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- Volume 5, Issue 2, 2013
African Journal of Health Professions Education - Volume 5, Issue 2, 2013
Volume 5, Issue 2, 2013
Author Vanessa BurchSource: African Journal of Health Professions Education 5 (2013)More Less
When the African Journal of Health Professions Education was launched in 2009, we set out to achieve the following: 'The AJHPE is an open access peer-reviewed journal which focuses on disseminating research results of work focusing on the education of health professionals, specifically, but not exclusively, in Africa.' Using this statement of intent as a yardstick, it is useful to reflect on the milestones achieved (or not) in the first four years of publication. The first milestone for any journal has to be visibility in the international community. In this regard, we have done exceptionally well.
South African Association of Health Educationalists Distinguished Educator Award Address : le bon Dieu est dans le détail - reflections on being a beaver : plenary lectureAuthor D. ProzeskySource: African Journal of Health Professions Education 5, pp 50 –55 (2013)More Less
I would like to thank the SAAHE executive very much for the honour of this award - I was not expecting it and I am not sure that I deserve it. It means a great deal to me. This morning, I wish to share a concept that all of us have used in the past, still use, and will always use in our educational work. It is more than a concept (or it should be - in fact, when it remains a concept and does not enter the realm of practice, it changes its nature, and becomes the opposite of what it should be). It is a concept that is common to all human endeavour and not only to education.
Micro, meso and macro issues emerging from focus group discussions : contributions to a physiotherapy HIV curriculum : researchSource: African Journal of Health Professions Education 5, pp 56 –62 (2013)More Less
Background. Physiotherapy in South Africa has not defined its contribution to the management of HIV. As part of developing an appropriate HIV/ AIDS physiotherapy curriculum, focus group discussions (FGDs) with physiotherapy clinicians and educators were undertaken.
Objectives. To understand the perceptions and experiences of HIV management in refining an HIV physiotherapy curriculum.
Methods. Six focus groups chosen using purposive sampling ensured representation from experienced and newly qualified academics and clinicians. Interpretive content analysis strengthened the knowledge areas required in practice and attitudes based on the groups' experiences of HIV management. Concepts were identified, and de- and re-contextualised to develop categories and themes.
Results and discussion. Five themes emerged: the need to include HIV in the physiotherapy curriculum; a physiotherapy-specific HIV curriculum; co-ordinated curriculum design; underlying concerns relating to HIV management and inclusion in the curriculum; and the need for professional development. Further analysis and abstraction highlighted micro, meso and macro issues. Micro issues included content, while meso-level concerns included perceived gaps in the curriculum and recommendations to respond to issues such as therapists' coping and burnout, therapists' attitude to HIV, and organisational problems threatening the application of knowledge regarding this condition. At a macro level, participants felt that the political nature of HIV and curriculum structure were problematic and that there was a need for continuous staff development.
Conclusion. A list of topics related to HIV, which tallied well with evidence in the literature and patients' clinical presentations, emerged. The need for a complex, well-designed programme for the physiotherapy management of HIV emerged and was informed by the difficulties experienced at the micro, meso and macro levels of the curriculum.
A reflection on professional development of registrars completing a module in Health Care Practice : researchSource: African Journal of Health Professions Education 5, pp 63 –67 (2013)More Less
Background. A need for professional development in the training of registrars was identified by the School of Medicine, University of the Free State (UFS), Bloemfontein, South Africa, in 2007.
Objective. To develop the module on Health Care Practice (HCP) (GPV703) to address these shortcomings.
Methods. A quantitative study, enhanced by qualitative data, was conducted. A self-administered questionnaire that included a rating scale and open-ended questions was used. The quantitative responses were analysed using Microsoft Excel, and the qualitative data were edited, categorised and summarised.
Results. The questionnaire was completed by 95% (n=38/40) of registrars. The quantitative questions, regarding the orientation session, content and applicability of the content of the module, showed satisfactory to very good responses. Of the 40 surveys collected from registrars, 77.5% (n=31/40) were completed by heads of department (HODs). The surveys showed a significant improvement in registrar competence: 17 were given an above-average rating and 14 an average rating; there were no below-average ratings.
