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- ItemCaring behaviours : the perceptions of first and fourth year nursing students(Stellenbosch : Stellenbosch University, 2014-12) Crafford, Ilse; Archer, Elize; Blitz, Julia; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professionals Education.ENGLISH ABSTRACT: Educators across the health professions are now concerned with the teaching and assessment of professional skills. Caring behaviour is one of the attributes of professionalism in the health sciences professions and in the nursing profession it is regarded as the essence of the profession. The aim of this study is to explore the understandings and experiences of caring behaviours of first- and fourth year nursing students and how they would like to be assessed about their caring behaviours in a curriculum where it is not overtly taught. This will be investigated according to Watson’s carative factors and theoretical framework of caring, while Bloom’s Taxonomy of the affective learning domain will also be consulted. The design of the study is qualitative and explorative. A purposive sample was drawn from first-year nursing students (n=64), and fourth-year nursing students (n=41) at one nursing education institution. The sample of students (n=105) from seven (7) private training hospitals in the Western Cape participated in nine (9) focus group interviews (n=10-15). Data analysis was done by means of a framework analysis approach with a deductive strategy. Research findings from this study are extensively discussed and will be used to inform the undergraduate nursing curricula in South Africa about the profiles of caring nursing students and to make recommendations about the internalisation of caring behaviours, according to the affective learning domain.
- ItemClinical learning environment and supervision : student Nurses experiences within private health care settings in the Western Cape(Stellenbosch : Stellenbosch University, 2014-04) Borrageiro, Filomena; Archer, Elize; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH ABSTRACT: Background - Student nurses indicated that the clinical environment was not conducive to learning because they were part of the ward staff ratio and clinical supervision was inadequate. Upon observations by the researcher and feedback from student nurses’ a study was planned to identify the clinical experiences and supervision. The study itself was conducted within private health care settings in the Western Cape Province of South Africa. Objectives - The objective of this study was to determine the experiences of student nurses of the clinical learning environment. To also identify the support and clinical supervision that the student nurses received from ward staff, clinical facilitators and lecturers. Methods and analysis - The CLES+T is a reliable and valid evaluation scale for the gathering of information on the clinical learning environment and supervision of student nurses. The CLES+T evaluation scale was completed by 234 student nurses within the selected sites. A quantitative, descriptive cross-sectional survey was conducted by making use of the CLES+T evaluation scale. The CLES+T evaluation scale is subdivided into three main sections with additional sub-sections: (1) the Learning environment, (2) the Supervisory relationship and (3) the Role of the nurse teacher (lecturer). Results - The clinical learning environment was experienced as mostly positive by the student nurses; however the format and type of clinical accompaniment and supervision students received varied. Conclusion - This study gave valuable insights into the status of the clinical learning environment, the clinical accompaniment and supervision of student nurses which can be useful to the nursing school in order to enhance existing nursing programmes.
- ItemEvaluation of a pilot "registrar-as-teacher" faculty development program at Stellenbosch University(Stellenbosch : Stellenboch University, 2014-12) Smit, Elizabeth Johanna; Archer, Elize; Blitz, Julia; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH ABSTRACT: A. Background - Registrars play a significant role as teachers for undergraduate medical students and junior doctors in the clinical setting. (Jack et al. 2010; Busari & Scherpbier 2004). Many however teach ineffectively as registrars are rarely taught how to teach (Morrison et al. 2002, Busari et al. 2002; Thomas et al. 2002). This has prompted a number of universities to implement “Registrar-as-Teacher” training programs as part of faculty development (FD) initiatives (Leslie et al. 2014; Post et al. 2009, Hill et al. 2009). Although available evidence has demonstrated a positive impact of these programs on the teaching performance of registrars, large differences exist in the interventions, curricula content and participant characteristics. Few studies identified a conceptual framework that informed the design. Most studies focused on a quantitative approach to evaluate outcome; ignoring contextual factors that may shape the successful implementation of new knowledge and skills gained. At Tygerberg Hospital, education is a key performance area of registrar’s staff performance management agreement but no formal training program for registrars as teachers exists. The Centre for Health Professions Education at Stellenbosch University thus piloted a half-day workshop for newly appointed registrars from various disciplines with the aim to develop the clinical supervision skills of registrars as clinical educators. B. Research Design and Methodology - The overall aim of this study was to evaluate the outcome of a pilot “Registrar-as-Teacher” workshop at the University of Stellenbosch. The specific objectives included: - To evaluate registrar perceived relevance of workshop content - To evaluate registrar self-evaluation of teaching practices - To identify factors affecting the teaching practices of registrars - To observe and evaluate registrar teaching practices in the clinical setting - To increase the “Registrar-as-Teacher” workshop effectiveness A two-phased mixed method design was used, using semi-structured interviews and observation of registrars. Phase one comprised of semi-structured interviews to elicit both numerical and text-based data. Phase two included observer ratings to further explore the application of knowledge, skills and attitudes gained. The “Registrar-as-Teacher” program content was informed by the teaching roles described by Harden and Crosby (2000). As educational strategy, Knowles’ adult learning theory (1980) was applied. The study was conducted at Tygerberg Hospital, a Stellenbosch University Faculty of Health Sciences affiliated teaching hospital in Cape Town, South Africa. The study population included newly appointed registrars (year 1 and 2) from the Departments of Internal Medicine, Paediatrics, Obstetrics and Gynaecology, Surgery, and Orthopaedics. An inductive approach was used to analyze the qualitative data. Demographic, registrar self- evaluations and workshop evaluation data was analyzed using descriptive statistics. This study was approved by the Health Research Ethics Committee of Stellenbosch University (protocol number S13/10/177). C. Results - Seven of the fifteen registrars attending the pilot workshop agreed to take part in phase 1 of the study; five from the Department of Paediatrics and Child Health, and one from Surgery and Obstetrics & Gynaecology respectively. Five agreed to take part in phase 2 of the study; all from the Department of Paediatrics and Child Health. Participants reported satisfaction with the program and experienced the workshop as a positive learning experience (Kirkpatrick level 1). Participants self-reported positive changes in attitudes, including motivation, self-confidence, enthusiasm, and conceptions of teaching. Knowledge and skills were gained, as self-reported and observed. Individual benefits such as increased self-awareness of teaching ability and increased awareness of student needs were reported (Kirkpatrick level 2). Participants self-reported behavior changes in their teaching practices. Participants, bar one, demonstrated appropriate educational