KNOWLEDGE, ATTITUDES, AND CLINICAL COMPETENCE IN CHEST TUBE MANAGEMENT AMONG MEDICAL INTERNS AT TERTIARY TEACHING HOSPITALS IN ADDIS ABABA, ETHIOPIA

Abstract

Abstract Background: Chest tube insertion is vital in managing thoracic emergencies such as pneumothorax, hemothorax, and pleural effusion. Evidence shows persistent gaps in knowledge, procedural competence, and preparedness among medical trainees in low- and middle-income countries. In Ethiopia, medical interns train in tertiary teaching hospitals, yet their competence in chest tube management has not been systematically assessed. This study addresses that gap, providing critical evidence to strengthen medical education and safeguard patient safety in emergency care. Objective: To assess the knowledge, attitudes, clinical and competence of medical interns regarding chest tube management in tertiary teaching hospitals in Addis Ababa, Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 297 medical interns at three tertiary teaching hospitals in Addis Ababa. Participants were selected using multistage sampling. Data was collected through a structured questionnaire assessing knowledge and attitude, and a simulation-based checklist evaluating clinical competence in chest tube management. Data quality was ensured through training, pretesting, and supervision and ethical clearance was obtained for the Collage IRB, and informed consents were secured from all participants. Data was analyzed in SPSS (version 29) using descriptive statistics, bivariate chi square tests. Results: A total of 297 medical interns participated in the study. The majority (51.2%) demonstrated poor knowledge of chest tube management, while 48.8% had good knowledge. Attitudes towards chest tube management were predominantly unfavorable, with 75.8% of interns reporting negative perceptions and only 24.2% showing favorable attitudes. Clinical competence was also limited, as 66.7% of interns were classified as incompetent based on self reported confidence and procedural assessment, whereas only 33.3% were competent. These findings highlight significant gaps in knowledge, attitudes, and practical competence among medical interns in Addis Ababa’s tertiary teaching hospitals, underscoring the need for strengthened training, structured supervision, and simulation-based learning to improve patient safety and clinical outcomes. Conclusion: This study reveals substantial gaps in medical interns’ preparedness for chest tube management in Addis Ababa’s tertiary teaching hospitals. More than half demonstrate poor knowledge, three-quarters hold unfavorable attitudes, and two-thirds lack competence in performing the procedure. These deficiencies in theoretical training and practical exposure pose risks to patient safety and clinical outcomes. Addressing these gaps requires strengthening the medical curriculum, expanding simulation-based training, and implementing structured mentorship programs. Such measures are essential to ensure that interns acquire the competence and confidence needed to manage thoracic emergencies effectively. Keywords:Chest tube management; tube thoracostomy; medical interns; knowledge, attitudes, and practice; clinical competence; Ethiopia