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- Volume 6, Issue 2, 2014
African Journal of Health Professions Education - Volume 6, Issue 2, 2014
Volume 6, Issue 2, 2014
Author Vanessa BurchSource: African Journal of Health Professions Education 6, pp 117 –118 (2014) http://dx.doi.org/10.7196/AJHPE.534More Less
The term 'simulation', as it pertains to the training of healthcare professionals, appears in three of the 10 articles selected for publication in this edition of AJHPE. This provides an ideal opportunity to pause and reflect on some aspects of this teaching technique in the context of healthcare training in Africa, a key mandate of the journal. Simulation-based training is not new. The technique, widely known for its use in non-medical industries such as commercial aviation and nuclear power production, was first used to train healthcare professionals more than 40 years ago. 'Resusci-Annie' was born in 1960 and many of us can recall how we carefully wheeled her around the medical school while she patiently endured, and survived, endless resuscitation training sessions on a daily basis. More than 30 years later, a dynamic interactive 'gentleman' - 'SimMan' - replaced ageing Annie. Since then, the human body simulation industry has grown in leaps and bounds and clinician educators are now confronted by a bewildering array of equipment designed to teach an ever-increasing number of basic and advanced technical and clinical skills.
Building on Tinto's model of engagement and persistence : experiences from the Umthombo Youth Development Foundation Scholarship Scheme : researchAuthor A. RossSource: African Journal of Health Professions Education 6, pp 119 –123 (2014) http://dx.doi.org/10.7196/AJHPE.404More Less
Background. Major inequalities in staffing levels at rural and urban hospitals contribute to poorer health outcomes in rural areas. Local and international studies have shown that healthcare professionals (HCPs) of rural origin are more likely than those of urban origin to work in and contribute to improved health outcomes in rural areas. However, absent role models, dysfunctional families, schools that perform poorly and inadequate funding make it almost impossible for rural-origin students to gain access to institutions of higher learning (IHLs) to train as HCPs.
Objective. To present the experiences of graduates from the Umthombo Youth Development Foundation Scholarship Scheme, build on Tinto's model of persistence and engagement, and contribute towards the success rates of rural-origin HCPs.
Methods. This qualitative study used a life-history methodology. Unstructured interviews, photomemory, artefacts and collage development were used to explore the educational experiences of six rural-origin HCPs. Data were coded and categorised and themes identified.
Results. Compulsory academic and peer mentoring promoted academic and social engagement, helped students to recognise their pre-university experiences as generative, and contributed to their success. The generative potential of pre-university experiences and compulsory work-based experiential learning were identified as initiatives that could strengthen Tinto's model of persistence and engagement.
Conclusion. A number of targeted interventions, if introduced at South African IHLs, could contribute to improved success rates of rural-origin health science students.
Source: African Journal of Health Professions Education 6, pp 124 –128 (2014) http://dx.doi.org/10.7196/AJHPE.211More Less
Background. The scholarship of teaching involves the integration of research into teaching activities, critical reflection of practice, and communication, and dissemination of the practice of one's subject. However, it is not clear what the needs of academics in the Faculty of Community and Health Sciences at the University of the Western Cape, Bellville, South Africa, are with regard to integrating research into their teaching practices.
Objective. To present the findings of the views, perceptions and experiences of academics in the above-mentioned faculty regarding their understanding and integration of research into their teaching activities.
Methods. The study followed a cross-sectional research design. Data were collected by means of an electronic questionnaire to explore the academics' views and perceptions with regard to the integration of research into their teaching and related experiences. Data were analysed using the first two phases of the Appreciative Inquiry process as a guideline.
Results. It was evident that participants had a clear understanding of research. The majority understood that the scholarship of teaching involved both the lecturer and the learner and, most importantly, the conducting of research to share it with others.
Conclusion. Findings from the needs assessment can be used as a guideline to assist in strategies for staff development. Academics need to give equal attention to both teaching and research. The scholarship of teaching facilitates this through the integration of research into teaching.
