Browsing by Author "Coetzee, Francois"
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- ItemEquipping family physician trainees as teachers : a qualitative evaluation of a twelve-week module on teaching and learning(London : Biomed Central, 2014-10) De Villiers, Marietjie R.; Cilliers, Francois. J.; Coetzee, Francois; Herman, Nicoline; Van Heusden, Martie; Von Pressentin, Klaus. B.; Faculty of Medicine and Health Sciences. Dept. of Interdisciplinary Health Sciences. Family Medicine and Primary Care.ENGLISH ABSTRACT: There is a dire need to expand the capacity of institutions in Africa to educate health care professionals. Family physicians, as skilled all-rounders at district level, are potentially well placed to contribute to an extended training platform in this context. To play this role, they need to both have an understanding of their specialist role that incorporates teaching and be equipped for their role as trainers of current and future health workers and specialists. A teaching and learning capacity-building module was introduced into a new master’s programme in family medicine at Stellenbosch University, South Africa. We report on the influence of this module on graduates after the first six years. Methods: A qualitative study was undertaken, interviewing thirteen graduates of the programme. Thematic analysis of data was done by a team comprising tutors and graduates of the programme and an independent researcher. Ethical clearance was obtained. Results: The module influenced knowledge, skills and attitudes of respondents. Perceptions and evidence of changes in behaviour, changes in practice beyond the individual respondent and benefits to students and patients were apparent. Factors underlying these changes included the role of context and the role of personal factors. Contextual factors included clinical workload and opportunity pressure i.e., the pressure and responsibility to undertake teaching. Personal factors comprised self-confidence, modified attitudes and perceptions towards the roles of a family physician and towards learning and teaching, in addition to the acquisition of knowledge and skills in teaching and learning. The interaction between opportunity pressure and self-confidence influenced the application of what was learned about teaching. Conclusions: A module on teaching and learning influenced graduates’ perceptions of, and self-reported behaviour relating to, teaching as practicing family physicians. This has important implications for educating family physicians in and for Africa and indirectly on expanding capacity to educate health care professionals in Africa.
- ItemFactors influencing post-partum women’s choice of an implantable contraceptive device in a rural district hospital in South Africa(Cogent OA, 2018) Potgieter, Francois; Kapp, Paul; Coetzee, FrancoisBackground: A single-rod subdermal contraceptive implant containing 68 mg of etonogestrel, ImplanonNXT®, was introduced to the South African healthcare system in 2014. Initially the new device was well received but later uptake tapered off. A need was identified to determine the factors that influence women's choices with regard to the use of ImplanonNXT® in order to improve its uptake. The aim of this study was to explore the factors that influence women’s choice of ImplanonNXT®. Method: A qualitative study was performed, using semi-structured interviews to explore patients’ knowledge, attitudes and beliefs regarding ImplanonNXT®. Ten patients were interviewed at Knysna Hospital. Findings: There was confusion amongst women about the harms and benefits of using ImplanonNXT® and it became apparent contraceptive counselling during pregnancy greatly affects the choices they make. Other factors that influenced the participants’ choice with regard to contraception included social influences, preference for familiar methods and the side effect profile of the various options. Perceptions of the adverse side effects of the implantable device added to confusion and fear of this method, which influenced women’s ideas about the use of ImplanonNXT®. Poor communication and reluctance from clinic staff to discuss ImplanonNXT® during antenatal visits contributed to poor knowledge about the implantable device and its side effects. Conclusion: Clearer communication during antenatal visits with pregnant women may address some of the fears and beliefs that surround its side effects, workings and efficacy. The fear of possible side effects should be a focus for counselling and education, as it predominantly contributes to women’s confusion and fear of the device. Further research is needed to address this as well as evaluate if interventions such as better counselling and a dedicated team approach can change the attitudes and beliefs of post-partum women towards the ImplanonNXT® device in the South African district health system.