Discussion. The module on HCP, which is part of the MMed programme, addressed aspects required by registrars to develop and/or enhance their skills, knowledge and professional behaviour with regard to ethics, practice management and patient communication. Registrars were generally satisfied with the content and presentation of the module. The open-ended questions raised concerns about aspects of patient communication and electronic learning. These need to be addressed to improve the quality of the module.
Conclusion. The module on HCP (GPV703), as implemented by the UFS, is successful in addressing key aspects often neglected because of the strong clinical focus of a medical programme.
Career and practice intentions of health science students at three South African health science faculties : researchSource: African Journal of Health Professions Education 5, pp 68 –71 (2013)More Less
Background. The distribution and accessibility of healthcare professionals as well as the quality of healthcare services are significantly affected by the career choices of medical and other health science graduates.
Objective. While much has been reported on the career intentions of medical students, little is known about those of their counterparts in the health sciences. This study describes the career plans of non-medical health science students at three South African health science faculties, and identifies some key motivating factors.
Methods. A self-administered survey of first- and final-year health science students was conducted at the health science faculties of the universities of Cape Town, KwaZulu-Natal and Limpopo. All data were entered into EpiData software and exported for analysis using IBM SPSS Statistics 19.0.
Results and discussion. The overall response rate was 47% (N=816). Over half of all respondents (57%, n=467) intended to work after completing their undergraduate studies, 38% (n=177) of these in a rural area. The most popular choices were private hospitals (58%, n=273), tertiary hospitals (53%, n=249) and private practices (51%, n=249). Thirty-two per cent (n=258) of respondents intended to further their studies. Just over half of all respondents intended to work in another country (51%, n=418), primarily motivated by career development, financial reasons and job opportunities.
Conclusion. The findings demonstrate that health science students, similar to medical students, are influenced by a multitude of factors in making career choices. This emphasises the relevance to all health science disciplines of national strategies to address the mal-distribution of healthcare professionals.
Student and staff perceptions and experiences of the introduction of Objective Structured Practical Examinations : a pilot study : researchSource: African Journal of Health Professions Education 5, pp 72 –74 (2013)More Less
Background. The Objective Structured Practical Examination (OSPE) is widely recognised as one of the more objective methods of assessing practical skills in healthcare programmes, including undergraduate physiotherapy curricula.
Objectives. To obtain feedback from both students and staff who were involved in the introduction of an OSPE in 2011, in order to refine and standardise the format throughout the curriculum.
Methods. A qualitative research design was used. Data were gathered through a questionnaire with semi-structured open-ended items and focus group discussion. Participants were all third-year undergraduate physiotherapy students (N=47) and all staff members (N=10) in the 2011 academic year who were exposed to the OSPE format or were involved in the first OSPE.
Results. The main concerns raised by both students and staff were: (i) pressure due to time constraints and how this might affect student performance; and (ii) the question of objectivity during the assessment. However, their initial concerns changed as they experienced the OSPE in a more positive manner owing to the structure and objectivity of the process of implementing the OSPE.
Conclusion. While both students and staff reported positive experiences, the challenges that emerged provided valuable insight in terms of refining the OSPE format in this undergraduate physiotherapy department.
Training on prevention of violence against women in the medical curriculum at the University of Ibadan, Nigeria : researchSource: African Journal of Health Professions Education 5, pp 75 –79 (2013)More Less
Objectives. To determine the knowledge and skills of final-year medical students in managing victims of violence against women (VAW), and to describe the extent to which VAW is included in the undergraduate curriculum of the College of Medicine, University of Ibadan.
Method. A mixed-method study design was used that collected qualitative data through a review of curriculum documents and interviews of departmental heads (or their representatives) of 6 departments in the college. A semi-structured, self-administered questionnaire was used to collect quantitative data from 109 final-year students.
