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- African Journal of Health Professions Education
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- Volume 8, Issue 1, 2016
African Journal of Health Professions Education - Volume 8, Issue 1, 2016
Volume 8, Issue 1, 2016
Preliminary study : predictors for success in an important premedical subject at a South African medical school : researchSource: African Journal of Health Professions Education 8, pp 81 –83 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.647More Less
Background. Admission to Sefako Makgatho Health Sciences University, Pretoria, South Africa is determined by the student's Matriculation (Matric) results, while the writing of the National Benchmark Test (NBT) is not compulsory. An average student pass rate of 80.1% in physiology (MB ChB II) in the past 13 years compelled this institution to investigate which criteria in the selection process could be predictors for success in physiology, a fundamental discipline for medical studies.
Objectives. To compile a profile of very successful physiology students and those who failed the subject, and to identify predictors for success in physiology.
Methods. A quantitative study, using Matric and available NBT results, was conducted among the MB ChB II group (N=228) of 2011. Two target groups were identified: highly successful students in physiology (n=37) and those who failed (n=46). Statistical analysis of the results was performed on SAS 9.2, Microsoft Windows (SAS Institute Inc., USA) (p-values ≤0.05 are significant) using the t-test, Fisher's exact test and the simple linear regression test.
Results. These indicated that a good Matric symbol (≥5) in English and life science and a good performance in the quantitative literacy domain of the NBT were statistically significant predictors for success in physiology.
Conclusion. This preliminary study indicates the need for our institution to rethink the effectiveness of the selection criteria, redesign the selection process of students for the MB ChB course, and consider making use of the NBT.
Author Oathokwa NkomazanaSource: African Journal of Health Professions Education 8 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.797More Less
Universal access to healthcare mandates that all people worldwide have access to comprehensive healthcare services, without suffering financial hardship. However, unless the severe shortages and inequitable distribution of healthcare workers, especially in many low- and middle-income countries, are addressed, universal access will, similar to 'Health for all by the year 2000', go down in history as a desirable but unattainable goal. The dearth of healthcare workers follows an 'inverse care law', with the direst shortages in areas of greatest need, mostly rural areas. In a bid to address the challenge in sub-Saharan Africa, many new medical schools with larger class sizes have sprung up in the past 20 - 30 years.
Implementation and outcome evaluation of the Medical Education Partnership Initiative biostatistical reasoning workshops for faculty and postgraduate students at the University of KwaZulu-Natal, Durban, South Africa : researchSource: African Journal of Health Professions Education 8, pp 87 –91 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.740More Less
Background. There is a shortage of biostatistics expertise at the University of KwaZulu-Natal (UKZN), Durban, South Africa and in the African region. This constrains the ability to carry out high-quality health research in the region.
Objectives. To quantitatively and qualitatively evaluate a programme designed to improve the conceptual and critical understanding of biostatistical concepts of UKZN health researchers.
Methods. A 40-hour workshop in biostatistical reasoning was conducted annually between 2012 and 2015. The workshops were structured around interpretation and critical assessment of nine articles from the medical literature, with a mix of in-class sessions and small group discussions. Quantitative evaluation of the knowledge gained from the workshops was carried out using a pre- and post-workshop quiz, and qualitative evaluation of the workshop process was done using a mid-workshop questionnaire and focus group discussions.
Results. For each year that the workshop was conducted, post-workshop quiz scores were significantly higher than pre-workshop scores. When quiz assessments from all 4 years of training were combined, the pretest median score was 55% (interquartile range (IQR) 40 - 62%) and the posttest median score was 68% (IQR 62 - 76%), with p<0.0001 for the overall comparison of pre- v. post-scores. There was a general consensus among participants that the workshop improved their reasoning skills in biostatistics. Participants also recognised the value of the workshop in building biostatical capacity at UKZN.
Conclusion. The workshops were well received and improved the critical and conceptual understanding of the participants. This education mode offers the opportunity for health researchers to advance their knowledge in settings where there are few professional biostatistician collaborators.
Predictors of site choice and eventual learning experiences in a decentralised training programme designed to preparemedical students for careers in underserved areas in South Africa : researchSource: African Journal of Health Professions Education 8, pp 92 –98 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.741More Less
Background. There is a dire need for medical schools in South Africa to train medical doctors who have the capacity and willingness to work in primary healthcare facilities, particularly in rural areas.
Objectives. To assess the effect of studentsâ?? gender, race, place of birth and place of high school completion on their choice of training site location and to assess the extent to which the training programme enhanced students' learning experiences relevant to primary care across training sites.
Methods. A survey design involving six cohorts of 4th-year undergraduate medical students (N=187) who were part of the 2013 Family Medicine rotation at the Nelson R Mandela School of Medicine. Self-administered questionnaires were completed by students at the end of each rotation. Data analyses involved descriptive computations and inferential statistical tests, including non-parametric tests for group comparison and generalised polynomial logistic regression.
