{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:41:10Z","timestamp":1790188870873,"version":"4.1.0"},"reference-count":50,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T00:00:00Z","timestamp":1716768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Ethiopia USAID","award":["72066320CA00008"],"award-info":[{"award-number":["72066320CA00008"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Ethiopia made a national licensing examination (NLE) for associate clinician anesthetists a requirement for entry into the practice workforce. However, there is limited empirical evidence on whether the NLE scores of associate clinicians predict the quality of health care they provide in low-income countries. This study aimed to assess the association between anesthetists\u2019 NLE scores and three selected quality of patient care indicators.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A multicenter longitudinal observational study was conducted between January 8 and February 7, 2023, to collect quality of care (QoC) data on surgical patients attended by anesthetists (<jats:italic>n<\/jats:italic>\u2009=\u200956) who had taken the Ethiopian anesthetist NLE since 2019. The three QoC indicators were standards for safe anesthesia practice, critical incidents, and patient satisfaction. The medical records of 991 patients were reviewed to determine the standards for safe anesthesia practice and critical incidents. A total of 400 patients responded to the patient satisfaction survey. Multivariable regressions were employed to determine whether the anesthetist NLE score predicted QoC indicators.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The mean percentage of safe anesthesia practice standards met was 69.14%, and the mean satisfaction score was 85.22%. There were 1,120 critical incidents among 911 patients, with three out of five experiencing at least one. After controlling for patient, anesthetist, facility, and clinical care-related confounding variables, the NLE score predicted the occurrence of critical incidents. For every 1% point increase in the total NLE score, the odds of developing one or more critical incidents decreased by 18% (aOR\u2009=\u20090.82; 95% CI\u2009=\u20090.70\u2009=\u20090.96; <jats:italic>p<\/jats:italic>\u2009=\u20090.016). No statistically significant associations existed between the other two QoC indicators and NLE scores.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The NLE score had an inverse relationship with the occurrence of critical incidents, supporting the validity of the examination in assessing graduates\u2019 ability to provide safe and effective care. The lack of an association with the other two QoC indicators requires further investigation. Our findings may help improve education quality and the impact of NLEs in Ethiopia and beyond.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-024-02575-w","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T05:01:47Z","timestamp":1716786107000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Does higher performance in a national licensing examination predict better quality of care? 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The school\u2019s Responsible Conduct of Research and the National Research Ethics Review Guidelines were strictly followed as guiding frameworks throughout the study. Permission to conduct the study was also secured from the Ministry of Health (MOH), the Amhara Public Health Institute (APHI-IRB), and individual hospital administrators. Given that we gathered de-identified secondary data from medical records, individual consent was waived by the ethics review boards for document review data. However, each satisfaction survey study participant provided oral consent before data collection, and measures discussed under data collection were taken to ensure privacy and confidentiality.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and informed consent"}},{"value":"Statements about publication permissions were included in the consent form for the satisfaction survey.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"188"}}