Results. The response rate was 85.1% and respondents' mean age was 25.2±3.1 years. Physical, sexual, psychological and economic abuse was found by 73.8%, 72.6%, 54.8% and 44.0% respectively, of the students. Most students (77.4%) felt it was part of their duty to ask patients about abuse. Students with previous training about violence were more likely to be knowledgeable (odds ratio (OR) 1.64; 95% confidence interval (CI) 0.61 - 4.42) and skilled (OR 1.27; 95% CI 0.53 - 3.05). Men had better knowledge and skills than women. VAW was not included as a topic in the curriculum.
Conclusion. Most students were willing to ask patients about abuse but lacked the fundamental knowledge and skills to do so. Faculty at the college agreed to review the curriculum to improve students' knowledge and management skills regarding VAW.
Source: African Journal of Health Professions Education 5, pp 80 –83 (2013)More Less
This paper discusses 10 key elements for the design and implementation of interprofessional education (IPE) in a skills centre. The elements are based on published literature as well as on the experience of an IPE initiative, simulating the management of a multiple-traumatised patient in the acute and rehabilitation phases, by students from 4 professions: medicine, nursing, occupational therapy and physiotherapy. The key elements are interrelated and include the partners involved (learners, facilitators and patient simulator), the content, learning resources, setting, faculty development, logistics, learning strategies and evaluation.
Source: African Journal of Health Professions Education 5, pp 84 –87 (2013)More Less
Background. The system-based curriculum of the Medical College of Alzaiem Alazhari University, Sudan, entails skills training for pre-clerkship students. The increased demands on full-time trained clinical teachers cannot be solved by employing part-time staff owing to the poor financial incentives that are offered.
Objectives. To verify the feasibility of implementing a peer tutor model for skills training of junior students and to establish whether this model can overcome the shortage of clinical teachers.
Methods. Eight selected and trained peer tutors participated in teaching certain aspects related to the basic skills module to 2nd-year students (N=144). Three sessions were prepared, conducted and implemented by peer tutors. The effectiveness of the experience was evaluated by an objective structured clinical examination (OSCE) and two questionnaires.
Results. Junior students received the peer teaching sessions favourably and requested a continuation of the process. The performance of the tutees was good. Peer tutors enjoyed and benefited from this teaching method without it negatively affecting their own learning.
Discussion. Our study demonstrated that a peer teaching educational model is feasible and can contribute to solving the problem of skills training of junior medical students. The peer teaching model is effective, provided the tutors are well trained and the educational experience is supervised.
Conclusion. Peer-assisted learning is effective and beneficial for both tutors and tutees in resource-limited environments. It can contribute towards addressing the problem of skills training of junior medical students where there is a shortage of trained clinical teachers.
Factors influencing the recruitment and retention of faculty at the Catholic University of Health and Allied Sciences, Bugando, Mwanza, Tanzania : researchSource: African Journal of Health Professions Education 5, pp 88 –90 (2013)More Less
Background. Attracting and retaining faculty is essential for the success of any higher learning institution, especially in the newer medical institutions in Tanzania.
Aim. To determine the factors favouring the recruitment and retention of faculty at the Catholic University of Health and Allied Sciences (CUHAS), Bugando, Tanzania, between November and December 2011.
Methods. Using standardised self-administered questionnaires, respondents were asked to rank a range of factors that might influence their recruitment and retention on a 4-point Likert scale.
Results. Of the 55 questionnaires distributed, 42 (76%) were returned. Opportunity for professional growth, support from colleagues, opportunities for promotion, support for scholarly activities, and staff collegiality were the top 5 factors that made the faculty take up CUHAS positions and remain at CUHAS. Salary was the most important factor for recruitment, and retention in 7.1% of the faculty surveyed.
Conclusion. The majority of the academic staff surveyed were junior; they cited opportunity for professional growth as the most important factor in recruitment and retention at CUHAS.