practices and teaching skills (Kirkpatrick level 3). Participants in our study reported their expanded conceptions of the roles of a teacher as one of the most useful aspects of the workshop. Role modelling was singled out as the most useful session. Participants generally had a positive view on their contribution to student learning. They saw it as a formative influence on how students view the profession and discipline. Unique aspects of registrar teaching were highlighted as being more informal in nature, more practice orientated; and working in a closer relationship with students; thus complementary to the consultant teaching role. Participants recognized that they are still developing their clinical teaching skills. Most participants rely on observed teaching methods or borrow from their own experiences as students. Participants based their self-assessment of being a good teacher on their personal views that mirrored their conceptions of a good teacher; seldom asking for or receiving feedback on their teaching skills to shape their own learning or performance as clinical teachers. Most participants in our study asked for regular or follow up training where they could reflect on their development and also receive feedback on progress made. Few participants felt comfortable to give feedback to students or to use the ‘one-minute preceptor’ compared to other aspects of clinical teaching. Our FD program’s session on teaching in the clinical setting and the ‘one-minute preceptor’ thus worked less well. This speaks to how to increase the effectiveness of future workshops. Even though all participants enjoyed teaching students, reported barriers to effective teaching were many. Participants often felt frustrated and overwhelmed by their teaching task. Limited time with competing responsibilities such as huge service demands and administrative duties impacted negatively on participants’ ability to teach students. Participants mostly felt unsupported and undervalued as teachers by their various departments, with little guidance on the expected student teaching content, process or learning outcomes. Although the expectation to teach is clearly communicated by the various departments, there is no training, supervision structure, formative feedback, or appreciation of their teaching performance. This lack of orientation and communication was further highlighted by participants pointing to the explanation of the MBChB undergraduate curriculum structure as the second most useful component of the course after role modelling. D. Conclusion and Recommendations - Our study confirmed the important role of registrars as teachers in the clinical setting. Apart from sharing theoretical and on-the-job knowledge, registrars teach practical skills and act as role models for the profession. Participants perceived the pilot “Registrar-as-Teacher” workshop content as relevant and the workshop shaped their teaching conceptions and practices. But workplace barriers like limited time with competing responsibilities impacted negatively on participants’ ability to teach students. A reported lack of guidance and support from the respective departments further undermined their ability to develop as clinical teachers. Future “Registrar-as-Teacher” FD initiatives at Stellenbosch University should thus provide registrars with optimal approaches and best teaching practices for busy clinical settings; enabling them to merge teaching with work. Strengthening FD requires the adoption of a broader conceptual framework that does not just focus on the individual participant, but link FD to the development of the department or institution as a whole (Swanwick & McKimm 2012). Workplace communities that include departmental faculty members should be involved in FD programs; allowing for ongoing learning and professional development of registrars as clinical teachers (O’Sullivan & Irby 2011; Steinert et al. 2010; Webster-Wright 2009; Hunter et al. 2008; Thorndyke et al. 2006). This requires a longitudinal strategy. Our “Registrar-as-Teacher” FD program should thus move away from the one-time workshop and instead create multiple learning events with opportunities for application and reflection.
- ItemEvaluation of the learning environment of teaching hospitals of twin cities in Pakistan(Stellenbosch : Stellenbosch University, 2014-12) Khan, Muhammad Nasir Ayub; Archer, Elize; Bezuidenhout, Juanita; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH ABSTRACT: Background - The College of Phycians and Surgeons Pakistan (CPSP) was established in 1962 and its role is to oversee the postgraduate medical education within Pakistan. At present, various specialties belonging to the CPSP carry out quality assurance visits including evaluation of the learning environment of the teaching hospitals by asking the supervisors and doctors in training about the qualification and experience of supervisors, equipment, library, infrastructure and type of work load. The CPSP do not make use of a valid and reliable method when performing these assessments and therefore there is a need for the CPSP to develop a standardized method of assessing the learning environments of the teaching hospitals in Pakistan. This method needs not only to be valid and reliable but also reproducible and transferable so that it can be used to measure the learning environments in various departments and teaching hospitals .It can further be used to compare the learning environments across different teaching hospitals and specialties with in Pakistan. The learning environment of teaching hospitals of Pakistan have not been studied before therefore the purpose of this study was to measure the postgraduate learning environment of private and public sector teaching hospitals of twin cities in Pakistan Islamabad and Rawalpindi .Public sector hospitals are fully funded by the government of Pakistan and patients receive free treatment, while private hospitals are commercial hospitals where everything is paid by patients. Following the postgraduate educational environment measurement results between house officers and residents working in the above mentioned environments was then compared. These results can inform supervisors and institutions about short comings as well as strong points with regards to the learning environment. Materials and Methods After approval from the Shifa International Hospital`s Ethical committee and Health Research Ethical committee of the University of Stellenbosch, and informed consent were obtained from research participants. The Postgraduate Hospital Educational Environment Measurement questionnaire (PHEEM) was administered to the house officers and residents of six public and one private sector teaching hospital of twin cities (Islamabad and Rawalpindi) in Pakistan with the help of the supervisors of CPSP based at these hospitals. The PHEEM was completed during their respective teaching sessions at the various hospitals .The supervisors was asked to encourage students to complete the PHEEM questionnaire .Supervisors were instructed to collect the completed questionnaires the from doctors in training at their individual hospitals and then send it back using the enclosed envelope The PHEEM contains of 40 items covering a range of issues directly related to the clinical learning environment of house officers and residents1. These statements make up 3 subscales of the clinical learning environment namely autonomy, social support and teaching. Autonomy (such as the quality of supervision) is represented by 14 statements teaching (the qualities of teachers by 15 statements and social support (such as facilities and atmosphere) by 11statements. Each of the 40 statements can be rated from 0-4 .The respondents are asked to indicate their agreement using a 5 point Likert scale .These range from strongly agree(4) ,agree(3), unsure(2), disagree(1) to strongly disagree (0). Agreement with the items indicates a positive learning environment and will result in high scores. The maximum possible scores are 56 for autonomy, 60 for teaching, 44 for social support and an overall score of 160.It is essential that each junior doctor applies the