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Paydar S, Esmaeeli E, Ameri F, Sabahi A, Meraji M. Investigating the advantages and disadvantages of electronic logbooks for education goals promotion in medical sciences students: A systematic review. Health Sci Rep 2023; 6:e1776. [PMID: 38125281 PMCID: PMC10730948 DOI: 10.1002/hsr2.1776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
Background and Aims Electronic logbook (E-Logbook) is one of the practical software in medical science that serves as an auxiliary tool for comprehensive education, formative evaluation, and student learning documentation in clinical education. E-logbooks are available to people on the Internet without any time or place restrictions. Experts' familiarity with e-logbooks and their advantages and disadvantages can be effective in their better design so professors and students can use their potential benefits. Therefore, this study examines the advantages and disadvantages of an e-logbook. Methods This systematic review was conducted until June 13, 2022, by searching relevant keywords such as logbook, e-logbook, and medical students in PubMed, Scopus, and Web of Science databases. Data were extracted using the data extraction form. The contents of the studies were analyzed based on the study's aim. The results of the analyses were presented in the form of descriptive statistics (tables and figures). Results Out of 365 retrieved studies, 13 were selected to investigate the advantages and disadvantages of e-logbooks. Most studies were conducted in Pakistan (n = 4) and focused on medical students with different specialties (n = 10). The advantages and disadvantages of e-logbooks were classified into nine and four categories, respectively. Most advantages of e-logbooks were related to monitoring and evaluating the performance of students and instructors (n = 11). Their most disadvantages were associated with hardware and software (n = 8). Conclusion According to the results, e-logbooks can improve clinical education, provide feedback to people, control the achievement of educational goals, and increase professor-student interaction. Hence, it is recommended to address their disadvantages and barriers to improve the quality of students' performance.
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Affiliation(s)
- Somayeh Paydar
- Department of Health Information Technology, School of Allied Medical SciencesKermanshah University of Medical SciencesKermanshahIran
| | - Erfan Esmaeeli
- Health Information Management Department, School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Fatemeh Ameri
- Department of Health Information Technology, School of Paramedical Sciences, Student Research CommitteeMashhad University of Medical SciencesMashhadIran
| | - Azam Sabahi
- Department of Health Information Technology, Ferdows Faculty of Medical SciencesBirjand University of Medical SciencesBirjandIran
| | - Marzieh Meraji
- Department of Health Information Technology and Medical Records, School of Paramedical SciencesMashhad University of Medical SciencesMashhadIran
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van Kesteren J, Meylahn-Jansen PJ, Conteh A, Lissenberg-Witte BI, van Duinen AJ, Ashley T, Bonjer HJ, Bolkan HA. Inguinal hernia surgery learning curves by associate clinicians. Surg Endosc 2023; 37:2085-2094. [PMID: 36303045 PMCID: PMC10017565 DOI: 10.1007/s00464-022-09726-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 10/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Open inguinal hernia repair is the most commonly performed procedure in general surgery in sub-Saharan Africa, but data on its learning curve are lacking. This study evaluated the learning curve characteristics to improve surgical training and enable scaling up hernia surgery in low- and middle-income countries. METHODS Logbook data of associate clinicians enrolled in a surgical training program in Sierra Leone were collected and their first 55 hernia surgeries following the Bassini technique (herniorrhaphies) were analyzed in cohorts of five cases. Studied variables were gradient of decline of operating time, variation in operating time, and length of stay (LOS). Eleven subsequent cohorts of each five herniorrhaphies were investigated. RESULTS Seventy-five trainees enrolled in the training program between 2011 and 2020 were eligible for inclusion. Thirty-one (41.3%) performed the minimum of 55 herniorrhaphies, and had also complete personal logbook data. Mean operating times dropped from 79.6 (95% CI 75.3-84.0) to 48.6 (95% CI 44.3-52.9) minutes between the first and last cohort, while standard deviation in operating time nearly halved to 15.4 (95% CI 11.7-20.0) minutes, and LOS was shortened by 3 days (8.5 days, 95%CI 6.1-10.8 vs. 5.4 days, 95% 3.1-7.6). Operating times flattened after 31-35 cases which corresponded with 1.5 years of training. CONCLUSIONS The learning curve of inguinal hernia surgery for associate clinicians flattens after 31-35 procedures. Training programs can be tailored based on this finding. The recorded learning curve may serve as a baseline for future training techniques.
