Do South African anaesthesiology graduates consider themselves fit for purpose? A longitudinal study

Abstract

Background: Before embarking on a career as an independent specialist anaesthesiologist, graduates must be assessed as being fit for purpose (FFP). Graduate self-assessment both at qualification and at a later time may be useful in assessing their fitness for purpose and its change over time. Methods: This quantitative, descriptive study included recent national anaesthesiology graduates. Each participant scored their own preparedness for competences deemed appropriate by national experts via an electronic survey at two separate time intervals. Nine meta-competences (i.e. Medical Expert, Communicator, Collaborator, Leader, Health Advocate, Scholar, Professional, Context Awareness and Humaneness) together with 101 component enabling competences, were assessed. Participants scored their preparedness for each competence using a 4-point Likert scale (1 – completely unprepared; 2 – somewhat prepared; 3 – prepared; 4 – completely prepared). During analysis, competences scored as 1 and 2 were considered as unprepared and competences scored as 3 and 4 as prepared. Scores given at the time of graduation were compared with those given after 12 months’ experience. Results: The overall response rate was 79%. At graduation, graduates felt prepared for seven of the nine meta-competences (i.e. Medical Expert, Collaborator, Communicator, Professional, Scholar, Context Awareness and Humaneness), and felt unprepared for the Leader and Health Advocate meta-competences. After 12 months, graduates felt prepared for all nine meta-competences but perceptions of preparedness for 14% (14 of 101) of the enabling competences had declined. Conclusion: At graduation, South African anaesthesiology graduates consider themselves unprepared for the meta-competences of Leader and Health Advocate, both comprising predominantly non-technical skills (NTS). The graduates’ perceptions at the time of graduation suggest that they are not fully prepared and may, therefore, not yet be fit for purpose as specialists. Graduates’ self-assessment longitudinally reflects that their perceptions of being fit for purpose change after a period of time and with specialist experience.