Factors that influence MSc (Med) (Pharmacy) completion rates at the Medunsa Campus of the University of Limpopo, South Africa : researchSource: African Journal of Health Professions Education 6, pp 129 –132 (2014) http://dx.doi.org/10.7196/AJHPE.367More Less
Background. Postgraduate degrees are costly for the candidate, Government and tertiary institution. Few Master's degree candidates complete their studies within the minimum prescribed time, while some do not finish at all. These two factors impact negatively on student finances and morale, staff workload, university funding and future student intake.
Objective. This study was conducted at the Department of Pharmacy, University of Limpopo, Medunsa Campus, Pretoria, South Africa, to establish the completion rates of Master's degrees in pharmacy and identify the factors impacting on completion.
Method. A cohort of 100 students who enrolled in the MSc (Med) (Pharmacy) degree between 2002 and 2009 was surveyed by means of an emailed questionnaire that was returned anonymously.
Results. Women were more likely to complete their degree than men (53% v. 40%). Full-time students had the highest completion rate (100%), followed by staff (78%). Only 35.5% of part-time postgraduates and those who communicated more frequently with their supervisors received their degree. Those who completed their degree also scored higher on quality of communication with and accessibility of the supervisor. Those who did not complete their degree, scored low on their adjustment to tertiary education and ability to reach a balance between social and academic activities. Finance was also a contributing factor for 40% of those who did not complete their degree.
Conclusion. Completion rates in our degree course compare reasonably well with those in other studies. Clarity about the roles and responsibilities of supervisors and students is of the utmost importance. Being mostly present at the university plays a major role in the successful completion of a postgraduate degree. Academic internship is the optimal route to a Master's degree in pharmacy, but if not possible close contact must be maintained between the student and university.
Access, pass, throughput and dropout rates : review of a problem-based learning BPharm curriculum at a previously disadvantaged university in South Africa : researchAuthor L.A. MabopeSource: African Journal of Health Professions Education 6, pp 133 –137 (2014) http://dx.doi.org/10.7196/AJHPE.345More Less
Background. Students from diverse backgrounds increasingly enter higher education institutions. Universities need to ensure that their programmes are responsive to these diversities. In 1999, the University of Limpopo, Medunsa Campus, Pretoria, South Africa (SA), in partnership with Tshwane University of Technology, Pretoria, SA, introduced a holistic teaching and learning approach with regard to the problem-orientated, integrated, thematic, modular-based Bachelor of Pharmacy programme, which included a student support mechanism.
Objective. To present access, pass, throughput and dropout rates of students in the problem-based learning BPharm programme over the 14-year period since its inception.
Method. The records of all BPharm applicants and those admitted to the course from 1999 to 2008 were reviewed. Access, pass and throughput rates, and failure to complete the course, were determined for a cohort of students (n=458).
Results. All applications from 1999 to 2008 indicating pharmacy as first choice (N=3 307) were screened, with just more than half (n=1 832) of the applicants qualifying for the selection process. Twenty-five per cent (n=458), resembling SA's demographic racial group profile, were selected and entered the BPharm programme. From this cohort, the programme has produced 404 graduates (88.2%), with 74% completing the course in the minimum time of four years. The overall average pass rate for the 14-year period was 92.3%. Finances, personal challenges and exclusions were some of the reasons why students did not complete the course.
Conclusion. The problem-based learning pharmacy curriculum yielded good pass and throughput rates for a diverse group of students.
Recommendations for the establishment of a clinical simulation unit to train South African medical students : researchSource: African Journal of Health Professions Education 6, pp 138 –142 (2014) http://dx.doi.org/10.7196/AJHPE.345More Less
Background. The burden of HIV and tuberculosis epidemics in South Africa (SA), Africa and developing countries in other parts of the world has an influence on the change in case mix. Shortages of beds in training hospitals and the need to train more healthcare professionals contribute to the saturation of the teaching platform. Clinical simulation as a tool to enhance the education and training of medical students in SA and recommendations in this regard were investigated.