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Affiliation(s)
- Jurre van Kesteren
- Department of Surgery, Amsterdam University Medical Centers, Location Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- Global Surgery Amsterdam, Amsterdam, The Netherlands.
| | - Pauline J Meylahn-Jansen
- Global Surgery Amsterdam, Amsterdam, The Netherlands
- Department of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands
| | | | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Location Vrije Universiteit, Amsterdam, The Netherlands
| | - Alex J van Duinen
- Institute of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Surgery, St. Olavs Hospital HF, Trondheim University Hospital, Trondheim, Norway
- CapaCare, Trondheim, Norway
| | - Thomas Ashley
- CapaCare, Trondheim, Norway
- Kamakwie Wesleyan Hospital, Kamakwie, Sierra Leone
- Department of General Surgery, North Cumbria University Hospital, Carlisle, UK
| | - H Jaap Bonjer
- Department of Surgery, Amsterdam University Medical Centers, Location Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Global Surgery Amsterdam, Amsterdam, The Netherlands
| | - Håkon A Bolkan
- Institute of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinic of Surgery, St. Olavs Hospital HF, Trondheim University Hospital, Trondheim, Norway
- CapaCare, Trondheim, Norway
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Barteit S, Schmidt J, Kakusa M, Syakantu G, Shanzi A, Ahmed Y, Malunga G, Blass K, Nieder J, Andreadis P, Neuhann F. Electronic logbooks (e-logbooks) for the continuous assessment of medical licentiates and their medical skill development in the low-resource context of Zambia: A mixed-methods study. Front Med (Lausanne) 2022; 9:943971. [PMID: 36507498 PMCID: PMC9727710 DOI: 10.3389/fmed.2022.943971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background Countries in sub-Saharan Africa continue to face insufficient health education resources and facilities, as well as a severe shortage of health care professionals. In 2019, the Levy Mwanawasa Medical University (LMMU) in Lusaka was launched to address the shortage of healthcare professionals implementing a decentralized training model utilizing selected regional and district hospitals in Zambia as training sites for various cadres. Decentralization makes it more challenging to monitor the learning process as part of continuous assessment; consequently, adequate approaches are necessary to ensure the quality and quantity of medical skills training. Electronic logbooks (e-logbooks) provide a promising tool for monitoring and evaluation of the medical training process. Objective We designed and implemented an e-logbook for Medical Licentiate students based on an existing software system. We evaluated the feasibility of this e-logbook, its acceptability among a cohort of Medical Licentiate students and their mentors, as well as its facilitators and barriers. Materials and methods During the course of a five-week-long clinical rotation in a training site in Kabwe, Zambia, two mentors and ten students participated in the pilot study and its evaluation. A mixed-methods approach utilized log-based usage data from the e-logbook web platform and conducted semi-structured in-depth interviews. Results Overall, both students and mentors accepted e-logbooks as a means to monitor skills development in this context, indicating that e-logbooks are a feasible tool in this decentralized setting. Feedback pointed out that the design and software-induced terminology of the e-logbook posed usability issues. The complexity and greater time commitment (mentors used a web-based platform instead of an app) limited the e-logbook's potential. Conclusion We conclude that there is acceptability of monitoring medical skill development through a tablet-based e-logbook. However, the e-logbook in its current form (based on an existing software system, with limited adaptation possibilities to the local context) was insufficient for the LMMU environment. Given that this was attributable to design flaws rather than technology issues or rejection of the e-logbook as a quality assessment tool in and of itself, we propose that the e-logbook be implemented in a co-design approach to better reflect the needs of students and mentors.
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Affiliation(s)
- Sandra Barteit
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany,*Correspondence: Sandra Barteit,
| | - Jelena Schmidt
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany,Faculty 11: Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Mwanja Kakusa
- Faculty of Medicine, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Gardner Syakantu
- Faculty of Medicine, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Aubrey Shanzi
- Faculty of Medicine, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Yusuf Ahmed
- Faculty of Medicine, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Gregory Malunga
- Faculty of Medicine, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Klaus Blass
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | - Jessica Nieder
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
| | | | - Florian Neuhann
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany,Faculty of Medicine, Levy Mwanawasa Medical University, Lusaka, Zambia
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A thematic review of the use of electronic logbooks for surgical assessment in sub-Saharan Africa. Surgeon 2021; 20:57-60. [PMID: 34922837 DOI: 10.1016/j.surge.2021.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Ensuring that surgical training programmes in low- and middle-income countries (LMICs) provide high quality training, including adequate operative experience, is of crucial importance in meeting the goals set out in the Lancet Global Surgery 2030. Electronic logbooks (eLogbooks) have been adopted to monitor both individual trainee progression and the performance of surgical training programmes. METHODS We performed a thematic review of the current evidence base surrounding the use of eLogbooks for the assessment of surgeons in training in sub-Saharan Africa, with a view to identifying the learning to date and areas for future research. RESULTS Whilst there are multiple papers highlighting the use of surgical eLogbooks in high-income countries, we identified only three papers which discussed their use in sub-Saharan Africa. Four common themes emerged which related to the use of surgical eLogbooks throughout sub-Saharan Africa: ease of analysis, centralised databases, discrepancies in reporting and technology limitations. CONCLUSIONS Robust data to demonstrate trainee progression and the quality of surgical training programmes are of crucial importance in ensuring that surgical training programmes can rapidly scale up to deliver large numbers of well-trained surgical providers to address the unmet patient need in LMICs in the next decade. The limited data on the use of well designed, centralised electronic surgical logbooks indicate that this tool may play an important role in providing key data to underpin these training programmes.
