The undergraduate paediatric surgery curriculum in Nigeria – how have we fared?

Abstract

Background. In the Nigerian setting the curriculum of each medical school is the sole responsibility of the senate of the respective university. This arrangement results in variability in learning objectives and in students’ acquisition of skills to manage clinical problems. Educational objectives can be used to both standardise and evaluate curricula. This study aimed to: (i) identify main objectives of paediatric surgery at he undergraduate level; (ii) establish students’ knowledge with regard to these objectives; (iii) evaluate the input of both specialists and non-specialists to these objectives; and (iv) examine the status of undergraduate paediatric surgery instruction in our medical schools. Materials and methods. This was a cross-sectional survey of students, teachers and undergraduate deans with regard to undergraduate paediatric surgery teaching. The cognitive and perceived level of knowledge about common paediatric surgical conditions of 4th- and 6th-year medical students in four randomly selected Nigerian universities was surveyed using educational objectives. The same objectives were used to survey 26 paediatric surgeons, 46 senior house officers and 46 general surgeons. Undergraduate paediatric surgery curricula, obtained from the offices of the deans of the four medical schools, were also reviewed. Data were analysed using descriptive methods and one-way analysis of variance (ANOVA). Results. The 6th-year students’ and house officers’ perceived knowledge of the objectives was remarkably similar. Overall, students’ familiarity scores increased from the 4th to the 6th year (p<0.05), but fell short of the expected proficiency levels in the 6th year. The general surgeons and paediatric surgeons expressed similar expectations. Thirty items on the objectives were considered to be essential (mean score >2.0) and 8 items to be non-essential (mean score <1.5) by paediatric surgeons, whereas the general surgeons regarded 27 items to be essential (mean score >2.0) and 11 to be non-essential (mean score <1.5). Data from the deans’ offices varied, but indicated limited exposure to paediatric surgery in the undergraduate curriculum in 2 (50%) of the 4 institutions. Conclusion. The study clarified the relationship between the expected and perceived students’ knowledge of these objectives, and identified areas requiring specific attention. These results, and perhaps similar ones in future, can be used towards establishing a unified, standardised undergraduate paediatric surgery curriculum.