Masters Degrees (Anaesthesiology)
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Browsing Masters Degrees (Anaesthesiology) by Subject "Anaesthetist"
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Item Open Access A comparative review of obstetric anaesthesia training, supervision and experience of public sector doctors in the Free State, 2005 vs. 2019(University of the Free State, 2021) Machai, Seta Liteboho; Lemmer-Malherbe, J.; Lamacraft, Gilian๐๐ป๐๐ฟ๐ผ๐ฑ๐๐ฐ๐๐ถ๐ผ๐ป: Obstetric anaesthesia is ranked first as a contributor to โpotentially preventable deaths per underlying causeโ of maternal death in South Africa. Lack of training, experience and supervision has been cited as the cause of these deaths. This study aimed to evaluate those public sector doctors administering obstetric anaesthesia in the Free State and compare training, experience and supervision findings with those of 14 years ago in a similar study by G Lamacraft. ๐ ๐ฒ๐๐ต๐ผ๐ฑ: This was a cross sectional analytical study carried out between the 11th and 19th December 2019. All caesarean section sites within the Free State were identified from a list obtained from the provincial government. Hospital CEOs and clinical managers were informed prior to the visit. On Arrival a list of doctors administering obstetric anaesthesia was obtained from the clinical manager. An audience with the doctors was requested and those that could not come were traced to their work areas and given the questionnaire. An implied consent was stated at the beginning of the questionnaire which was self-administered. The same questionnaire as by Lamacraft (with one added question) was handed over after a brief description of the study and collected into a box at the end of the session. The collected data was kept anonymous. ๐ฅ๐ฒ๐๐๐น๐๐: A total of 124 medical doctors met the inclusion criteria with 103 of them completing the questionnaire, thus an overall response rate of 83%. Level 1 and level 2 hospital response rates were 78% and 91% respectively. This was an improvement from the 69% overall response rate of 2005. Exposure to obstetric anaesthesia during internship has improved: in 2005 12% of respondents lacked exposure but this dropped to 5% in 2019. The reported level of supervision also improved: In 2005 21% of supervision was by junior medical officers and only 25% by consultants compared to 2019 where junior medical officerโs supervision contributed 15% and consultants 44%. A lack of exposure and training post internship was observed with only 1 doctor having a Diploma in anaesthesia in 2005 compared to 5 in 2019. Employment of a senior anaesthetist improved: 54% and 47% reported to have no senior anaesthetist employed by their hospital in 2005 and 2019 respectively. Unfortunately the added responsibility of neonatal resuscitation while administrating anaesthesia to the mother increased slightly from 42% in 2005 to 47% in 2019. ๐๐ผ๐ป๐ฐ๐น๐๐๐ถ๐ผ๐ป: Training, supervision and experience of doctors in level 1 and 2 hospitals in the Free State post internship has marginally improved in the last 14 years. Greater improvement has been noted during internship training.Item Open Access The prevalence of burnout among anaesthesiology registrars in the University of the Free State(University of the Free State, 2020-01) Adeleke, Durotolu Motunrayo; Lamacraft, GillianIntroduction: In January 2019 the leading health care organizations in the United States declared burnout as a โpublic health crisisโ with an alarming figure of 78% among the nationโs physicians. Burnout is an โindividual experience that is specific to the work contextโ which is associated with poor outcomes in job performance and health. Studies have revealed burnout ranging from 18-84% during postgraduate medical education (residency). The aim of the study was to quantify the prevalence of burnout among anaesthesiology registrars and to identify protective and aggravating factors. Method: A descriptive, prospective cross-sectional study was done in November 2018 among 23 anaesthesiology registrars using the Maslach Burnout Inventory (MBI), which is the instrument that has been validated globally to assess the dimensions of burnout: emotional exhaustion, depersonalization and a reduced sense of personal accomplishment. A self-developed questionnaire that assessed demographics, factors that contributed to and protected from burnout was also administered. Results: A prevalence of 17.4% of burnout was found with an equal distribution between males and females. The analysis of the data showed that all the participants who reported burnout were married. Difficulty in maintaining a balance between work, family and a social life was the greatest factor for reconsidering anaesthesia as a career. This was exacerbated by not having fixed working hours. The protective factors identified were: spending time with loved ones, praying, taking a break or spending time in solitude and exercise. About half (47.8 %) of the participants reported themselves as being prone to errors particularly when sleep deprived. Conclusion: The registrars in the department of anaesthesiology showed less burnout in comparison with counterparts in anaesthesiology residency training programmes within South Africa and internationally. This reinforces the findings in other studies that physicians in small urban settings show less burnout when compared with national averages. The protective factors identified in Bloemfontein can be further adopted as preventive action to further improve the wellbeing of the registrar vis-ร -vis patient outcomes.