items to their own current learning place1. - Statistical analysis - The statistical analysis was conducted by using SPSS 16.0 and the four negative items were scored in reverse (question 7, 8, 11, 13). The scores for the total as well as the sub-scales were described by using means and standard deviations (SD). Comparisons of the perception of the educational environments between house officers and residents were expressed as a mean and ± SD and its statistical significance was determined by student t- tests. A p value ≤ 0.05 was considered statistically significant. The results from the three construct of the PHEEM survey were compared among the house officers and residents from surgery, medicine, pediatrics and Obstetrics’ and Gynecology by ANNOVA and post hoc sidak test. A p value ≤ 0.05 was considered statistically significant. - Results - The internal reliability of the questionnaire was good with a total Cronbach`s Alpha value of 0.92 (a Cronbach`s alpha of more than 0.7 or 0.8 is accepted as being good). The questionnaire further revealed Crobach`s alpha value of 0.78, 0.89 and 0.70 for the various subscales of autonomy, teaching and social supports .When this was analyzed to exclude each question in turn, using the alpha if deleted there was no significant improvement in the score, thus confirming all questions were relevant and should be included. A total of 286 out of 300 (95.33% response rates) house officers and residents belonging to the seven different teaching hospitals of twin cities of Islamabad and Rawalpindi, Pakistan participated in the study. The PHEEM questionnaire was completed by all the participating doctors composing of 51% house officers and 49 % residents .Both genders were almost equally represented in the two groups comprising of 52% male and 48% female doctors. The distribution of male and female gender is different among respondents from various specialties. There was 23.60% male and 15.03% females in surgery, 22.20% males and 18.30% females in medicines, 6.20% males and 4.32% females in Pediatrics and 10.33% females in obstetrics. House officers and residents belonging to all major specialties took part in the study with the distribution looking as follows, Medicine 44.8%, Surgery 33.6% Obstetrics and Gynecology11.2% and Pedriatics10.50%. The mean score (M) and the standard deviation (SD) for each of the subscale namely the perceptions of autonomy, teaching and social support of house officers and residents are shown Table number 1 (Autonomy), Table number 2 (Teaching) and Table number 3 (Social support) respectively. These tables also show the mean of the total scores of each subscale. The lowest recorded score was 1.37 for question number 4.Question number 1, 4,5,9,11,17 and 32 with in the autonomy section were found to have a relatively low rating as shown in table number 1. Teaching quality questions 3, 21 and 33 showed a low rating as demonstrated in table number 2. Social support showed a low rating for question number 19, 20, 25, 26, 36 and 38 again shown in table number 3. The results from the three subscales of the PHEEM survey were compared between residents and house officers from the teaching hospitals of the twin cities are shown in Table number 1, 2, and 3 respectively. The perception of autonomy was higher amongst residents with a mean of 28.74 compared to house officers 28.27. The difference, however, was not statistically significant between the two groups but there was a statistically significant difference between the two groups in question number 32, where the residents perceived that work load for them was better than house officers. It seems as the residents have better opportunities to access and participate in educational events and programs compared to the house officers seeing that there was a statistically significant difference in question numbers 12 and 21 respectively as shown in table number 1. The perceived level of quality of teaching was higher for residents with mean of 32.02 as compared to the house officers with a mean of 31.12. However this difference was not statistically significant as shown in table 2. The perception of social support was high amongst house officers with a mean of 19.66 compared to residents with a mean of 19.06. There was statistically no difference between the two groups regarding the social support provided at these teaching hospitals; however the house officers felt physically more save compared to residents as shown in table 3 Regarding the difference between private and public sector hospitals, the mean score of the three subscales of the PHEEM, namely the mean score for the perception of autonomy (28.71 vs. 27.14, p=0.24) teaching (33.08 vs. 32.37, p=0.25) and social support (21.94 vs. 21.22, p=0.24) were not statistically significant. The results from the three subscales of the PHEEM survey were compared amongst the junior doctors from Surgery, Medicine, Pediatrics and Obstetrics’ and Gynecology by ANNOVA and post hoc sidak test. There was no statistically significant difference among these junior doctors in the majority of the PHEEM questions. For question number 4, I had an informative induction programme, there was statistically significant difference between the junior doctors of medicine and obstetrics & gynecology .Regarding the question number 5, I had appropriate level of responsibility in this post, and there was statistically significant difference between junior doctors of surgery & pediatrics and surgery and obstetrics & gynecology. There was significant difference between the junior doctors of medicine and Obstetrics and gynecology for question number 29, I feel part of the team working here. Regarding perception of question number 30, I have opportunity to acquire the appropriate practical procedures for my grade; there was significant difference between the junior doctors of obstetrics & gynecology and surgery. For perception of teaching, there was a significant difference between the junior doctors of medicine and obstetrics & gynecology in the following questions. Question number 10: my clinical teachers have good communication skills; Question number 23: my clinical teachers are well organized; and question number 27: I have enough clinical learning opportunity of my needs. In the subscale of social support there was a significant difference for item number 13 which states that there is sex discrimination in this post between the junior doctors of surgery and pediatrics .The junior doctors from medicine perceive that there was more calibration among the doctors of medicine as compared to pediatrics. - Discussion and conclusion - This study shows that the PHEEM questionnaire consists of a practical, reliable and simple set of questions to measure the learning environment of doctors in training at teaching hospitals of Pakistan; a country which is socially, culturally and economically different from the country where this questionnaire was originally constructed. This could imply that the perceptions of doctors in training are similar regardless of geographical boundaries and economic conditions of the country where they live. . Other studies that employed PHEEM in different parts of the world show similar scores. This study does not show a statistically significant difference between house officers and residents in terms of teaching, role of autonomy and social support. The reasons for this may be that house officers and residents share the same infrastructure for accommodation, catering and social support. Furthermore, there is no practically organized structured training programme with a specified job description for doctors at different levels of training. This study therefore does not confirm results of the studies performed in United Kingdom and Australia, where house officers experienced a better learning environment than residents in many respects. This study was completed by house officers and residents from private as well as public sector teaching hospitals. We did not find a statistical difference in the level of perceptions between doctors in training working in these two different set up of hospitals. This goes against the common notion