Preferred Approach to Clinical Performance Improvement among Physicians at the University College Hospital, Ibadan Nigeria

Abstract

Background: Training needs assessment involves the identification and prioritization of training requirements. The medical practice regulatory authority in Nigeria recommends continuing medical education for physicians. The courses are preplanned and often do not take into consideration the training needs and the preferred method for performance improvement. This study aimed to assess the preferred method for performance improvement among physicians at a tertiary health facility in Southwest Nigeria.

Methods: This is a descriptive cross‑sectional survey carried out among 355 doctors employed in the University College Hospital, Ibadan. Sampling was conducted using stratified random sampling with a proportionate allocation to size across different cadres of doctors in various departments/units. The World Health Organization Hennessy‑Hicks Training Needs Analysis Questionnaire was adopted for this study. The self‑administered questionnaire consisted of 33 items (assignments) grouped into five subcategories: clinical assignments, communication/teamwork, research/audit, management/supervisory assignments, and administration. Participants were requested to rate each of the 33 items/assignments along with seven‑point scales (one = not at all important and seven = very important). The  Hennessy‑Hicks training manual quadrant chart was adopted for the interpretation of the training needs gap.

Results: Three hundred and three (85.4%) of 355 participants responded to the survey. The mean age ± standard deviation of participants was 37.62 ± 6.7 years. About four‑fifths of the participants were resident doctors. Regarding the most important rating, the clinical assignment subcategory was rated (6.3) as the most important to participants’ job, out of the five subcategories. Participants, however, rated their performance best in the communication/teamwork subcategory. The training needs gap was highest (0.82) in the  research/audit subcategory and lowest (0.48) in the communication/teamwork category. All subcategories reported a similar score (5.8) on participants’ perception of the organization’s development as a method to bridge the gap in training needs. Participants also rated the training course method as a better method to improve performance in all five subcategories.

Conclusion: The research/audit subcategory reported training needs gap that requires close monitoring and possible intervention. This could be done by organizing and sponsorship physicians for training courses.

Keywords: Health resources, Nigeria, physicians, training needs assessments