Roles and attributes of physiotherapy clinical educators : is there agreement between educators and students? : researchAuthor D.V. ErnstzenSource: African Journal of Health Professions Education 5, pp 91 –94 (2013)More Less
Objectives. To determine which roles and attributes of clinical educators are perceived as important in creating a clinical learning environment that is conducive to learning, and if there were differences between the perceptions of undergraduate physiotherapy students and clinical educators.
Design. A cross-sectional survey in the form of a purpose-built questionnaire was conducted among physiotherapy students and clinical educators.
Setting. The study was performed at the Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa.
Participants. All enrolled undergraduate physiotherapy students (n=80) with clinical experience, and all clinical educators (n=37) involved in the delivery of clinical education were invited to participate.
Results. The educator roles that strongly influence the clinical learning environment were found to be those of technique demonstrator, mentor, assessor, knowledge provider and facilitator of learning. Educators' and students' views about the role of the educator as role model, reflector, knowledge provider and technique demonstrator differed. Participants agreed that the attributes of the clinical educator that are conducive to learning are approachability, recognising student abilities, and good communication skills.
Conclusion. The clinical educator is pivotal in the success of the physiotherapy clinical education programme. The study found similarities and differences about the role perceptions of educators and students. The differences might influence the learning experience, and it is recommended that expectations be clarified at the start of the clinical education programme.
Shortage of faculty in medical schools in Tanzania : a case study at the Catholic University of Health and Allied Health Sciences : researchSource: African Journal of Health Professions Education 5, pp 95 –97 (2013)More Less
Background. The number of medical schools in Tanzania, and their respective student enrolments, has tripled in the last decade in response to the growing population and healthcare needs. There has, however, not been a corresponding increase in the number of faculty, resulting in a critical shortage of teachers.
Objective. To determine the extent of the faculty shortage at the School of Medicine, Catholic University of Health and Allied Sciences (CUHAS), Bugando, Tanzania.
Methods. A cross-sectional descriptive survey was conducted of all heads of departments and their staff to determine the number of available and required faculty. Postgraduate trainees were also interviewed about their role in undergraduate teaching activities.
Results. At the time of the study, the School of Medicine had a total of 83 faculty and about 700 undergraduate students and residents. Of the entire faculty, 32 (38.6%) worked as full-time employees and 51 (61.4%) as part-time employees. The Department of Surgery had the greatest number of faculty while Psychiatry and Ophthalmology had the smallest staff complement. Over 50% of departments reported faculty shortages of 30% or more. Postgraduate trainees confirmed that they were regularly called upon to teach medical students.
Conclusion. The critical shortage of faculty at CUHAS is likely to compromise the quality of education offered and, as a consequence, the competence of healthcare professionals being trained in Tanzania. Interventions that may improve the situation include the establishment of a residents-as-teachers training programme, and a faculty development programme to groom junior faculty to take on leadership roles and develop strategies to improve the quality of health professions education in Tanzania.
Source: African Journal of Health Professions Education 5, pp 98 –99 (2013)More Less
Introduction. The ability to communicate across cultures requires a combination of knowledge, skills and attitude. Our current medical school curriculum includes innovative methods of teaching communicative knowledge and skills. Our aim is to encourage students to examine their attitudes toward patients from social groups and cultures other than their own and, ultimately, to interact with empathy in a multicultural society.
Method. An experiential learning technique where students were given various tasks intended to improve their attitude towards cross-cultural learning.
Results. A number of students expressed appreciation at being in a multicultural group, having a shared experience, and engaging in open and respectful discussion about similarities and differences.
Conclusion. Students need to be involved in activities that encourage them to examine their attitudes and develop respect for patients from cultures other than their own. We suggest ways in which learning experiences of this type can be integrated within the medical undergraduate programme.
Author Thomas I. LemonSource: African Journal of Health Professions Education 5 (2013)More Less
To the Editor: Madzima et al. address a very real issue in current medical and health education - lack of teaching of research skills. They have piloted workshops aiming to fill the void in research skills and statistics for those who want them, and I applaud them for their efforts. This shortcoming is not limited to South Africa; teaching of research technique and skills is also lacking in the undergraduate curriculum in the UK, although statistics teaching is more than adequate.