Objective. To obtain recommendations regarding the development of simulation training, assessment facilities and programmes, and determine whether simulation training could enhance medical education and training in the developing world.
Methods. Qualitative research methods, including semi-structured interviews with international simulation experts and focus group interviews with heads of department and lecturers of the local medical school, were used to generate data.
Results. A set of recommendations regarding the introduction of simulation training at an SA medical school was developed to improve patient safety, create a better training environment, and address the healthcare education challenges in SA hospitals.
Conclusion. The incorporation of simulation into medical curricula and the development of clinical simulation training facilities for healthcare professionals in SA could bridge the gap currently experienced in health sciences education in the country. The recommendations outlined in our study may assist other medical training institutions in the developing world in setting up simulation training facilities.
Assessment of the education environment of senior medical students at the University of the Free State, Bloemfontein, South Africa : researchSource: African Journal of Health Professions Education 6, pp 143 –149 (2014) http://dx.doi.org/10.7196/AJHPE.397More Less
Background. The education environment (EE) of a medical school plays a critical role in the learning of its students. The learner, other learners, teachers and the physical environment (campus and hospitals) influence the EE. In addition to recommendations of the Health Professions Council of South Africa (HPCSA) to revise the clinical training platform, staff and senior medical students occasionally experienced the EE in the clinical departments to be challenging.
Objective. To assess the perceived EE in clinical departments at the University of the Free State, Bloemfontein, South Africa, among the 2012 fourth- and fifth-year medical students. Differences in perceived EE scores between different demographic groups were also assessed.
Method. Only the departments where students rotated in both their fourth and fifth years (Obstetrics and Gynaecology, General Surgery, Paediatrics and Neonatology, Internal Medicine, and Psychiatry) were assessed. The Dundee Ready Education Environment Measure (DREEM) questionnaire was contextualised for each department and distributed among fourth- and fifth-year medical students. Questionnaires were self-administered and participation was voluntary. Differences among demographic groups and departments were assessed using the Mann-Whitney U-test and Kruskal-Wallis test (p<0.05).
Results. The overall response rate was 87.7%. The overall median DREEM combined score for the departments was 137/200. Paediatrics and Neonatology was consistently top-rated, whereas Obstetrics and Gynaecology consistently received the lowest rating in all domains and subscale analyses. There were few significant differences between the DREEM scores of demographic groups.
Conclusion. The overall EE in the clinical departments was mostly positive, although concerns were raised regarding some departments.
Making use of an existing questionnaire to measure patient-centred attitudes in undergraduate medical students : a case study : researchSource: African Journal of Health Professions Education 6, pp 150 –154 (2014) http://dx.doi.org/10.7196/AJHPE.351More Less
Background. Patient-centred care is widely acknowledged as important to achieve improved patient outcomes in healthcare. Therefore, it is vital that medical schools should foster this attitude in their students. Studies report that students are becoming less patient-centred in the period between entry to medical school and graduation.
Objective. To determine the shift in attitude towards patient-centredness in a group of South African undergraduate medical students. Simultaneously, the reliability and validity of the Patient-Practitioner Orientation Scale (PPOS) in our context were measured.
Methods. A cross-sectional survey was undertaken by asking all the medical students from year 1 to year 6 to complete the PPOS. The mean PPOS score for each cohort was calculated using SPSS for Windows. Reliability and validity testing was conducted using Cronbach's alpha and confirmatory and exploratory factor analysis.
Results. The average return rate across the 6 years of study was 81%. The results indicated low initial scores on the PPOS and a decrease in scores over the years of study, with the most dramatic drop being from year 1 to year 2. The PPOS showed poor validity and reliability in our context.