present amongst junior doctors that training at public sector hospitals have a higher level of satisfaction due to better and more learning opportunities than at private sector hospitals because in these hospitals independent work is not allowed. The result off this study indicates that the perception level of house officers and residents in training in various specialties was different regarding the learning environment. This difference was even more marked for the specialty of Gynecology and obstetrics where the PHEEM items were scored lessened compared to the other specialties. The reason for this could be due to better training opportunities, more structured and availability of mentors in Surgery, Medicine and Pediatrics compared to the female dominated specialty of Gynecology and obstetrics. The female work and learn in different way because they score three items directly related to perception of teaching lower compare to male dominated specialities. The PHEEM questionnaire results have been taken from seven teaching hospitals of the twin cities, and therefore provide a good overall picture of the learning environments of teaching hospitals in Pakistan seeing that the teaching hospitals of Pakistan almost have similar infrastructure and faculties with few individual variations. This sample represents all major specialties thus provide a good picture of the learning environment for all doctors in training. It is clear that in order to ensure high standards in education and training of junior doctors, the importance of the learning environment cannot be ignored. The following are recommendations for the CPSP so that they take steps in collaboration with administrative and medical staff to improve the learning environments where needed. 1. A meeting between the CPSP and administrative staff should held every year to overcome the weakness pointed out in this study 2. Teaching hospitals should publish an informative junior doctors hand book , with a job description, responsibilities, expectation and information about working hours 3. The junior doctors should have protected time for educational activities 4. The attendance at educational sessions must be supported by the Supervisors of CPSP 5. Career advice and counseling opportunities should be avaible at each regional center of CPSP 6. Accommodation should meet the appropriate standards 7. Good quality hygienic catering facilities should be present around the clock for junior doctors. 8. Each teaching hospital should administer the PHEEM ever year to measure their quality and potentially improve their standards. In conclusion this study shows a great need for the creation of a supportive environment as well as designing and implementing interventions to remedy unsatisfactory elements of the educational environment if effective and successful learning is to be realized by the CPSP.
- ItemExploring final year dental students’ attitudes toward and understanding of reflection and reflective practice in the Conservative Dentistry Clinics at a South African dental school(Stellenbosch : Stellenbosch University, 2020-12) Cloete, Colleen Carol Anne; Archer, Elize; McNamee, Lakshini S.; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY : In the field of health professions education, it is well accepted that reflection and reflective practice have numerous benefits ranging from increasing self-awareness, to promoting learning and behaviour changes, to enabling self-empowerment and ultimately aiding in the development of professional competence. Reflection provides opportunities for students to explore experiences in the workplace and integrate existing knowledge with new understandings. Undertaking this process promotes deep personal and transformative learning, the overarching goal being to foster reflective practitioners who provide holistic patient care. The study was conducted at the University of the Western Cape (UWC), Faculty of Dentistry, where the purpose of the study was to explore students’ attitudes towards reflection and reflective practice and what they understood about practicing reflection in the clinical environment. A phenomenological qualitative approach was used to examine the experiences of final year dental students and this method of inquiry allowed the researcher to gain an understanding of situations through the subjective experiences of the participants, and the meanings these participants attributed to the experiences. All final year dental students enrolled at the UWC, Faculty of Dentistry were eligible to be participants in the research project. Audiotaped individual interviews were conducted in a semi-structured, informant style interview format. Data were analysed applying an inductive approach and using the assignment of codes to organise the data into themes and sub-themes. The findings of this study indicate that students have an understanding of reflection and reflective practice and an idea of the value as it relates to Dentistry, however, their focus is solidly geared toward procedures and techniques with minimal mention of the benefit being related to improving patient care. This finding is aligned with the limited literature on reflection and reflective practice in dental education. Further highlighted in this study was the lack of guidance and support of reflective learning by a number of clinical teachers. It is hoped that this study will better inform educational activities so that the clinical environment becomes a more meaningful learning platform. The facilitation of critical thinking and clinical reasoning will result in improved patient care which would be the ultimate outcome.
- ItemExploring medical laboratory scientist students’ experiences during their fourth year clinical practice period(Stellenbosch : Stellenbosch University, 2018-03) Van Niekerk, Liezel; Archer, Elize; Volschenk, Mariette; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY : Medical Laboratory Sciences (MLS) recently introduced a new degree course for professionals of laboratory medicine. The revision of the qualification has led to the re-evaluation and restructuring of the clinical practical period (CPP) by organizations that accommodate the students during their fourth year. The purpose of this study was to explore and describe the experiences of medical laboratory scientist students in a private pathology laboratory in the Western Cape, South Africa. An embedded aim of this research was the optimization of the fourth year programme. A qualitative approach, guided by an interpretive paradigm and exploratory design, was used in this study. Focus group interviews were conducted with three groups of students of medical laboratory sciences. These included students that were either in the process of completing their CPP at the time of the study or recent graduates that completed the CPP during the years that preceded the study. Semi-structured focus group interviews were conducted, recorded and the audio-recorded data was transcribed verbatim and coded through inductive data analysis to identify themes and subthemes. Three themes were derived from the data analysis, which represent the factors that affected student learning during the CPP namely ‘teaching-learning dynamics’; ‘workplace dynamics’ and ‘suggestions for overall improvement’. The major findings of the research revealed that excessive workload due to perceived staff shortages was the most significant contributing factor that affected the students’ learning. The benefit of peer assisted learning and interaction with positive role models of laboratory medicine was also highlighted. Insights into the different experiences of the MLS students provided information to address challenges students face during the CPP and how current clinical laboratory experiences contributed to students' learning and readiness for practice. Suggestions for reviewing and restructuring of current practices from both industry and university perspectives should be considered and implemented. Improved preparation and exposure to the laboratory prior to the fourth year practice period might help to optimize the CPP for future professionals of laboratory medicine.
