Effect of a structured surgical skills workshop on infection prevention and theatre safety practices among house officers at a Nigerian tertiary hospital: a quasi-experimental study

Abstract

Surgical site infections (SSIs) remain a leading cause of perioperative morbidity in low- and middle-income countries (LMICs) including Nigeria. House officers routinely participate in theatre activities and wound care yet frequently commence internship without structured, competency-focused training in infection prevention and control (IPC). No published evidence from Northern Nigeria has evaluated IPC simulation training for this cadre. This study aimed to evaluate the effect of a structured two-day surgical skills workshop on IPC knowledge and theatre safety confidence among house officers at a Northern Nigerian tertiary hospital. A quasi-experimental single-group pre-test/post-test study was conducted among 20 of 38 eligible house officers (participation rate 52.6%) attending House Officers’ Week at Federal Teaching Hospital Katsina (FTHK). A two-day workshop integrated didactic teaching, live demonstration, and supervised low-fidelity simulation covering surgical hand hygiene, asepsis, sharps safety, wound dressing, and WHO Surgical Safety Checklist use. The primary outcome was change in IPC knowledge score (7-item questionnaire sub-score; range 0 to 7). The secondary outcome was change in theatre safety confidence (6-item Likert sub-scale; range 6 to 30). Paired t-tests were used following Shapiro-Wilk normality confirmation. Cohen’s d was computed as the effect size. Primary and secondary outcomes were assessed immediately before the workshop on Day 1 and immediately after the final session on Day 2. All 20 participants completed both assessments (100% retention). IPC knowledge improved from a mean of 4.45 (SD 1.96) to 5.95 (SD 0.69) (mean difference 1.50; 95% CI 0.50 to 2.50; t(19) = 3.14, p = 0.006; d = 0.70). Theatre safety confidence improved from 17.65 (SD 6.89) to 25.70 (SD 5.34) (mean difference 8.05; 95% CI 3.21 to 12.89; t(19) = 3.48, p = 0.003; d = 0.78). Post-workshop, all 20 participants met minimum IPC knowledge competency threshold compared with 11 (55%) pre-workshop. Knowledge standard deviation narrowed by 65%, demonstrating a standardising effect. A short simulation-based workshop was associated with statistically significant and large improvements in IPC knowledge and theatre safety confidence among house officers at a Northern Nigerian tertiary hospital. An important policy-relevant finding was the posting-specific inverse relationship between internship duration and IPC knowledge that argues for scheduled, recurring, posting-targeted IPC training throughout internship.