{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/36008"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/36008","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"Surgical trainee supervision during non-trauma emergency laparotomy in Rwanda and South Africa","abstract":"Objective: The primary objective was to describe the level of surgical trainee autonomy during non-trauma emergency laparotomy (NTEL) operations in Rwanda and South Africa. The secondary objective was to identify potential associations between trainee autonomy, and patient mortality and reoperation. Design, Setting, and Participants: This was a prospective, observational study of NTEL operations at three teaching hospitals in South Africa and Rwanda over a oneyear period from September 1, 2017 – August 31, 2018. A total of 543 operations on adults over the age of 18 years who underwent NTEL performed by the acute care and general surgery services were included. Results: surgical trainees led three quarters of NTEL operations, and of these, 72% were performed autonomously in Rwanda and South Africa. Trainees were less likely to perform the operations autonomously for patients who were: age ≥ 60 years, had ASA classification ≥ III, had cancer or TB. Notably, trainee autonomy was not significantly associated with reoperation or mortality. Conclusions: trainees were able to gain autonomous surgical experience without impacting mortality or reoperation outcomes, while still providing surgical support in a high-demand setting. More in-depth studies to understand the association of high trainee autonomy with surgical competency and patient safety is needed.","abstract_html":"Objective: The primary objective was to describe the level of surgical trainee autonomy during non-trauma emergency laparotomy (NTEL) operations in Rwanda and South Africa. The secondary objective was to identify potential associations between trainee autonomy, and patient mortality and reoperation. Design, Setting, and Participants: This was a prospective, observational study of NTEL operations at three teaching hospitals in South Africa and Rwanda over a oneyear period from September 1, 2017 – August 31, 2018. A total of 543 operations on adults over the age of 18 years who underwent NTEL performed by the acute care and general surgery services were included. Results: surgical trainees led three quarters of NTEL operations, and of these, 72% were performed autonomously in Rwanda and South Africa. Trainees were less likely to perform the operations autonomously for patients who were: age ≥ 60 years, had ASA classification ≥ III, had cancer or TB. Notably, trainee autonomy was not significantly associated with reoperation or mortality. Conclusions: trainees were able to gain autonomous surgical experience without impacting mortality or reoperation outcomes, while still providing surgical support in a high-demand setting. More in-depth studies to understand the association of high trainee autonomy with surgical competency and patient safety is needed.","abstract_has_math":false,"creators":["Pohl, Linda M"],"institution":"Division of General Surgery","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Chu, Kathryn"],"committee_chairs":[],"committee_members":[],"year":2021,"date_issued":"2021","date_published":"2021","updated_at":"2026-07-22T22:23:02Z","subjects":["surgery","training","education","supervision","laparotomy","Africa"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/36008","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Chu, Kathryn"]},{"key":"dc:creator","label":"Author","values":["Pohl, Linda M"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2022-03-09T15:51:20Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2022-03-09T15:51:20Z"]},{"key":"dc:date.issued","label":"Date","values":["2021"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Division of General Surgery"]},{"key":"dc:type","label":"Dc Type","values":["Master Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["surgery","training","education","supervision","laparotomy","Africa"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/36008"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Objective: The primary objective was to describe the level of surgical trainee autonomy during non-trauma emergency laparotomy (NTEL) operations in Rwanda and South Africa. The secondary objective was to identify potential associations between trainee autonomy, and patient mortality and reoperation. Design, Setting, and Participants: This was a prospective, observational study of NTEL operations at three teaching hospitals in South Africa and Rwanda over a oneyear period from September 1, 2017 – August 31, 2018. A total of 543 operations on adults over the age of 18 years who underwent NTEL performed by the acute care and general surgery services were included. Results: surgical trainees led three quarters of NTEL operations, and of these, 72% were performed autonomously in Rwanda and South Africa. Trainees were less likely to perform the operations autonomously for patients who were: age ≥ 60 years, had ASA classification ≥ III, had cancer or TB. Notably, trainee autonomy was not significantly associated with reoperation or mortality. Conclusions: trainees were able to gain autonomous surgical experience without impacting mortality or reoperation outcomes, while still providing surgical support in a high-demand setting. More in-depth studies to understand the association of high trainee autonomy with surgical competency and patient safety is needed."]},{"key":"dc:title","label":"Title","values":["Surgical trainee supervision during non-trauma emergency laparotomy in Rwanda and South Africa"]}]}],"canonical_facts":{"dc:contributor.advisor":["Chu, Kathryn"],"dc:creator":["Pohl, Linda M"],"dc:date.accessioned":["2022-03-09T15:51:20Z"],"dc:date.available":["2022-03-09T15:51:20Z"],"dc:date.issued":["2021"],"dc:description.abstract":["Objective: The primary objective was to describe the level of surgical trainee autonomy during non-trauma emergency laparotomy (NTEL) operations in Rwanda and South Africa. The secondary objective was to identify potential associations between trainee autonomy, and patient mortality and reoperation. Design, Setting, and Participants: This was a prospective, observational study of NTEL operations at three teaching hospitals in South Africa and Rwanda over a oneyear period from September 1, 2017 – August 31, 2018. A total of 543 operations on adults over the age of 18 years who underwent NTEL performed by the acute care and general surgery services were included. Results: surgical trainees led three quarters of NTEL operations, and of these, 72% were performed autonomously in Rwanda and South Africa. Trainees were less likely to perform the operations autonomously for patients who were: age ≥ 60 years, had ASA classification ≥ III, had cancer or TB. Notably, trainee autonomy was not significantly associated with reoperation or mortality. Conclusions: trainees were able to gain autonomous surgical experience without impacting mortality or reoperation outcomes, while still providing surgical support in a high-demand setting. More in-depth studies to understand the association of high trainee autonomy with surgical competency and patient safety is needed."],"dc:identifier.uri":["http://hdl.handle.net/11427/36008"],"dc:publisher.department":["Division of General Surgery"],"dc:subject":["surgery","training","education","supervision","laparotomy","Africa"],"dc:title":["Surgical trainee supervision during non-trauma emergency laparotomy in Rwanda and South Africa"],"dc:type":["Master Thesis"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:02Z"}