Results. Students believed that their knowledge and skills relevant to primary care increased after the rotation (p<0.0001). There were statistically significant differences between rural and urban sites on certain measures of perceived programme effectiveness. Male students were less likely to choose urban sites. Black students were less likely to choose rural sites compared with their white and Indian counterparts, as were students who attended rural high schools (odds ratio (OR) 9.3; p<0.001). Students from a rural upbringing were also less likely to choose rural sites (OR 14; p<0.001).
Conclusion. Based on the findings, an objective approach for student allocation that considers students' background and individual-level characteristics is recommended to maximise learning experiences.
Exploring the relationship between demographic factors, performance and fortitude in a group of diverse 1st-year medical students : researchSource: African Journal of Health Professions Education 8, pp 99 –103 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.748More Less
Background. The majority of 1st-year students are ill-equipped for university life. This heightens stress levels, which are accentuated by a lack of resilience and impact negatively on academic performance and personal wellbeing.
Objectives. To explore, within the paradigm of positive psychology, the relationship between the self, family and support constructs of fortitude, and academic performance of 1st-year medical students.
Method. First-year medical students completed a fortitude questionnaire and their academic performances in two academic modules were collated.Mann-Whitney and Kruskal-Wallis tests were employed for statistical analysis of the variables. Pearson correlation coefficients were calculated to assess the relationship between academic performance and fortitude subscales, as well as the fortitude composite score.
Results. The student population was multicultural, multilingual and had different educational and residential backgrounds. The fortitude instrument was found to be reliable and correlated significantly with student academic performance. Male students had significantly higher fortitude scores than female students. Students who had attended state/government schools had significantly lower fortitude than those who had attended private and ex-Model C schools. Students with prior degrees had higher fortitude than matriculants.
Conclusion. The significant, albeit moderate, positive correlation between fortitude and academic performance highlights the need for further exploration of wellbeing and holistic development of medical students. Support programmes are recommended to bridge the gap related to gender and educational background. Low and fair levels of fortitude indicate a need for corrective measures. These could include consulting relevant support networks such as student counsellors, mentors and academic development personnel.
Motivated strategies for learning and their association with academic performance of a diverse group of 1st-year medical students : researchSource: African Journal of Health Professions Education 8, pp 104 –107 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.757More Less
Background. Most instruments, including the well-known Motivated Strategies for Learning Questionnaire (MSLQ), have been designed in western homogeneous settings. Use of the MSLQ in health professions education is limited.
Objective. To assess the MSLQ and its association with the academic performance of a meterogeneous group of 1st-year medical students.
Methods. Eighty-three percent of 1st-year medical students consented to participate in this quantitative study. The MSLQ consisted of a motivation strategies component with six subscales, while the learning strategies component had nine subscales. Demographic and academic achievement information of the students was also collected. Stata version 13 (StataCorp LP, USA) was used for the statistical analyses of all data.
Results. Female students displayed significantly higher motivational scores. Students with prior educational experience and those who attended peermentoring sessions had significantly higher learning strategy scores. Significant but moderate relationships were found between academic performance and the motivation strategies subsumed within the categories 'task value' and 'self-efficacy for learning performance'. In terms of the 'learning strategy component', 'critical thinking', and 'time and study environment', the composite score was significantly but poorly correlated to academic performance.
Conclusion. Overall, limited correlations were found between the MSLQ scores and academic performance. Further investigation of the use of the MSLQ and its association with academic achievement is recommended, with greater focus on specific learning events than on course outcomes. This study highlights the importance of evaluating an instrument in a specific context before accepting the findings of others with regard to the use of the instrument and its correlation with academic performance.
Assessing the effect of an online HIV/AIDS course on 1st-year pharmacy students' knowledge : researchAuthor F. SulemanSource: African Journal of Health Professions Education 8, pp 108 –112 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.750More Less
Background. More international HIV/AIDS intervention initiatives targeting young adults are needed to help reach targets set by the Joint United Nations Programme on HIV and AIDS (UNAIDS).
Objectives. To determine the effect of an online HIV/AIDS course on 1st-year pharmacy students' knowledge of HIV prevention and transmission and of the science of HIV infection.
Methods. Online anonymous surveys, the Pre- and Post-Confirmation of Acceptance for Studies, were administered by means of an online survey tool, Survey Monkey (USA), to 1st-year pharmacy students, from 2009 to 2013. These surveys were administered online during the first and last weeks of class, respectively.
Results. With regard to HIV prevention and transmission, student knowledge of the manner in which HIV is transmitted improved during the course. Overall, students were more confident about their knowledge of HIV prevention. They also indicated that as a direct result of taking the AIDS Online International course they were more reluctant to have unsafe sex and more confident about how to protect themselves against HIV/AIDS. Their scientific knowledge also improved.
Conclusion. The implementation of an online HIV/AIDS course has proved to be an effective method of HIV/AIDS education, and may also be aviable HIV intervention initiative.
