The physician workforce in Kuwait to the year 2020

Microaggressions: Prevalence and Perspectives of Residents and Fellows in Post-Graduate Medical Education in Kuwait

Objective

Microaggression prevalence in post-graduate medical education is unknown in Kuwait. The objective is to determine the prevalence of and capture the perspectives on microaggression among post-graduate trainees in Kuwait.

Materials and Methods

This is a cross-sectional study of an anonymous online survey targeting residents and fellows in Kuwait. Data collected included demographics, level of training, country of training, microaggression experience, types, and response. Univariate and multivariate analyses were performed using the Chi-square test and binary logistic regression, respectively.

Results

A total of 319 participants (69.1% females) included 52% junior residents, 39.2% senior residents, and 8.78% fellows. Forty-three percent were aware of the microaggression definition. The percentage was significantly higher in respondents from Gulf/Middle East Countries (57.9%) than from Kuwait. Approximately three-quarters experienced microaggressions. Senior residents were more likely to report exposure to microaggressions [Odds ratio (OR) = 2.4, P < 0.05] and had higher odds of exposure than juniors (OR = 9.85, P < 0.05). Exposure to microaggressions was highest in surgery/surgical specialties. The most common act of microaggression was verbal, followed by invalidation/dismissal of thoughts/ideas, and then acts of discrimination. Of those who experienced microaggressions, two-thirds thought that the experience had a psychological effect on them. Both groups reported low confidence in dealing with microaggressions (Gulf/Middle East Countries 18.8% and Kuwait 30.1%); the difference was not statistically significant.

Conclusions

Microaggressions are common among post-graduate medical trainees in Kuwait. Implementation of strategies to manage it is necessary. Further research on its impact on medical-training outcomes is needed.

An evaluation of patient safety culture in a secondary care setting in Kuwait

OBJECTIVES

To improve patient safety outcomes, it is considered essential to create a positive culture of patient safety. This study carried out an initial evaluation of the patient safety culture in a secondary care setting in Kuwait.

METHODS

This cross-sectional questionnaire study was conducted in a general hospital medical department in Kuwait, using the Hospital Survey on Patient Safety Culture (HSPSC). Multiple linear regression analyses were used to identify patient safety culture predictors. Both an ANOVA and a Kruskal Wallis test were carried out to assess the differences between participants' total scores and the scores they achieved in each dimension, categorized by nationality.

RESULTS

A total of 1008 completed questionnaires were received, yielding a response rate of 75.2%. Three dimensions of patient safety culture were found to be priority areas for improvement: non-punitive responses to errors, staffing, and communication openness. Teamwork within units and organizational learning with continuous improvement were identified as areas of strength. Respondents from Kuwait and the Gulf State countries had a less positive perception of the hospital's patient safety culture than did Asian respondents. A regression analysis showed that the respondents' countries of origin, professions, age, and patient safety course/lecture attendance were significantly correlated with their perceptions of the hospital's patient safety culture.

CONCLUSION

This study demonstrates that patient safety is perceived differently by medical staff members from different countries of origin, professional groups, and age groups. These variables must be acknowledged and addressed when planning or evaluating patient safety initiatives.

Adverse drug reaction reporting among physicians working in private and government hospitals in Kuwait

Introduction

To improve patient safety and care, the identification and reporting of adverse drug reactions (ADRs) should be systematic and mandatory for all healthcare professionals (HCPs). Physicians remain the main HCPs with direct patient care whose role in ADRs reporting should not be ignored.

Objective

To document the awareness and attitude of physicians working in private and government hospitals in Kuwait with regard to pharmacovigilance (PV) and ADR reporting and to identify their practices of reporting ADRs.

Material and methods

A cross-sectional study was conducted using a paper-based 25-item questionnaire. The Statistical Package for Social Science (SPSS) was used for data analysis.

Results

A total of 1017 questionnaires were distributed to the eligible physicians in the government and private hospitals, giving a response rate of 84.2% and 83.0%, respectively (an overall response rate of 83.8%). Private physicians exhibited a better knowledge profile with regards to the purpose of PV (75.2% vs 64.8%; p = 0.002) and the correct ADR definition (75.8% vs 65.3%; p = 0.001). The majority of physicians showed good attitude towards reporting ADRs, nevertheless, private physicians had a significantly stronger belief that reporting ADRs is a professional obligation (93.4% vs 85.5%; p = 0.001). Three quarters of the study population (74.6%) had identified an ADR during their daily practice, however, only a small proportion (34.2%) confirms having ever reported ADRs. Regardless, significantly more private physicians had done so (42.4% vs 29.6%; p < 0.001). ADR reporting was significantly higher in physicians who knew the correct ADRs to be reported (adjusted OR = 1.86, p = 0.036), and those who were aware of any center or ADR reporting system in Kuwait (adjusted OR = 2.88, p = 0.020).

Conclusions

A national PV center empowered by clear legislation on “how” and “what” to report should improve physicians’ reporting practices and hence is required in the country. This should be combined with constant training and education in this regard.