Brief Article
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World J Gastroenterol. Jul 7, 2013; 19(25): 3996-4000
Published online Jul 7, 2013. doi: 10.3748/wjg.v19.i25.3996
Gastroenterology training in a resource-limited setting: Zambia, Southern Africa
Akwi W Asombang, Eleanor Turner-Moss, Anil Seetharam, Paul Kelly
Akwi W Asombang, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, St. Louis, MO 63110-0250, United States
Eleanor Turner-Moss, Paul Kelly, Barts and the London School of Medicine, Queen Mary University of London, London E14NS, United Kingdom
Anil Seetharam, Banner Health Liver Center, Phoenix, AZ 85006, United States
Author contributions: Asombang AW and Kelly P contributed to the concept and design; Asombang AW, Turner-Moss E and Kelly P contributed to acquisition of data; Asombang AW, Turner-Moss E, Seetharam A and Kelly P contributed to the analysis, interpretation of data, drafting of manuscript and final approval.
Correspondence to: Akwi W Asombang, MD, Division of Gastroenterology and Hepatology, Saint Louis University School of Medicine, 3635 Vista Avenue at Grand Boulevard, St. Louis, MO 63110-0250, United States.
Telephone: +1-314-8796448 Fax: +1-314-8796222
Received: January 22, 2013
Revised: May 14, 2013
Accepted: May 22, 2013
Published online: July 7, 2013

AIM: To evaluate need for and efficacy of a structured gastroenterology didactic session in expanding awareness and understanding of digestive disorders.

METHODS: A four-day symposium was developed with didactic sessions (days 1, 2) and practical endoscopy (days 3, 4). Didactic sessions included case presentations highlighting pathophysiology and management. One nurse and four practicing gastroenterologists from the United Kingdom led lectures and supervised workshops with audience participation. Practical endoscopy focused on diagnostic and therapeutic procedures and their application to diagnosis and treatment of ailments of the gastrointestinal tract. Pre- and post-workshop questionnaires were distributed to participants during didactic sessions. A pre-workshop questionnaire gauged expectations and identified objectives to be met at the symposium. Post-workshop questionnaires were administered to assess efficacy of each session. Participants graded sessions from 1 (poor) to 5 (excellent) on quality of case presentations, knowledge, clarity and mode of presentation. We assessed if time allotted to each topic was sufficient, value of sessions, impact on practice and interest in future symposiums.

RESULTS: There were 46 attendees on day 1: 41% undergraduates, 41% residents, 11% consultants and 4% unspecified. Day 2 (a Saturday) had 24 participants: 17% undergraduates, 71% residents, 9% consultants, 4% unspecified. Primary pre-workshop symposium expectation was to gain knowledge in: general gastroenterology (55.5%), practical endoscopy (13.8%), pediatric gastroenterology (5%), epidemiology of gastrointestinal disorders specific to Zambia (6%), and interaction with international speakers (6%). The post-symposium questionnaire was answered by 19 participants, of whom 95% felt specific aims were met; all would attend future conferences and recommend to others.

CONCLUSION: The beneficial effect of a structured symposium in developing countries warrants further attention as a mechanism to improve disease awareness in areas where resources are limited.

Keywords: Gastroenterology training, Resource-limited country, Zambia, Specialist training, Postgraduate training, Hepatology

Core tip: The global burden of digestive diseases is increasing, yet formal training in gastroenterology is lacking in traditionally underserved areas such as the African continent. In this study we designed, implemented, and evaluated the effectiveness of a structured 4 d symposium focusing on general topics in the diagnosis and management of digestive disease. This symposium was geared towards health care professionals and attendees reported improvement in their knowledgebase in gastrointestinal disorders. Structured symposiums are an effective and viable adjunct to medical education and their utility may be highest in regions where traditional academic medical resources are limited.