Trainee resident participation in health research in a resource-constrained setting in south-eastern Nigeria: perspectives, issues and challenges. A cross-sectional survey of three residency training centres

BACKGROUND The participation of trainers and trainees in health research is critical to advance medical science. Overcoming barriers and enhancing incentives are essential to sustain a research culture and extend the frontiers of medical education. In this study, we investigated the roles of individual and system factors influencing trainee resident participation in health research in Enugu, south-eastern Nigeria. METHODS This cross-sectional survey of trainee residents was conducted across three residency training centres in Enugu, Nigeria, between February and March, 2010. The number and speciality distribution of trainee residents were determined from personnel records at each centre. A 19-item questionnaire was used to record demographic characteristics, research training/experience, and attitudes toward and perceived barriers to health research. Data were analysed to yield frequencies, percentages and proportions. Values of p<0.05 were considered significant. RESULTS The response rate was 93.2%. The respondents (n=136) comprised 109 males and 27 females. Their mean±standard deviation age was 35.8±5.6 years (range: 25-53 years). Participation in research was significantly associated with previous research training [odds ratio (OR): 2.90; 95% confidence interval (CI): 1.35-6.25, p=0.003, β=22.57], previous research participation (OR: 2.21; 95% CI: 0.94-5.29, p=0.047, β=22.53) and research publication (OR: 2.63; 95% CI: 1.00-7.06, p=0.03, β=22.57). Attitude towards research was significantly influenced by perceived usefulness of research in patient care (OR: 7.10; 95% CI: 3.33-15.13, p=0.001), job promotion (OR: 8.97; 95% CI: 4.12-19.53, p=0.001) and better understanding of disease (OR: 21.37; 95% CI: 8.71-54.44, p=0.001). Time constraints (OR: 0.06; 95% CI=0.025-0.14, p=0.001), funding (OR: 0.028; 95% CI: 0.008-0.10, p=0.001) and mentorship (OR: 0.086; 95% CI: 0.36-0.21, p=0.001) were significant barriers to research participation. CONCLUSIONS System and individual factors are significant incentives to research participation, while system-derived factors are significant barriers. Pre-residency research, dedicated research time, adequate research funding and commensurate research mentorship rewards are instructive. Prospective longitudinal studies are warranted to confirm these findings.