Are South African anaesthesiologists fit for purpose? A comparison of opinions of graduates, teachers and examiners

Abstract

Background: Anaesthesiologists must be assessed as and deemed fit for purpose (FFP) to function independently as specialists prior to their embarking on independent practice. Opinions of various stakeholders are useful in determining whether graduating specialists are prepared for practice, some of which include teachers, examiners and the graduates themselves.
Methods: This descriptive quantitative study comprised recent graduates and anaesthesiology teachers and examiners from all eight national university departments of anaesthesiology. Each participant scored the preparedness of graduates’ competences deemed appropriate by national experts via an electronic survey. Nine specialist role meta-competences (medical expert, communicator, collaborator, leader, health advocate, scholar, professional, context awareness, humaneness) with their accompanying 101 component enabling competences were assessed. Participants used a 4-point Likert scale to score preparedness for each meta- and enabling competence (1– completely unprepared; 2 – somewhat prepared; 3 – prepared; 4 – completely prepared). Scores of 1 and 2 were considered as unprepared and 3 and 4 as prepared. Scores of graduates, teachers and examiners were compared. After individual group comparisons, the scores of combined teachers and examiners (seniors) were compared with those of graduates.
Results: Response rates for graduates, teachers and examiners were 85%, 68% and 96% respectively. Graduates felt prepared for 7/9 roles (medical expert, collaborator, communicator, professional, scholar, context awareness and humaneness) and unprepared for the roles of health advocate and leader. Teachers’ and examiners’ scores were similar, perceiving graduates as prepared for 4/9 roles (medical expert, collaborator, context awareness and humaneness) and unprepared for the majority of their roles (communicator, scholar, professional, leader and health advocate). Leader and health advocate roles were unanimously perceived as unprepared by all three groups. Statistically significant disparate scores were evident between seniors and graduates for the roles of communicator, scholar and professional, with graduates assessing themselves as more prepared compared to the opinions of seniors.
Conclusion: According to South African national anaesthesiology teachers and examiners, local graduates may not be fit for purpose, despite the contrasting perceptions of graduates. Graduates’ self-assessment may be less objective than that of experienced opinions, necessitating the need for longitudinal assessments to establish the impact of experience on subsequent graduate perceptions.