Views of early career doctors on residency training and clinical practice in Nigeria: A qualitative report from charting study

In Nigeria, Early Career Doctors (ECDs) constitute a significant number of the doctor's health workforce and play a crucial role in health service delivery. However, there is a paucity of data concerning attitude, perception, and challenges in training and skill acquisition faced by ECDs undergoing residency training in Nigeria. This study is a component of Challenges of Residency training and early career doctors in Nigeria (CHARTING study) a multicentre and multidisciplinary study that explored the views of ECDs on residency training and clinical practice in Nigeria. Methods: Focus Group Discussions (FGD) were conducted among fourteen respondents, to address specific aspects of the residency training program and encourage respondents to express themselves about issues relevant to their personal experiences as regards the assessment of practice and proffer recommendations. Discussions were digitally recorded with an audio recorder. Audio-recordings was transcribed verbatim. Transcripts were analysed, and coding was done using NVivo 12 program. Results: All the study participants expressed various degrees of dissatisfaction and challenges such as lack of up to date knowledge, poor&contingent rewards, workload distribution, lack of mentorship, and unequipped facility during the residency training program. Majority of the study participants considered the program is currently skewed towards service delivery at the detriment of training and research. Conclusion: The study provided robust information on the knowledge of the trainees' perception of the residency training program in Nigeria as well as the challenges of residency training among ECDs as regards their experience and practice; it also proffered recommendations to mitigate the challenges. Keywords: Career, Internship, Postgraduate, Registrar, Trainee, Residency, Doctors, Dentist, Early Career Doctors, Nigeria, Education, Graduate Medical, Residenc

The Relationship Between Structural Empowerment And Organizational Commitment Among Nurses: A Structured Literature Review

Background: The empowerment of nurses is imperative for the provision of high-quality care. The creation of an empowered and supportive work  environment is important to increase the organizational commitment of nurses.Objectives: The purpose of the structured literature review was to examine relevant past studies to systematically identify the relationship between  structural empowerment and organizational commitment of nurses in healthcare settings,Methods: Electronic databases searches were conducted in CINAHL, Google scholar, Springer Link, Science Direct, PubMed, OVID Medline, and  Wiley Library covering the period of 2005-2020. Studies involving nurses with evidence of the relationship between structural empowerment and  organizational commitment were included. All included articles were assessed using the Preferred Reporting Items for Systematic Reviews and  Meta-Analyses (PRISMA).Results: A total of 987 papers were identified following an electronic database search and 19 studies were included in the review. Thematic analysis  identified four main themes in the papers; factors influencing structural empowerment and organizational commitment; relationship between  structural empowerment and organizational commitment; relationship between structural empowerment, job satisfaction, and organizational  commitment and relationship between structural empowerment, leadership quality, and organizational commitment. The result confirmed that structural empowerment is strongly related to nurses’ organizational commitment.Conclusion: Nurses' access to empowering structures such as access to resources, support, information, and opportunities have increased  commitment to their health organizations. There is a dire need for health institutions inclusive of South Africa to invest in empowerment structures  to improve the organizational commitment of nurses by providing a supportive work environment

Exploring issues and challenges of leadership among early career doctors in nigeria using a mixed-method approach: CHARTING study

Background: leadership behaviour is a poorly explored phenomenon among early-career doctors (ECDs). Good leadership is vital in maximising the effective management of patients in a clinical setting. While a good number of studies, though with small sample surveys, have researched the role of leadership in clinical setting quantitatively, qualitative investigations are yet to be done in Nigeria. This study aims to explore the attitudes, skills, and experience of ECDs in Nigeria on issues pertaining to leadership in a medical setting, using a mixed-method approach. (2) Methods: we conducted two sessions of key informant focus group discussion (FGD) that involved 14 ECD leaders in Nigeria, exploring their leadership experience in a clinical setting. Furthermore, we used a self-administered questionnaire to quantitatively survey 474 ECDs from seven Nigerian teaching hospitals to explore their attitudes, skills, and experience on issues pertaining to medical leadership. (3) Results: taking on leadership roles is a common phenomenon (52.7%) among the surveyed ECDs; however, the medical leadership position can be very challenging for ECDs in Nigeria. Despite the fact that many (91.1%) of the surveyed ECDs perceived leadership skills as essential skills needed by a doctr, many (44.1%) of them were yet to be formally trained on medical leadership. About three out of every 10 (23.6%) of surveyed ECDs that have ever held leadership positions in a medical setting experienced major leadership challenges while in such office due to their lack of training on leadership skills. Leadership skill acquisition programmes are highly recommended to become an integral part of medical training programmes in Nigeria. (4) Conclusion: there is a need for a structured leadership skill acquisition programme for ECDs in Nigeria. This programme will help in the robust delivery of highly effective healthcare services in Nigeria, as effective leadership is crucial to patient care services

Exploring Issues and Challenges of Leadership among Early Career Doctors in Nigeria Using a Mixed-Method Approach: CHARTING Study

(1) Background: leadership behaviour is a poorly explored phenomenon among early-career doctors (ECDs). Good leadership is vital in maximising the effective management of patients in a clinical setting. While a good number of studies, though with small sample surveys, have researched the role of leadership in clinical setting quantitatively, qualitative investigations are yet to be done in Nigeria. This study aims to explore the attitudes, skills, and experience of ECDs in Nigeria on issues pertaining to leadership in a medical setting, using a mixed-method approach. (2) Methods: we conducted two sessions of key informant focus group discussion (FGD) that involved 14 ECD leaders in Nigeria, exploring their leadership experience in a clinical setting. Furthermore, we used a self-administered questionnaire to quantitatively survey 474 ECDs from seven Nigerian teaching hospitals to explore their attitudes, skills, and experience on issues pertaining to medical leadership. (3) Results: taking on leadership roles is a common phenomenon (52.7%) among the surveyed ECDs; however, the medical leadership position can be very challenging for ECDs in Nigeria. Despite the fact that many (91.1%) of the surveyed ECDs perceived leadership skills as essential skills needed by a doctr, many (44.1%) of them were yet to be formally trained on medical leadership. About three out of every 10 (23.6%) of surveyed ECDs that have ever held leadership positions in a medical setting experienced major leadership challenges while in such office due to their lack of training on leadership skills. Leadership skill acquisition programmes are highly recommended to become an integral part of medical training programmes in Nigeria. (4) Conclusion: there is a need for a structured leadership skill acquisition programme for ECDs in Nigeria. This programme will help in the robust delivery of highly effective healthcare services in Nigeria, as effective leadership is crucial to patient care services