- ItemExploring medical students’ perceptions on the effectiveness of a clinical skills rotation at a clinical skills laboratory(Stellenbosch : Stellenbosch University, 2018-03) Rahim, Muhammad Faisal; Smith-Tolken, Antionette; Archer, Elize; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY : Learning skills and competencies through simulation is a safe way of teaching medical students clinical procedures before exposing real patients to their practice. This is the case at the Ziauddin University (ZU) in Pakistan. The study was done after a Clinical Skills Laboratory (CSL) was established where Clinical Skills Rotation (CSR) was taught. The aim of the study was to determine how students experienced this new form of teaching and how it affected the rotations following the training in the CSL. The focus of the CSR was the transfer of knowledge into a variety of skills such as communication, interpersonal, and psychomotor skills, mostly through simulation-based training on manikins and on standardised patients. The study adopted an explorative approach by making use of both qualitative and quantitative data. One-to-one interviews were conducted with participants who attended CSR along with other rotations in the third year of their Bachelor of Medicine Bachelor of Surgery (MBBS) class. Quantitative data was also gathered. The design comprised a quantitative component in the form of a Likert scale type questionnaire coupled with a qualitative component comprising unstructured interviews. The sample was selected from the third year MBBS class of 2016. The students were divided into two groups that completed the questionnaires and took part in the interviews, which the researcher conducted. The data gathered from the questionnaires were collated in tables to indicate the trends found in the answers. The interviews were audio recorded, transcribed, and analysed through thematic analysis using a coding process to develop evolving themes. The quantitative data analysis showed overall positive perceptions and experiences of attending CSR. The majority of respondents perceived that the clinical skills sessions were conducted with clear aims and objectives. There was a clear indication that they thought the educational content was appropriate for a student’s level of understanding. Two thirds of students positively responded, describing the CSL sessions as relevant to their clinical contexts. Most of them agreed that these sessions created interest and enthusiasm among students. The qualitative data showed that most of the students enjoyed learning in a CSL and valued the experiences that would enhance their performance of procedural skills, communication skills, and universal precaution. In addition, skills that students learned at CSR moderately affected their learning in other rotations.
- ItemExploring the perceptions of registrars on communication skills training at the department of Obstetrics and Gynaecology at Stellenbosch University(Stellenbosch : Stellenbosch University, 2019-12) Swart, Hester Alida; Archer, Elize; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: There is strong evidence that health outcomes are improved by effective doctor-patient communication. Additionally, poor communication between healthcare colleagues is associated with medical error. Despite this evidence, there is a lack of training and assessment of communication skills at postgraduate level in South Africa. The views and needs of registrars should be considered when designing a postgraduate communication skills curriculum as it may impact its appropriateness and effectiveness. The aim of this study was to explore registrars’ perceptions of communication skills and the training thereof. This was an exploratory qualitative study that included one-to-one interviews with ten obstetrics and gynaecology registrars at Stellenbosch University. Four strong themes emerged namely registrars’ views on communication skills in general, communicating with colleagues, postgraduate communication skills training practices, and recommendations for communication skills training. The key findings of this study reveal that registrars value communication skills and believe it could be improved with training. They emphasised communication challenges with colleagues, especially consultants. The registrars experience the communication skills training in the department as mostly informal and of variable quality. They recommended that communication skills should be formally taught and assessed. Additionally, they suggested that communication training includes ways to overcome registrar communication challenges with consultants as these likely has a negative impact on both patient care and the learning environment. This study’s results demonstrate the value of a needs assessment as part of a curriculum development initiative.
- ItemFacilitating critical thinking in nursing students : lecturers’ perspectives(Stellenbosch : Stellenbosch University, 2019-04) Went, Amanda; Archer, Elize; Bell, Janet; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: As health care systems become more complex, health professionals are faced with multifaceted situations requiring suitable critical thinking skills. These critical thinking skills allow health professionals to integrate information and make prompt, appropriate decisions resulting in safe and effective health care practice. Health professional education is fundamental to facilitating the development of critical thinking skills in students. However, there are many factors affecting this process including teaching strategies, the lecturers, the students, academic literacy, the educational institution, and various societal factors. The aim of this study was to explore lecturers’ perspectives of strategies that could facilitate the development of critical thinking in nursing students in class room teaching, in order to make recommendations for lecturers. A qualitative study using semi-structured interviews was conducted at a nursing college in the Western Cape. The data were analysed using an iterative process that involved repeated readings of the transcripts, identification of codes, and the subsequent generation of two focus areas. The understanding of critical thinking by the lecturers revealed in the first focus area, was found to be primarily related to cognitive skills in nursing students with more limited reference to their affective skills. The general finding related to the second focus area, was that lecturers continue to use the lecture method as their main teaching strategy, rather than more student-centred strategies that promote active learning and assist with the facilitation of critical thinking in students. There was a realisation among the respondents that the lecture method did not necessarily facilitate critical thinking in nursing students. Yet, resource constraints such as large student numbers and the large amount of content in the curriculum were the reasons proposed by the lecturers for continuing with the lecture method. Other resource constraints mentioned by the lecturers included the lack of availability of Wi-Fi in classrooms and the lack of a well-equipped simulation laboratory that could assist with the facilitation of critical thinking in the student. The preparedness of lecturers to teach critical thinking seemed to be problematic with lecturers expressing a desire for further education and training on critical thinking and various appropriate teaching strategies to facilitate it. Language was also seen as a challenge in the facilitation of critical thinking. This study represents the first of its kind in this institution and it is hoped that this contribution would add to the conversations that are currently being held about the knowledge, skills, and attitudes that educators have in relation to critical thinking.
