Write-up and dissemination of undergraduate and postgraduate research at the University of Rwanda: a cross-sectional study

Introduction: research is essential in all areas of health development. However, medical students and residents frequently lack the time and training on performing research. This is especially prevalent in resource-limited settings. We aimed to compare the word counts of undergraduate and postgraduate dissertations with published projects in Rwanda, and to identify the proportion of postgraduate pediatric research projects that have been published since 2012. Methods: retrospective, cross-sectional study of undergraduate and postgraduate research dissertations at the University of Rwanda. Dissertations were then compared to randomly selected published papers of Rwandan research. Each IMRaD (Introduction, Methodology, Results and Discussion) section word count was compared using Student's t-test. Results: 19/190 (10%) undergraduate dissertations and 22/41 (54%) postgraduate dissertations, were available in electronic format for word-count analysis. The mean total word count for postgraduate dissertations (5163 words) was significantly longer (p<0.001) than the randomly selected peer-reviewed journal articles (2959 words). Each section of the IMRaD structure of postgraduate dissertations was significantly longer than those of the control group. Undergraduates used a similar number of words to published papers, but used significantly more tables and figures. Of the 41 postgraduate dissertations, only four (10%), were published in peer-reviewed journals. Conclusion: this is the first study to assess the writing style of Rwandan medical students and pediatric postgraduate residents. A simple step to increase dissemination of research findings would be for institutions to modify academic regulations so that students write-up in manuscript form rather than dissertation format

Clinical experiences of perioperative nursing Masters students in selected Rwandan referral hospitals

Background: Clinical experiences allow nursing students to apply theoretical knowledge into practice hence socialize with their future professional roles and responsibilities. This is a report of observations made by thirteen perioperative nursing students in the first cohort of Master of sciences in nursing training program during their practicum in selected Rwandan Referral Hospitals aimed at improving students’ learning outcomes in future.Methods: Teams of four to five students were allocated to the operating theatres in three selected referral and teaching hospitals in Rwanda for thirteen weeks. At the end of their clinical placement, they wrote clinical reports that highlighted their observations informed by theoretical knowledge of perioperative nursing care using a structure, process and outcome format. These reports focused on the strengths and challenges observed.Results: Students were able to translate theoretical knowledge gained in class to clinical practice. Although the hospitals provided good learning opportunities in relation to the number of patients attended to and the various surgical treatments provided, the existing infrastructures, and care delivery systems, still need improvement.Conclusions: Hospital structure and processes helped the students to achieve their clinical learning objectives. Fostering strong collaboration of Universities, Hospitals and Ministry of Health will promote specialization in the emerging field of perioperative nursing in Rwanda.Keywords: clinical experiences, masters program students training, perioperative nursing, referral hospita

Identifying, Prioritizing and Visually Mapping Barriers to Injury Care in Rwanda: A Multi-disciplinary Stakeholder Exercise.

BACKGROUND: Whilst injuries are a major cause of disability and death worldwide, a large proportion of people in low- and middle-income countries lack timely access to injury care. Barriers to accessing care from the point of injury to return to function have not been delineated. METHODS: A two-day workshop was held in Kigali, Rwanda in May 2019 with representation from health providers, academia, and government. A four delays model (delays to seeking, reaching, receiving, and remaining in care) was applied to injury care. Participants identified barriers at each delay and graded, through consensus, their relative importance. Following an iterative voting process, the four highest priority barriers were identified. Based on workshop findings and a scoping review, a map was created to visually represent injury care access as a complex health-system problem. RESULTS: Initially, 42 barriers were identified by the 34 participants. 19 barriers across all four delays were assigned high priority; highest-priority barriers were "Training and retention of specialist staff", "Health education/awareness of injury severity", "Geographical coverage of referral trauma centres", and "Lack of protocol for bypass to referral centres". The literature review identified evidence relating to 14 of 19 high-priority barriers. Most barriers were mapped to more than one of the four delays, visually represented in a complex health-system map. CONCLUSION: Overcoming barriers to ensure access to quality injury care requires a multifaceted approach which considers the whole patient journey from injury to rehabilitation. Our results can guide researchers and policymakers planning future interventions

Pediatric self-medication use in Rwanda \u2013 a cross sectional study

Background: Self-medication, a worldwide practice, has both benefits and risks. Many countries have regulated non-prescription medications available for use in self-medication. However, in countries such as Rwanda, where prescriptions are not required to purchase medications, prescription, non-prescription and traditional medications have been used for self-medication. Objectives: To determine the reported self-medication use in Rwanda and to determine attitudes and reasons associated with parental decisions to self-medicate their children. Methods: A cross-sectional multi-center questionnaire based quantitative study of 154 parents/caregivers of children under ten years undertaken in private and public health facilities. Results: The use of self-medication was reported to be 77.9%. Among these parents/caregivers, 50.8% used modern self-medication only, 15.8% used traditional self-medication only and 33.3% used both types of self-medication. Paracetamol was the most commonly used drug in modern self-medication; the traditional drugs used were Rwandan local herbs. Parents/caregivers who used modern medicines had slightly more confidence in self-medication than self-medication users of traditional medicines (p=0.005). Parents/caregivers who used modern self-medication reported barriers to consultation as a reason to self-medicate more frequently than those who used traditional drugs. Having more than one child below 10 years of-age was the only socio-demographic factor associated with having used self-medication (AOR=4.74, CI: 1.94-11.58, p=0.001). Being above 30 years (AOR= 5.78, CI: 1.25-26.68, p=0.025) and living in Kigali (AOR=8.2, CI: 1.58-43.12, p=.0.012) were factors associated with preference of modern self- medication compared to traditional self-medication. Conclusion: Self-medication is common in Rwanda. Parents/caregivers are involved in this practice regardless of their socio-demographic background

Perceived attitudes of the importance and barriers to research amongst Rwandan interns and pediatric residents – a cross-sectional study

Abstract Background Globally, interns and residents face significant challenges with respect to research activity. Despite this, they are motivated and have an interest in undertaking research. To date, there has been no research regarding the perceived attitudes towards research activities amongst Rwandan residents and interns. Objectives The primary objective of this study was to describe the perceived attitudes regarding the educational benefits and barriers surrounding research activity amongst interns and residents, and to identify any differences between these groups. The secondary objective was to describe the research methods used by interns and residents in Rwanda. Methods A cross-sectional descriptive study of interns and pediatric trainees at the University of Rwanda. An online questionnaire using Likert scale questions was sent electronically to eligible participants. Results A total of sixty participants (38 interns and 22 pediatric residents) responded to the survey. Both groups acknowledged the educational importance of undertaking research, with interns reporting this more than residents. Both groups identified the following as barriers to research: faculty lacking time to mentor, lack of funding, lack of statistical support, and lack of faculty experienced in conducting research. Interns (87%) were much more likely to have undertaken retrospective research than pediatric residents (14%). Few interns or residents submitted their research for publication (27%). Conclusions Both interns and residents understood the importance of research, but many barriers exist. Increasing the time available for experienced faculty members to supervise research is challenging due to low faculty numbers. Novel solutions will need to be found as well as expanding the time for trainees to perform research