Surgical Trainee Supervision During Non-Trauma Emergency Laparotomy in Rwanda and South Africa

Linda Pohl, Megan Naidoo, Jennifer Rickard, Egide Abahuje, Nazmie Kariem, Surita Engelbrecht, Christo Kloppers, Isaie Sibomana, Kathryn Chu

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


OBJECTIVE: The primary objective was to describe the level of surgical trainee autonomy during non-trauma emergency laparotomy (NTEL) operations in Rwanda and South Africa. The secondary objective was to identify potential associations between trainee autonomy, and patient mortality and reoperation. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective, observational study of NTEL operations at 3 teaching hospitals in South Africa and Rwanda over a 1-year period from September 1, 2017 to August 31, 2018. The study included 543 NTEL operations performed by the acute care and general surgery services on adults over the age of 18 years. RESULTS: Surgical trainees led 3-quarters of NTEL operations and, of these, 72% were performed autonomously in Rwanda and South Africa. Notably, trainee autonomy was not significantly associated with reoperation or mortality. CONCLUSIONS: Trainees were able to gain autonomous surgical experience without impacting mortality or reoperation outcomes, while still providing surgical support in a high-demand setting.

Original languageEnglish (US)
Pages (from-to)1985-1992
Number of pages8
JournalJournal of surgical education
Issue number6
Early online dateJun 25 2021
StatePublished - Nov 1 2021

Bibliographical note

Funding Information:
This work was supported by the University of Cape Town International Collaborative Research Project Grant.

Publisher Copyright:
© 2021 Association of Program Directors in Surgery


  • Africa
  • Education
  • Laparotomy
  • Supervision
  • Surgery
  • Training

PubMed: MeSH publication types

  • Journal Article
  • Observational Study
  • Research Support, Non-U.S. Gov't


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