- ItemFactors that influence a group of MBChB lecturers to use blended learning in their teaching(Stellenbosch : Stellenbosch University, 2021-03) Brits, Elizabeth; Archer, Elize; Strydom, Sonja; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: Information and communication technologies (ICTs) are globally an emerging development in education. The trend is increasingly to integrate blended learning approaches in higher education institutions to create alternative learning opportunities. Blended learning has the possibility of accommodating students in making learning more accessible and creating a more satisfying learning experience. However, lecturers do not appear to be convinced of the benefits of using digital technologies in their teaching. Digital technologies are often only used for tasks such as word processing and internet searches instead of for the full benefits they can offer in teaching and learning. This raised the question of what the different factors are that influence MBChB lecturers’ integration of blended learning in their teaching. The study took on a qualitative exploratory research design in an attempt to better understand how teachers view blended learning and to possibly identify factors that enhance or inhibit their use of digital technologies in their teaching. The population for this study consisted of the ten module co-ordinators in the third year of the MBChB programme. Semi-structured, individual interviews were conducted with a total of eight participants. All the participants were experts in their respective medical fields, with several years of teaching experience both in the clinical and classroom settings. The participants were from a variety of specialities within medicine, which aided in rich data collection. The transcribed interviews were coded and then themes were grouped by means of a thematic analysis process. This study identified five main themes with various subthemes. These were meaning-making of blended learning, the medical curriculum, teachers’ individual differences, the medical student and institutional factors. It was evident that teachers’ dual role as clinicians and teachers as well as their multiple responsibilities influence their behaviour in the implementation of a blended learning approach. It was also found that the learning environment plays a key role in a clinician teacher’s implementation of a blended learning approach. Lastly, the importance of faculty development was highlighted and it is clear that teachers need continuous support and development in the implementation process, which implies longitudinal faculty development opportunities. These findings indicate that blended learning is not necessarily as useful in all learning environments, and that some teachers actually fail to see the usefulness of blended learning in the clinical learning environment. However, contextualised faculty development opportunities could inform the affordances of blended learning in the different learning environments.
- ItemFinal-year dental students’ perceptions of verbal feedback in the clinical setting(Stellenbosch : Stellenbosch University, 2018-12) Peck, Craig William; McNamee, Laksini; Archer, Elize; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: It is well accepted that verbal feedback has a range of benefits which spans from improving student learning and performance, to increasing professional collaborative dialogue and communication, and even for the development of student identity and self-worth. This study was undertaken at the Dental Faculty of the University of the Western Cape, on a cohort of 71 final year dental students. The purpose of the study was to quantify final year dental students’ perceptions of verbal feedback practices within the clinical setting, as well as to identify any association between their perceptions with gender and home language. The main constructs investigated included the nature of feedback, the value of feedback, the clinical environment and supervisor-specific factors which impact on verbal feedback practices, using a quantitative approach (questionnaire-based) with a strong qualitative component. The findings of this study indicate that not only are final year dental students aware of the multiple benefits of verbal feedback for the improvement of both their theoretical knowledge and clinical skills, but they feel that not enough time is devoted to verbal feedback practices following their clinical sessions. Although dental students within this study are aware of the inherent limiting nature of the dental clinical environment, the over-arching themes which emerged from open-ended written responses overwhelmingly identified the high value that students place on supervisor actions and behaviours during feedback. These findings are well aligned with current literature on feedback practices, which emphasise the importance of mutual respect, professionalism and autonomy of thought as key variables which underpin successful verbal feedback delivery by educators. It is hoped that this study would have contextual significance for the Dental Faculty as well as contribute to the overall body of knowledge regarding feedback, and lead to the development of a faculty student feedback policy. Such a policy would not only have benefit for improving student learning experiences, performances and outcomes, but would directly translate to improving dental care delivery to faculty patients.
- ItemThe first African regional collaboration for emergency medicine resident education : the influence of a clinical rotation in Tanzania on Ethiopian emergency medicine residents(Stellenbosch : Stellenbosch University, 2017-12) Murray, Britrany; Archer, Elize; Smit, Liezl; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY : The African Federation for Emergency Medicine (AFEM) has regional groups dedicated to furthering African Emergency Medicine. In AFEM East, Tanzania and Ethiopia have emergency medicine residency programs at Muhimbili University of Health and Allied Sciences (MUHAS) and Addis Ababa University (AAU), respectively. In 2016, residents from AAU began to rotate for one month at MUHAS. To our knowledge this represents the first formal rotation of its kind, with residents from one African emergency medicine program rotating in another similarly resourced country as part of their clinical training. Prior to this study, there had been no formal evaluation of this program. The aim of this study was to evaluate the influence of a clinical rotation in Tanzania on Ethiopian emergency medicine residents. This was an evaluative study utilizing narrative information from semi-structured interviews with residents that participated in the first AAU-MUHAS rotation. Interview questions focused on residents’ experiences during their rotation in Tanzania, their perceptions of the rotation, and the impact of the rotation. Interviews were recorded and transcribed. Anonymous transcriptions were then coded and themed using an inductive, iterative approach. All 13 Ethiopian residents who participated in the first year of the AAU-MUHAS rotation were interviewed individually. Four strong themes emerged from the interviews: 1) exposure to a different system, 2) the teaching environment, 3) rotation objectives, and 4) effects of the rotation upon returning to AAU. In conclusion, a rotation in Tanzania was found to positively influence Ethiopian emergency medicine residents. Key findings included: exposure to a new system of emergency care highlighted areas for improvement in their home setting, an environment conducive to teaching was greatly valued by residents, and the rotation resulted in implementable initiatives to improve patient care and education at AAU.
- ItemLearning in the clinical skills and simulation centre University of Ghana : medical students’ experiences of teaching sessions : an exploratory study(Stellenbosch : Stellenbosch University, 2016-03) Muniru, Ayishetu; Archer, Elize; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH ABSTRACT: Many Clinical Skills and Simulation Centres have been established in medical institutions around the world. In Ghana, the Clinical Skills and Simulation Centre, University of Ghana Medical School is a facility for simulation based medical training. The Centre provides a realistic patient experience, which is artificially created to mimic substantial experience of the real world in a fully participatory and interactive situation. The desire to ensure patient safety and the quality of patient care delivery has become necessary and it is for this reason that simulation has a huge role to play. This research explores medical students’ experiences of teaching and learning sessions in the Clinical Skills and Simulation Centre, University of Ghana Medical School with the aim to optimise teaching and learning of clinical skills. Qualitative data was collected from medical students through focus group discussions. The data were analysed using thematic networks, which is an analytical tool for qualitative research. Several basic themes were identified from the interview transcripts, which were categorised into five broad organizing themes being; positive experiences, negative experiences, challenges, motivation and recommendations. Out of these organising themes, emerged the global theme, which was medical students’ experiences of teaching sessions at the Clinical Skills and Simulation Centre. The thematic analysis identified the process of skills acquisition as a mainly positive experience expressed by the medical students amidst the negative experience of some of the students and a challenge with regards to the distance of the Centre from the main campus. Students were however, motivated by their need to practise and suggested some useful recommendations to improve upon their teaching and learning sessions at the Centre.
