African Journal of Health Professions Education
The AJHPE is a bi-annual journal for health professionals. It carries research articles and letters, editorials, education practice, personal opinion and other topics related to education for health professionals. It also carries related African education-related news, obituaries, general correspondence, and classified advertisements.
|Publisher||Health and Medical Publishing Group (HMPG)|
|Coverage||Vol 1 Issue 1 2009 - current|
Department of Higher Education and Training (DHET)
Exploration of high-fidelity simulation : nurse educators’ perceptions and experiences at a school of nursing in a resource-limited setting
Background. Simulations are defined as situations where models are used for practice and to gain experience that will enhance students’ practical skills. The use of simulations in clinical skills training can stimulate deep learning and help students to bridge the gap between theory and practice in nursing. This has been revealed in many studies where simulations positively impacted on clinical decision-making and patient care, and there has been great interest in the use of simulation in nurse training. However, the introduction of technologically driven simulators, especially in resource constrained settings, has been met with mixed feelings.Objective. To explore the perceptions and experiences of nurse educators in using high-fidelity simulation (HFS) in teaching.
Methods. A qualitative case study design was utilised. Seven educators at a school of nursing, which has HFS, participated in a focus group discussion. Data were thematically analysed.
Results. Four themes emerged from the educators’ experiences and perceptions. The use and benefits of HFS were generally accepted by educators. They valued its positive impact on learning outcomes in learners and the ability to simulate more complex scenarios during training. Lack of prior planning, inadequate training and lack of resources impacted negatively on the effective use and implementation of HFS.
Conclusion. The results indicated that nurse educators perceived HFS as a learning pedagogy that can improve students’ learning outcomes if used effectively. They believed that to realise the potential of HFS, more support should be provided through training, the availability of necessary resources, and improved planning and organisation.
Occupational therapy students’ perspectives on the core competencies of graduates to practise in the field of neurology
Background. The South African (SA) health system is characterised by limited resources, high bed turnover rates and a high therapist-to-patient ratio. Patients with neurological dysfunction form a large majority of the caseload of occupational therapists. Feedback from stakeholders alluded to some discrepancies between the content taught in the Stellenbosch University undergraduate curriculum and what is expected within the clinical setting. This raises questions regarding the relevance and applicability of what undergraduate occupational therapists are taught, given the nature and demands of the SA public health system.
Objective. To explore the perspectives of final-year occupational therapy students with regard to the core competencies required for optimal preparation of students for practice in the field of neurology.
Methods. This explorative study used three focus groups to obtain the perspectives of 18 final-year students who had experienced clinical placements in neurology. Information from the focus groups was transcribed and analysed thematically to determine the findings.
Results. Analysis of the data revealed four themes, i.e. core knowledge and skills; attitude; resource and time constraints in clinical areas; and factors influencing optimal learning experiences.
Conclusion. The curriculum should prepare students to be well equipped for the current climate of the profession. While the current neurology curriculum may be viewed as having some positive features, there are some aspects that need to be updated and revised. Key considerations to optimise learning include a more regular interface between clinical areas and the university, scheduling of teaching blocks, and applying relevant teaching methods.
Background. Problem-based learning (PBL) has been adopted across many health professions training institutions. Small-group student tutorials are a major component of PBL. Facilitator feedback during a tutorial is a key activity to promote self-regulated learning.Objective. To explore ways in which students use feedback to promote self-regulated learning in a PBL environment.
Methods. This was an exploratory qualitative study in which individual interviews and focus group discussions were conducted with health science students who had experience of the tutorial process. Data were collected through audio recording and writing of field notes. Thematic analysis was employed to generate the reported themes.
Results. Students used feedback in various ways that can lead to self-regulated learning. Their experiences were summarised into three themes, i.e. activation of prior knowledge; reflection; and formulation of a personal learning plan. From the findings, a conceptual model linking feedback and self regulated learning in a PBL context was developed.
Conclusion. In this study, we propose a conceptual model illustrating how feedback is a major activity in the critical pathway that leads to self-regulated learning.
Self-directed learning: Status of final-year students and perceptions of selected faculty leadership in a Nigerian medical school – a mixed analysis study
Background. Self-directed learning (SDL) is the essential mechanism of lifelong learning, which, in turn, is required for medical professionals to maintain competency because of advancing technology and constantly evolving disease care and contexts. Yet, most Nigerian medical schools do not actively promote SDL skills for medical students.
Objective. To evaluate the status of SDL behaviour among final-year students, and the perceptions of faculty leadership towards SDL in a Nigerian medical school.
Methods. A mixed research method was used, with a survey consisting of a validated Likert-based self-rating scale for SDL (SRSSDL) to assess students’ SDL behaviour. Focus group discussions with selected faculty leaders were thematically analysed to assess their perceptions of SDL.
Results. The medical students reported moderate SDL behaviour, contrary to faculty, who considered their students’ SDL behaviour to be low. Faculty leadership further defined SDL as the self-motivated student demonstrating initiative in learning under the guidance of teachers, who use interactive forums for teaching. Furthermore, teachers and students should partner towards the goal of ensuring that student learning takes place. Teachers expressed concerns about SDL methods in medical schools owing to the fear that this will require medical students to teach themselves medicine without expert guidance from teachers.
Conclusion. This study suggests that final-year students have a low to moderate level of SDL behaviour. The index faculty are willing to develop teacher guided self-motivated learning for their students, rather than strict SDL. Faculty should be concerned about this behaviour and should encourage SDL in such a way that students realise its benefits to become lifelong learners. Further study of the perceptions about self-regulated learning are recommended.
Pioneering small-group learning in Tanzanian emergency medicine : investigating acceptability for physician learners
Background. Emergency medicine (EM) is a relatively new, but growing medical specialty in sub-Saharan Africa. African EM training programmes have used small-group learning (SGL) modalities in their curricula. However, there is little knowledge of whether SGL modalities are perceived to be effective in these African EM training programmes.
Objectives. To investigate the acceptability of SGL for physicians’ training in an academic Tanzanian emergency department using a novel EM curriculum.
Methods. Using responses to a written questionnaire, we explored the perceived effectiveness of SGL compared with traditional didactic lectures among 38 emergency department physician learners in Dar es Salaam, Tanzania. Perceptions of SGL were identified from qualitative responses, and regression analyses were used to determine strength of association between quantitative outcomes.
Results. Reported benefits of SGL included team building, simulation training, enhancement of procedural skills, and the opportunity to discuss opinions on clinical management. SGL scored more favourably with regard to improving clinical practice, enjoyment of learning, and building peer-to-peer relations. Lectures scored more favourably at improving medical knowledge. Preference towards SGL over lectures for overall training increased with years of clinical experience (95% confidence interval (CI) 0.16 - 0.62, p=0.002, Spearman’s rho 0.51), and the perception that SGL reinforces learner-teacher relationships correlated with seniority within residency training (95% CI 0.14 - 0.86, p=0.007, Spearman’s rho 0.47).
Conclusion. Techniques of SGL were perceived as effective at improving clinical practice in the emergency department setting. These modalities may be more favourably accepted by more experienced physician learners – therefore, new EM teaching programmes in Africa should consider these factors when targeting educational strategies for their respective regions and learner cohorts.