Conclusion. The study appears to indicate the same decrease in patient-centredness in our students as has been shown in other studies using this tool. However, the low reliability and validity of the PPOS in our environment means that the result should be interpreted with caution. Factors such as our medical students' not having had first-hand experience of the doctor-patient relationship and second-language issues may play a role. It is recommended that the PPOS not be used in our context without further exploration of the factors contributing to this loss of reliability and validity.
Source: African Journal of Health Professions Education 6, pp 155 –160 (2014) http://dx.doi.org/10.7196/AJHPE.358More Less
Introduction. In a traditional curriculum, medical students are expected to acquire clinical competence through the apprenticeship model using the Halstedian 'see one, do one, and teach one' approach. The School of Medicine, University of Zambia, Lusaka, Zambia, used a traditional curriculum model from 1966 until 2011, when a competence-based curriculum was implemented.
Objective. To explore medical students' clerkship experiences and self-perceived competence in clinical skills.
Methods. A cross-sectional survey was conducted among 5th-, 6th-, and 7th-year medical students at the School of Medicine, University of Zambia, two months before the final examinations. Students were asked to rate their clerkship experiences with regard to specific skills on a scale of 1 - 4 and their level of self-perceived competence on a scale of 1 - 3. Skills evaluated were in four main domains: history-taking and communication, physical examination and procedural skills, professionalism, teamwork and medical decision-making. Using the Statistical Package for the Social Sciences (SPSS), correlations were performed between experiences and self-perceived competence of specific skills, within domains and overall.
Results. Of clinical students (N=197), 138 (70%) participated in the survey. The results showed a significant increase in the proportion of students performing different skills and reporting feeling very competent with each additional clinical year. Overall correlations between experience and self-perceived competence were moderate (0.55). For individual skills, the highest correlation between experience and self-perceived competence was observed mainly with regard to medical- and surgical-related procedural skills, with the highest at 0.82 for nasogastric tube insertion and 0.76 for endotracheal intubation.
Conclusion. Despite the general improvement in skills and self-perceived competence some deficiencies were noted, as significant numbers of final-year students had never attempted important common procedures, especially those performed in emergency situations. Deficiencies in certain skills may call for the incorporation of teaching/learning methods that broaden students' exposure to such skills.
Source: African Journal of Health Professions Education 6, pp 161 –164 (2014) http://dx.doi.org/10.7196/AJHPE.350More Less
Background. In resource-poor environments of the developing world, young and inexperienced interns and community service doctors are often responsible for treating trauma patients without sufficient supervision. Time and experience are required for competency to develop, but in the understaffed environment of many hospitals time is often a constraint. Educational interventions are needed to accelerate competency development of the novice doctor.
Method. The researchers designed an intervention using real cases and error theory to expand young doctors' experiences of common trauma errors made in our setting. We analysed cases at the regular morbidity and mortality meetings and selected cases where error contributed to the condition of the patient. Using error theory, these cases were presented to doctors with the objective to increase error awareness. To assess the success of this intervention, three doctors who were exposed to the intervention and three who were not exposed to it were included in the study using a structured interview.
Results. This study demonstrated that interns who had been exposed to the intervention had a broader understanding of how errors can compound a patient's pathology and are often the result of systematic rather than individual failure.
Conclusion. The researchers focused on the rationale for and the development of an intervention for novice doctors to expose them to trauma experiences in the framework of understanding error. The immediate success of the intervention is illustrated in the structured interviews. Further development of this intervention and more formal research into its pedagogical value are planned after formalisation of the intervention into a teaching curriculum for trauma doctors. This educational initiative will have to be part of a comprehensive multifaceted quality-improvement programme if it hopes to be successful.
A qualitative survey of top-achieving undergraduate medical students' perspectives of medical education : an Iranian exploration : researchSource: African Journal of Health Professions Education 6, pp 165 –168 (2014) http://dx.doi.org/10.7196/AJHPE.51More Less
Background. Curriculum reform has received a great deal of attention in the field of medical education in recent years. Many studies are being conducted worldwide to assess the deficiencies of current curricula in order to construct new ones.