- ItemMedical students perceptions about a newly implemented clinical skills module(Stellenbosch : Stellenbosch University, 2014-04) De Kock, Carina; Archer, Elize; De Villiers, Adele; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.INTRODUCTION: For this MPhil research assignment, I have chosen to write an article based on a small scale research project conducted in the Clinical Skills Centre (CSC) at Stellenbosch University. Medical students’ perceptions were gathered in order to evaluate the usefulness and relevance of the Clinical Skills module and the different components thereof as experienced by the students themselves. This in the end led to valuable feedback that were given to the course coordinators which in turn may lead to curricula changes being made to improve the overall teaching and learning experience for future medical students rotating through the CSC.
- ItemMedical students’ perspectives on the development of empathy and its determinants during their undergraduate training(Stellenbosch : Stellenbosch University, 2020-11) Chhabra, Namrata; Archer, Elize; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: BACKGROUND: Empathy is a crucial component of clinical practice and professionalism. Several medical institutes and professional organisations now encourage empathy in medical students. However, studies have reported that empathy erosion occurs during medical training and that medical students demonstrate a decrease in self-reported empathy during their studies. AIM OF THE STUDY: This study aimed to explore medical students’ perspectives on the development of empathy during their undergraduate training. METHODOLOGY: A descriptive phenomenological approach was used to generate illustrations of empathy development and decline that had educational significance and applicability. Individual online semi-structured interviews were conducted to elicit experiential details from twelve final-year medical students. The interview recordings were transcribed verbatim, and data were analysed employing Braun and Clarke’s (2006) thematic analysis method. RESULTS: Most of the students defined empathy as having four interrelated and overlapping dimensions: cognitive, affective, behavioural, and moral. They believed that empathising with patients was a bidirectional relational process. A notable finding of this study was that the empathic behaviour of medical students had improved over time in the medical school, contrary to the empathy decline reported by several researchers. They attributed their empathy development to real patient encounters, positive role-modelling by teachers, and attainment of confidence, personal maturity, and emotional regulation in their behaviours. Students identified exams, academic overload, time constraints, personal stresses, negative role models, unconducive learning environments, lack of formal empathy training, and emphasis on the biomedical aspect of the curriculum as barriers to the development of empathy. They recommended early clinical exposure, increased patient contact, formal empathy training, and introduction of medical humanities in the curriculum to improve their empathic behaviour with patients. CONCLUSION: Empathy is more than a personal attribute; this multifaceted, bidirectional relational process is affected by a multitude of factors. Medical institutes should identify and address the barriers to empathy development and encourage the holistic development of medical students. Medical educators should model their behaviour accurately for their increasing roles and responsibilities and support the students in their empathic expressions with patients.
- ItemNewly qualified registered nurses’ experiences and perceptions of mentorship in a public private partnership hospital in Lesotho(Stellenbosch : Stellenbosch University, 2019-04) Thamahane, Moratuoa Suzan; Volschenk, Mariëtte; Archer, Elize; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: Background: Mentoring is used widely in the nursing fraternity to enhance socialisation and professional development for newly employed registered nurses. To date, most studies have explored the mentoring needs of newly qualified nurses and outcomes of mentoring programmes within high resource contexts. This qualitative study addressed the gap identified in the literature by exploring the experiences and perceptions of newly qualified registered nurses regarding mentoring as a mechanism for professional socialisation and development within a resource-constrained context that did not have a structured mentoring programme in place. Objectives: The objectives of this study were to explore the mentoring needs of newly qualified registered nurses, determine barriers and enablers to the mentoring process as experienced by newly qualified registered nurses, and to make recommendations regarding the possible development of a structured mentoring programme at Queen Mamohato Memorial Hospital (QMMH). Methods: For the purpose of this study, an exploratory descriptive design, using qualitative methodology to generate data, was selected. Focus group interviews were used to explore newly qualified registered nurses’ experiences and perceptions of mentoring during their first year of employment at QMMH. Themes and sub-themes were identified by means of content analysis. Results: The results of this study showed that newly qualified registered nurses have the need for a structured mentoring process during their first year of employment. Various barriers related to mentoring at QMMH were identified, including the lack of an adequate induction process, the high workload experienced by both the newly employed registered nurses and the experienced registered nurses who were expected to mentor them, and the negative attitude of some of the experienced staff members towards newly employed registered nurses. Potential enablers to mentoring at QMMH included multi-disciplinary team work and the welcoming attitude that some of the nurses in the wards displayed towards newly qualified registered nurses when they entered the wards for the first time. Conclusion: The findings of the study reflected the challenges experienced by newly qualified registered nurses in terms of professional growth and development during their first year of clinical practice. The findings revealed important information regarding mentoring at QMMH, which enabled the researcher to develop a clear understanding of participants’ experiences and perceptions. It is envisaged that the findings of this study will make a contribution to the development of a needs-oriented mentoring programme at QMMH. The need for further research, that explores mentoring as a mechanism for professional socialisation and development, was also identified.
- ItemDie persepsies van nuut-gekwalifiseerde professionele gesondheidswerkers oor hulle verpligte gemeenskapsdiens in ‘n landelike gemeenskap in die Wes-Kaap(Stellenbosch : Stellenbosch University, 2017-03) Esterhuyse, Wilhelmina Jacoba; Archer, Elize; Keiller, Lianne; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health professions education.ENGLISH SUMMARY : Every person is entitled to basic health care, but access to health services is a global problem. Many rural communities have no basic health services available, with health professionals concentrated in and around urban areas and in private practice. Registration of health professionals with the Health Professionals Council of South Africa is only possible when the one year of community service has been completed. Compulsory community service commenced in 1998 and was expanded to include all the health professions by 2016. The goals of compulsory community service are to take health services to rural communities, to foster continued education, and to stimulate retention of health workers in rural communities through improved social accountability. This, however, is not always the goal of the health professionals performing this community service. Various studies regarding the perceptions of health practitioners on compulsory community service have been done. This study was intended to explore the perceptions of the health practitioners on their compulsory service in a rural district in the Western Cape. Nine newly qualified professionals who had completed their community service in the Matzikama Sub-District between 2006 and 2012, participated in the qualitative study. The Matzikama district services are delivered at the local provincial hospital, as well as at the 17 clinics that are spread over the entire district. Three participants worked at the hospital and did not attend to any clinics in the district, while six were allocated to the clinics, but not to the hospital. Internal and External factors were identified as themes of the semi-structured interviews held with the study participants as those which influenced their experience of community service in the Matzikama Sub-District. The perceptions of health professionals in this area highlighted a lack of support for newly qualified professionals, as well as a need for management and leadership skills to be better incorporated in their pre-qualification training. Final recommendations to the Department of Health include better orientation and planning regarding the allocation of professionals to rural areas as a mechanism for providing a better experience for the newly-graduated health professional.
