Heterogeneity in Nonphysician Anesthetist Training and Practice: Preliminary Results of a Survey in Sub-saharan Africa

摘要: Methods: We conducted a survey of anesthesia providers, physicians or NPAs, who lived or worked in SSA. One-hundred and thirty potential respondents were selected by snowball sampling. The survey focused on NPA education, training program details, and clinical scope of practice. Results were aggregated at the country level, and means and proportions were calculated. Results: 85 respondents completed surveys representing 33 countries. Respondents reported a median of 24 NPA graduates per year per country, with a mean of 3 programs per country. 43% of described programs required a nursing diploma for entrance, and 54% conferred a “diploma” qualification after training. Programs were on average 25 months (SD 13) in duration, with 95% being 48 months or less (Figure 1). The most common teaching modalities were lectures and in-theatre instruction (67%)(Table 1). Simulation and online materials were least used (29% and 10%). Obstetrics was the clinical subspecialty taught most frequently (61%), while cardiac anesthesia was taught least frequently (16%). NPAs could perform most tasks independently (eg induction and intubation, 92%), but few could perform fiberoptic intubation or epidural anesthesia (4% and 13%)(Figure 2).Conclusion: There is significant heterogeneity in the educational prerequisites, training details, and scope of practice of NPAs in SSA. Lack of specificity in survey responses precluded country-level analysis, and we are currently conducting validation of several questions with key informants to enable country-level description. Further characterization of anesthesia training models around the world is an …