Objective. To investigate the perception of a group of students regarding the curriculum currently being taught in medical schools in Iran.
Methods. This qualitative research was conducted in a cohort of 20 top-achieving students who ranked 1 - 10 in the medical university entrance examination and those who succeeded in the International Biology Olympiad examination in the past eight years. These students were in different stages of their studies, ranging from the second term of study to clerkship to internship. Several semi-structured focus group discussions were held and the results were extrapolated from the transcription of these sessions.
Results. The majority of medical students, regardless of the stage of study, were deeply concerned about the current curriculum. They believed that the existing discipline-based approach, teacher-centred curriculum and shortage of hospital-based learning were deficient and suggested that the lectures, handouts, and multiple choice question examinations should be blamed for the development of unskilled doctors.
Conclusion. There is a need for educational reform to contribute towards providing communities with doctors with better skills.
Building a research agenda in health professions education at a Faculty of Medicine and Health Sciences : current research profile and future considerations : researchSource: African Journal of Health Professions Education 6, pp 169 –173 (2014) http://dx.doi.org/10.7196/AJHPE.288More Less
Background. To generate evidence in and for health professions education (HPE) that can enable reform and establish new relevance, a comprehensive HPE research foundation is required. Gaps identified in the sub-Saharan Africa (SSA) HPE literature should be addressed, while a need for more clarificatory and collaborative research to strengthen evidence has been expressed. Relatively few HPE centres exist in SSA. At Stellenbosch University's Faculty of Medicine and Health Sciences (FMHS) the Centre for HPE was established in 2006, followed by an HPE Research Unit in 2011.
Objectives. To determine and analyse the current status of educational research in the FMHS, thereby contributing to conversations around an HPE research agenda for Africa.
Methods. A database of all HPE-related research was compiled, followed by a desktop analysis of all documents pertaining to current educational research projects in the FMHS in 2012, categorising projects according to: general information; sites where research was conducted; research focus; and research purpose. All data were recorded in an Excel spreadsheet and a descriptive analysis was performed.
Results. There were 106 projects, mostly aimed at undergraduate programmes. More than half focused on teaching and learning, while a few focused on assessment. A number of projects were community-based or involved national and/or international collaborations. Only 20% of projects were classified as clarification research.
Discussion. Educational research appears healthy in the FMHS, but more clarificatory and macro-projects are required. The profile of research is similar to the SSA profile. A research strategy relevant and feasible in our context has to be established with a shift to areas beyond our professional/institutional boundaries, posing HPE questions of relevance to South Africa and the African continent.
Principles of Medicine in Africa, David Mabey, Geoffrey Gill, Eldryd Parry, Martin W. Weber and Christopher J.M. Whitty (Eds.) : book reviewAuthor Bridget FarhamSource: African Journal of Health Professions Education 6 (2014)More Less
This is the 4th edition of this important book, which was first published in 1976, and a far thicker tome than the original. As implied by the title, the scope of the publication is huge - medicine in Africa, arguably one of the more interesting continents in terms of pathology. And that pathology is not always driven by disease-causing organisms, as the opening section of the book reminds us, covering people and the environment, food and nutrition, refugees and disasters, and how to manage a health service.
Author Susan HanekomSource: African Journal of Health Professions Education 6, pp 178 –179 (2014) http://dx.doi.org/10.7196/AJHPE.527More Less
A curriculum is described as an expression of educational ideas in practice. It is a living document which should be adaptable to a changing environment. When faced with specific contextual challenges that required curriculum renewal, we took a phronetic approach. The process was predominantly based on craft knowledge and relied in most part on the insightfulness of staff. The curriculum renewal provided a unique opportunity to evaluate both the content and the mode of delivery. In this edition of AJHPE we share the valuable lessons learned along the journey of curriculum renewal. We started with the end in mind by defining the profile of the Stellenbosch University physiotherapy graduate.