Feedback as a means to improve clinical competencies : consultants' perceptions of the quality of feedback given to registrars : researchSource: African Journal of Health Professions Education 8, pp 113 –116 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.758More Less
Background. Effective supervision by consultants in postgraduate medical education involves the process of feedback. Giving feedback may be challenging for consultants who have no formal training in this process, which may be further compounded in heterogeneous diverse settings.
Objective. To explore consultants' perceptions of feedback to registrars in a multicultural, multilingual diverse academic hospital setting.
Methods. Thirty-seven consultants consented to completing a questionnaire on what, when, where, how often, and how feedback was provided, as well as on the type and effect of feedback to registrars. Descriptive statistics were used to analyse the data. Differences between groups were calculated using Pearson's χ2 test for independent variables, with a p-value of <0.05 regarded as being statistically significant.
Results. Only 40% of consultants reported that they provided feedback often or always and 62.2% reported that standards were not predetermined and communicated to registrars. When feedback was provided, it was based on concrete observations of performance (78.4%), it incorporated a plan for improvement (72.9%) and it supplied information on techniques performed incorrectly (72.9%). Only 40.5% of consultants provided feedback on procedures performed correctly. Moreover, only half of the consultants believed they were proficient at giving feedback.
Conclusion. Consultants need to develop the art of giving feedback through appropriate training so that they are more comfortable and proficient with the various aspects of feedback, leading to a positive effect on enhancing registrar training.
Feedback as a means to improve clinical competencies : registrars' perceptions of the quality of feedback provided by consultants in an academic hospital setting : researchSource: African Journal of Health Professions Education 8, pp 117 –120 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.768More Less
Background. The training of novices, in any field, to achieve the optimum state of cognitive, clinical, technical and professional development requires a variety of teaching methodologies, including the process of feedback. Feedback is defined as a process where the desired standard of proficiency in a task has already been established and communicated to the student before gaps in performing the task or in the level of knowledge are identified. The process of feedback has often been evaluated and has consistently revealed students' dissatisfaction with the amount and type of feedback they receive in their clinical and postgraduate training, as they perceive it to be inadequate, inappropriate or non-existent.
Objectives. To investigate the perceptions of the quality of feedback received by a diverse, heterogeneous population of registrars in postgraduate training at an academic hospital.
Methods. A study was conducted using a questionnaire to determine the perceptions of all registrars in the six major clinical training programmes with regard to the quality, efficacy and effectiveness of feedback received during clinical training. Descriptive statistics were used to interpret the responses of the registrars, with mean values being calculated.
Results. Perceptions of the quality of feedback received differed across disciplines.Overall, the registrars rated the feedback they received as poor. The majority (51.4%) reported that both formal and informal feedback was only sometimes, even rarely, received during all encounters with consultants. Others (51.3%) felt that the feedback received was unacceptable, and did not perceive it to be based on concrete observations of performance. The proficiency of consultants in giving feedback was scored as unacceptable by 64.8% of registrars.
Conclusion. Registrars in training regard feedback as an essential component of their postgraduate medical education and as an important component of achieving clinical competence. More formalised processes need to be implemented. The majority of registrars agreed that consultants required training in providing feedback effectively.
Third-year medical students' and clinical teachers' perceptions of formative assessment feedback in the simulated clinical setting : researchSource: African Journal of Health Professions Education 8, pp 121 –125 (2016) http://dx.doi.org/http://dx.doi.org/10.7196/AJHPE.2016.v8i1.769More Less
Background. Clinical skills training in the clinical skills laboratory (CSL) environment forms an important part of the undergraduate medical curriculum. These skills are better demonstrated than described. A lack of direct observation and feedback given to medical students performing these skills has been reported. Without feedback, errors are uncorrected, good performance is not reinforced and clinical competence is minimally achieved.
Objectives. To explore the perceptions of 3rd-year medical students and their clinical teachers about formative clinical assessment feedback in the CSL setting.
Methods. Questionnaires with open- and closed-ended questions were administered to 3rd-year medical students and their clinical skills teachers. Quantitative data were statistically analysed while qualitative data were thematically analysed.
Results. Five clinical teachers and 183 medical students participated. Average scores for the items varied between 1.87 and 5.00 (1: negative to 5:positive). The majority of students reported that feedback informed them of their competence level and learning needs, and motivated them to improve their skills and participation in patient-centred learning activities. Teachers believed that they provided sufficient and balanced feedback. Some students were concerned about the lack of standardised and structured assessment criteria and variation in teacher feedback. No statistical difference (p<0.05) was found between the mean item ratings based on demographic and academic background.
Conclusion. Most teachers and students were satisfied with the feedback given and received, respectively. Structured and balanced criterion-referenced feedback processes, together with feedback training workshops for staff and students, are recommended to enhance feedback practice quality in the CSL. Limited clinical staff in the CSL was noted as a concern.