (CHPS) facilities, municipal and teaching hospitals, and community settings to assess ventilation effectiveness. Analyses compared CO2 readings in community and hospital settings as well as in those settings with and without natural ventilation. A total of 40 facilities were evaluated in this study; 90% were healthcare facilities and 75% had natural ventilation (with an open window, door or wall). Facilities that relied on natural ventilation were mostly community health centers (60% vs 0%) and more commonlyhadpatients present (83% vs 40%) compared with facilities without natural ventilation. Facilities with natural ventilation had signifi cantly lower CO2 concentrations (CO2 to meet international thresholds of COppm: 663vs1378,p=0.0043) and were morelikely 2 <800ppm(87%vs10%,p=<0.0001) and CO 1000 ppm(97%vs20%,p=<0.0001).The adjusted oddsratio oflow CO2< in the natural facilities compared with non-natural were: odds ratios, OR (95% CI): 21.7 (1.89, 247) for CO22 <800 ppm,and16.8(1.55, 183) for CO2 <1000ppm.Natural ventilation in these facilities was consistently significantly associated with higher likelihood of low CO2 concentrations. Improved ventilation represents one cost-effective layer of IPC. This study highlights the continuing role natural ventilation can play in health facility design in community health care clinics. Most health facilities met standard CO2 thresholds, particularly in community health facilities. Further research is needed to optimize the use of natural ventilation. The use of a handheld devices to track a simple metric, CO2 levels, could improve appreciation of ventilation among healthcare workers and public health professionals and allow for them to target improvements. This study highlights potential lessons in the built environment of community primary health facilities as a blueprint for low-cost, integrated multi-layer IPC measures to mitigate respiratory illness and anticipate future outbreaks.