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Sung S, Hørthe H, Svendsen ØV, van Duinen AJ, Salvesen Ø, Vandi A, Bolkan HA. Early evaluation of the transition from an analog to an electronic surgical logbook system in Sierra Leone. BMC MEDICAL EDUCATION 2021; 21:578. [PMID: 34781930 PMCID: PMC8591157 DOI: 10.1186/s12909-021-03012-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/26/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Surgical logbooks are a commonly used tool for quality assurance of surgical training. Electronic logbooks are increasingly applied in low-resource settings, but there is limited research on their quality. The aim of this study is to evaluate the quality of an app-based surgical e-logbook system shortly after its implementation in a low-income country and to identify potential areas of improvement for the system. METHODS Entries in the e-logbook system were cross-checked with hospital records and categorized as matched or overreported. Moreover, the hospital records were checked for underreported procedures. Additionally, semi-structured interviews were conducted with users of the e-logbook system. RESULTS A total of 278 e-logbook database entries and 379 procedures in the hospital records from 14 users were analyzed. Matches were found in the hospital records for 67.3% of the database entries. Moreover, 32.7% of the database entries were overreported and 50.7% of the procedures in the hospital records were underreported. A previous study of an analog surgical logbook system in the same setting estimated that 73.1% of the entries were matches or close matches. Interviews with 12 e-logbook users found overall satisfaction but also identified potential areas of improvement, including the need for more training in the use of the system, modifications to improve user-friendliness, and better access to the necessary technology. CONCLUSIONS A reliable documentation system is necessary to evaluate the quality of health workforce training. The early evaluation of a surgical e-logbook system in a low-income country showed that the collected data should be approached with caution. The quantitative analysis suggests that the e-logbook system needs to be improved in terms of accuracy. In interviews, users reported that digitalization of the logbook system was a much-needed innovation but also identified important areas of improvement. Recognition of these aspects at an early stage facilitates guidance and adjustment of further implementation and might improve the accuracy of the system.
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Affiliation(s)
- Sophia Sung
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), P.O. Box 8905 MTFS, 7491 Trondheim, Norway
| | - Hilde Hørthe
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), P.O. Box 8905 MTFS, 7491 Trondheim, Norway
| | - Øyvind Veel Svendsen
- CapaCare, c/o Dr Håkon Bolkan, Clinic of Surgery, St. Olavs Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway
- Clinic of Internal Medicine and Rehabilitation, Levanger Hospital, P.O. Box 333, 7601 Levanger, Norway
| | - Alex J. van Duinen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), P.O. Box 8905 MTFS, 7491 Trondheim, Norway
- CapaCare, c/o Dr Håkon Bolkan, Clinic of Surgery, St. Olavs Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway
- Clinic of Surgery, St. Olavs Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway
| | - Øyvind Salvesen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), P.O. Box 8905 MTFS, 7491 Trondheim, Norway
| | - Alphonsus Vandi
- CapaCare, c/o Dr Håkon Bolkan, Clinic of Surgery, St. Olavs Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway
| | - Håkon A. Bolkan
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), P.O. Box 8905 MTFS, 7491 Trondheim, Norway
- CapaCare, c/o Dr Håkon Bolkan, Clinic of Surgery, St. Olavs Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway
- Clinic of Surgery, St. Olavs Hospital, P.O. Box 3250 Sluppen, 7006 Trondheim, Norway
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Harrington CM, Jang SS, Mangaoang D, O’Flynn E, Minja C, Chikoya L, Bekele A, Borgstein E. Integration and Sustainability of Electronic Surgical Logbooks in Sub-Saharan Africa. World J Surg 2020; 44:3259-3267. [DOI: 10.1007/s00268-020-05613-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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