- ItemRole modelling : a critical component of bedside teaching in a critical care unit(Stellenbosch : Stellenbosch University, 2020-03) Herman, Vironica; Archer, Elize; van der Merwe, Charmaine; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: In the evolving and complex healthcare system, clinical teaching and training of new nurses in the critical care unit is indispensable to ensure safe and quality healthcare. The registered professional nurses’ (RPN) awareness and understanding of role modelling being a crucial teaching and learning method depends on their contribution to growth and development. Role modelling is a pervasive means where development through observation and practice in the clinical environment occur. Therefore, it is a foundation in helath professions education. The aim of the study is to determine how RPNs understand role modelling as a teaching strategy. A qualitative, phenomenological design was used to obtain data by conducting semi-structured interviews with purposive sampling of seven RPNs working in the critical care unit of a tertiary teaching hospital in the Western Cape. Interviews were audio recorded and transcribed verbatim. The transcribed data were analysed and manually coded, which generated two themes that illustrated the findings of the study. The first theme illustrated the participants’ understanding of role modelling and revealed that new nurses intentionally and unintentionally aspire to imitate specific behaviour and that they aquire knowledge and skills in critical care nursing, including soft skills. Furthermore, reflection was used to link information or actions to foster learning. The second theme found that a number of challenges prevent RPNs and new nurses from teaching and learning through role modelling. The findings illustrated that the RPNs do not understand that role modelling is implicit in executing their daily tasks. Participants’ eagerness to use rolemodelling as a teaching and learningmethod could not be questioned, but their utilisation thereof should be reinforced. The study represents the first of its kind at this institution and presumes that this contribution could add value to the understanding of role modelling as a teaching method for healthcare practitioners.
- ItemStepping on the ladder of integration : the perspectives of foundational science teachers on a discipline-based curriculum(Stellenbosch : Stellenbosch University, 2019-04) Omoniyi-Esan, Ganiat Olutoyin; Archer, Elize; Meyer, Ilse; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: Integrated curriculum is defined variously by different researchers. Integration involves intentionally bringing together knowledge, skills, values and attitudes within and across courses to develop a more holistic understanding of the subject. The College of Health Sciences, Obafemi Awolowo University (CHS, OAU) Ile-Ife, Nigeria, was established over forty-five years ago and still runs the traditional discipline-based curriculum. There are an overwhelming number of calls by some faculty members at the College to review the medical curriculum and to change it to a more innovative curriculum. Most curricular innovations have integration as part of their components. For integration to be effective, the teachers need to be involved in the curriculum development, design, implementation and the process of evaluation. Full understanding, support and commitment of teachers are necessary for effective integration of the curriculum. The learning needs of the foundational science teachers also need to be addressed and the level of integration desired must be understood. The purpose of this research assignment was to explore the perspectives of foundational science teachers on integration of courses within a discipline-based curriculum. The understanding of foundational science teachers of the term ‘Integration within the curriculum’ and their perceptions of the need for integration, were explored. When integrating the foundational sciences and possible strategies by which integration could be implemented, barriers and enablers were identified. This was a qualitative enquiry based study within an interpretive paradigm framework. The data was obtained by the researcher through focus group discussions conducted with participants. Using the process of thematic analysis the perspectives of the foundational teachers were grouped into the themes that emerged. Four prominent themes that emerged were knowledge of integration, perception of the need for and benefits of integration, the enablers and barriers to integration, and suggestions in order to implement curriculum integration. The participants demonstrated their understanding of what curriculum integration meant and expressed their perspectives of the need for and benefits of integration. Various barriers were identified and suggestions were discussed with some recommendations made.
- ItemStudent Nurses’ Experience of Feedback During Clinical Learning at a Rural Nursing School: An Exploratory study(Stellenbosch : Stellenbosch University, 2016-12) Masava, Beloved; Archer, Elize; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY : Introduction and background Feedback is an integral element of clinical teaching and acts as a platform for identification and correction of learners’ mistakes to improve their future performances. Without feedback mistakes could be repeated in future as the learner will be unaware of such. Learners’ enrolments at Paray School of Nursing have quadrupled during the past four years. Since feedback provision during clinical practice of learners is mainly done by clinical teachers, an imbalance between learners and clinical nursing staff enrolments during the past five years has increased the workload of nurses as they strive to balance between teaching role and patient care. These circumstances have casted a doubt on the adequacy and quality of feedback learners are subjected to during their clinical practice. Aim and purpose of the study The aim of this study was to explore learners’ experiences of feedback they received during clinical practice. The results better the understanding of the learners’ experiences of such feedback. Methods A qualitative explorative descriptive design was used to describe the learner’s understanding of the concept of feedback during clinical practice. Purposive sampling technique was utilised to select a sample of twenty eight learners who participated in focus group discussions. Sample size was determined on the basis of data ‘saturation’. Selected students were asked to give a written consent to participate in the study. A semi-structured interviews schedule was used to guide focus group discussions. Data obtained was analysed through content thematic analysis. Findings and conclusion Ten themes emerged from data gathered namely learners’ understanding of feedback; feedback occurrence; means for feedback provision; learners’ perception of impact of feedback on learning; learners’ interest in feedback; learners’ response to feedback; feedback content; positive and negative feedback; lack of standards for feedback provision as well as timing of feedback provision. Generally, learners expressed dissatisfaction regarding the feedback citing that it lacks necessary scaffolds to help them to improve their performance. Besides, learners’ shared experiences demonstrated that feedback provision process does not conform to guidelines from literature. However, learners’ responses supported the opportunity of introducing self-regulation feedback model in future.