Deriving criteria by which to determine core curriculum content : high engagement process : supplement 1 - researchSource: African Journal of Health Professions Education 6, pp 180 –184 (2014) http://dx.doi.org/10.7196/AJHPE.496More Less
Background. During curriculum revision, an important task is identifying a core curriculum. Deciding what criteria to use to determine core content is crucial and impacts on graduate outcomes and patient care.
Objective. To identify criteria to apply in order to determine core content.
Methods. A high engagement process involving eleven staff and two undergraduate student representatives was used. The process consisted of a stimulus question; brainstorming; sharing, clarification and clustering of ideas; second-phase brainstorming, clarification and clustering; prioritisation; and finally vote tally and categorisation.
Results. The group initially identified 28 criteria to use when deciding on core content. The criteria were reduced stepwise to 15, and finally 3 criteria that enjoyed widespread support were identified. Content would be included in the curriculum if: (i) it was relevant to the South African context; (ii) it would ensure safe and effective practice by first-line practitioners; and (iii) it was evidence-based.
Conclusion. The process lends itself to the participation of multiple stakeholders in an engaging yet anonymous manner. It helps ensure that all voices are heard and ideas included in prioritisation. The process easily manages a multiplicity of ideas; similar ideas are efficiently identified and clustered. Finally, the process is time-efficient.
Does a problem-based learning approach benefit students as they enter their clinical training years? Lecturers' and students' perceptions : supplement 1 - researchSource: African Journal of Health Professions Education 6, pp 185 –191 (2014) http://dx.doi.org/10.7196/AJHPE.529More Less
Background. This paper presents the findings of a study completed to establish the differences between the lecturers' and students' perceptions of a hybrid problem-based learning (PBL) approach in successfully completing a PBL module in the third year of physiotherapy training at Stellenbosch University.
Objectives. To assess the perception of the achievement of the PBL benefits, the module outcomes, the barriers to learning and positive aspects of the module.
Methods. A theory-based evaluation approach using both qualitative and quantitative methods was used. All students and lecturers involved with the new module were invited to participate in the study. The participants consisted of 37 students and 11 lecturers. The data were collected using questionnaires and focus group discussions for both groups. The different components of the theory (PBL methods) were used as the guiding themes for the analysis of the qualitative data. The quantitative (ordinal) data are presented using descriptive statistics.
Results. The results indicated that the module was enjoyed by both groups. The achievement of the generic outcomes for the module produced mixed results. Areas of agreement and areas of differences in perceptions relating to the achievement of the expected PBL benefits are discussed.
Conclusion. PBL as a new methodology presents challenges for both groups; however, many of the benefits of PBL, in particular self-directed learning, were achieved. Some areas of shortfall are discussed.
What does an enquiry-based approach offer undergraduate physiotherapy students in their final year of study? : supplement 1 - researchSource: African Journal of Health Professions Education 6, pp 192 –197 (2014) http://dx.doi.org/10.7196/AJHPE.532More Less
Background. Physiotherapy students in their final year at Stellenbosch University (SU) complete a module that follows an enquiry-based learning (EBL) approach. This module exposes them to higher-order problem solving and was developed to facilitate independent self-directed learning and improved higher-order thinking skills.
Objective. To describe the perceptions of undergraduate physiotherapy students on the impact of this EBL approach on their learning.
Methods. A cross-sectional descriptive study was conducted with three consecutive cohorts of final-year undergraduate physiotherapy students. A questionnaire was used to obtain information related to the students' perception of this module. Coding and identification of themes were done independently using an inductive approach. Initial themes were compared and discussed to achieve consensus regarding the final themes reported.
Results. Students reported the development of skills such as the ability to source relevant information and problem-solving abilities. Students attributed improvements in their clinical reasoning and performance during clinical work to the skills they developed during this module. The main themes identified as barriers to learning during this module were availability of learning materials, quality assurance and time constraints. Group work was identified as both a facilitator and a barrier to their learning.
