Patients’ Level of Knowledge and Perception of the Involvement of Post-Graduate Trainees in their Surgical Care at Aga Khan University Hospital, Nairobi.

Introduction: Surgical training is fashioned on a system of graduated responsibilities and independence for acquisition of skills and competence. While many benefit from acquisition of these skills, few would want to be the ‘practicing ground’ for the trainee surgeon. Moreover, disclosure is inappropriate and surgical care does not specifically spell out the role of the surgical trainee in these procedures. A pilot survey conducted on 20 first-time patients presenting to General Surgery and Orthopaedic Clinics at Aga Khan University Hospital, Nairobi, revealed varied understandings as to who is a post-graduate surgical trainee. Objective: To explore the patients’ level of knowledge of involvement of post-graduate trainees in their surgical care and their perceptions towards the same. Design: Qualitative study conducted through in-depth interviews Methods: Data was collected via in-depth interviews until theoretical saturation was attained. Eighteen first-time patients presenting to the General Surgery and Orthopaedic clinics and eight medical personnel were interviewed; the latter were Key Informants. All interviews were conducted by the principal investigator and were audio-recorded as well as documented via field notes. Audio recordings were transcribed verbatim with data analysis done by two reviewers using the thematic framework, with aid of the MAXQDA Analytics Pro 12 Software. Results: Generally, patients displayed either acceptance or apprehension of the role of the surgical trainee. The overarching themes identified from this study were: 1) Varied knowledge base of the surgical training system; 2) Patients are willing to be part of the surgical training process; 3) Divergent effects of full disclosure on informed consent; 4) Factors linked to patients’ receptivity or apprehension of involvement of post-graduate trainees in their surgical care. Conclusion: Patients are eager to be part of the surgical training process, provided that adequate trainee supervision is provided. In addition, the scope of full disclosure may need to be patient-based, rather than adopt a ‘one-size-fits-all’ approach