Conclusion. Physiotherapy students at SU perceived the introduction of a module following an EBL approach positively. They developed skills such as sourcing information and problem-solving, which they perceived improved their clinical work. The main barriers to learning were time constraints and concerns regarding quality assurance of learning material. Group work was regarded as both facilitatory and a barrier to learning. Programmes considering the implementation of EBL should ensure sufficient resource material and that quality assurance mechanisms are in place to address students' anxiety regarding learning material. Guidance and support to students during the initial implementation phase of an EBL approach are necessary to allay fears and frustrations.
Integrating evidence-based principles into the undergraduate physiotherapy research methodology curriculum : reflections on a new approach : supplement 1 - researchSource: African Journal of Health Professions Education 6, pp 198 –202 (2014) http://dx.doi.org/10.7196/AJHPE.516More Less
Background. The research methodology module was reviewed as part of the overall revision of the undergraduate physiotherapy curriculum of Stellenbosch University. This created an ideal platform from which to assess how to align the principles of evidence-based practice (EBP) with research methodology. Fostering the principles of EBP provides students with research skills and attributes to be able to seek, evaluate and integrate new knowledge and to apply critical thinking in order to effectively facilitate professional growth and support lifelong learning.
Objective. To describe the process of changing the undergraduate research methodology module from a primary research to a secondary research approach.
Methods. We consulted international experts and searched the literature for ideas and concepts of how to incorporate the principles of EBP. The overall objective of the new research module was formulated to provide students with lifelong skills in obtaining, evaluating, synthesising and forming clinical recommendations, as well as applying research evidence to the clinical setting.
Results. Structuring the research methodology module using an EBP teaching framework prepares students to formulate a research question, effectively search for and critically appraise the evidence and formulate clinical recommendations. The barriers and strategies of implementing the new undergraduate research methodology module, as well as lessons learnt, are presented.
Conclusion. Utilising a secondary research approach in the form of a systematic review or meta-analysis in our undergraduate research methodology module provides the opportunity for students, as novice researchers, to be trained in the principles of EBP.
Teaching my peers : perceptions of tutors in physiotherapy practical skills training : supplement 1 - researchSource: African Journal of Health Professions Education 6, pp 203 –206 (2014) http://dx.doi.org/10.7196/AJHPE.497More Less
Background. A near-peer tutorial system was introduced and implemented as part of a second-year module to assist physiotherapy students with the practising of manual techniques. Although not the primary drive for initiating this system, there are potential added benefits for the tutor reported in the literature.
Objective. To determine the effect of near-peer teaching on the perceptions undergraduate physiotherapy students have of their own learning.
Methods. A descriptive study utilising mixed methods was used. A pre-tutorial focus group discussion (FGD) format explored the expectations and perceptions of tutors' own abilities and the proposed tutorial system. The researchers conducted a post-tutorial FGD to explore the experiences and perceptions of the tutors' learning experiences. The responses were transcribed and analysed using deductive thematic analysis. A questionnaire was used to quantify which competencies or skills student tutors thought they had obtained through the facilitation of the tutorial sessions. The results were explored using a competency framework.
Results. All ten tutors in the 2012 programme participated in the study. Students moved from unconscious incompetence to conscious incompetence, and seemed to have reached the phase of conscious competence by the end of the programme. unconscious competence was not observed. More than half of the tutors agreed that the programme had a positive impact on their communication, ability to transfer skills and their own understanding of techniques and underlying theory, while two tutors felt that the programme did not improve their own theoretical basis of techniques.
Conclusion. Participating and functioning as near-peer tutors had a positive influence on physiotherapy students' perceptions of their own learning both in terms of own clinical technique competency, but also as teachers and facilitators of learning. It is hypothesised that these students will transition effectively between clinician and health advocator/teacher.