- ItemA survey of wound care knowledge in South Africa(Stellenbosch : University of Stellenbosch, 2015-07-23) Coetzee, Francois; Hagemeister, Dirk; University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health SciencesAbstract Chronic wounds afflict millions worldwide, incurring significant health care costs and chronic suffering. Clinicians are often unsure about treatment, resulting in poor outcomes. Objective To determine the scope of knowledge possessed by fifth year medical students, general practitioners (GP’s) and surgical registrars, concerning chronic wound management. Design Cross sectional study Methods Deans of eight South African medical schools received letters requesting information regarding time devoted to wound-care training. Knowledge-based questionnaires were distributed to final-year students at two universities, surgical registrars at three universities and general practitioners attending refresher courses. Result. Four medical schools replied, of whom only two offered formal teaching. 162 medical students, 45 GP’s and 47 surgical registrars completed questionnaires. The overall median (25th–75th percentiles) knowledge scores for registrars, GP’s and students were 65%;(55%–70%), 55%;(45%–65%) and 45%;(35%–50%) respectively. Whereas the scores of registrars and GP’s did not differ, the student scores were significantly less. Only 32% of registrars and 18% of GP’s attained scores of 70% or more. 96% considered training to be inadequate. Interest in wound-care was only mild to moderate, with more GP’s than registrars requesting literature. Conclusions Very little, if any training on chronic wounds is offered in South Africa. The levels of knowledge cannot be considered adequate for successful treatment, nor for teaching to undergraduates. This preliminary study cannot reflect the attitudes and knowledge throughout the country; however it is clear that there is a need for improved education about these conditions that have huge clinical and economic consequences.
- ItemA survey of wound care knowledge in South Africa(Stellenbosch : Stellenbosch University, 2010-12) Coetzee, Francois; Hagemeister, Dirk; Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Family Medicine and Primary Care.Chronic wounds afflict millions worldwide, incurring significant health care costs and chronic suffering. Clinicians are often unsure about treatment, resulting in poor outcomes. Objective To determine the scope of knowledge possessed by fifth year medical students, general practitioners (GP’s) and surgical registrars, concerning chronic wound management. Design Cross sectional study Methods Deans of eight South African medical schools received letters requesting information regarding time devoted to wound-care training. Knowledge-based questionnaires were distributed to final-year students at two universities, surgical registrars at three universities and general practitioners attending refresher courses. Result. Four medical schools replied, of whom only two offered formal teaching. 162 medical students, 45 GP’s and 47 surgical registrars completed questionnaires. The overall median (25th–75th percentiles) knowledge scores for registrars, GP’s and students were 65%;(55%–70%), 55%;(45%–65%) and 45%;(35%–50%) respectively. Whereas the scores of registrars and GP’s did not differ, the student scores were significantly less. Only 32% of registrars and 18% of GP’s attained scores of 70% or more. 96% considered training to be inadequate. Interest in wound-care was only mild to moderate, with more GP’s than registrars requesting literature. Conclusions Very little, if any training on chronic wounds is offered in South Africa. The levels of knowledge cannot be considered adequate for successful treatment, nor for teaching to undergraduates. This preliminary study cannot reflect the attitudes and knowledge throughout the country; however it is clear that there is a need for improved education about these conditions that have huge clinical and economic consequences.
- ItemTraining for transformation : opportunities and challenges for health workforce sustainability in developing a remote clinical training platform(Frontiers, 2021-04) Muller, Jana; Reardon, Cameron; Hanekom, Susan; Bester, Juanita; Coetzee, Francois; Dube, Kopano; Du Plessis, Elmarize; Couper, IanBackground: In 2018, Stellenbosch University’s Ukwanda Centre for Rural Health led a faculty initiative to expand undergraduate health professions training to a new site, 9 hours drive from the health sciences campus in the sparsely populated Northern Cape Province of South Africa in the town of Upington. This is part of a faculty strategy to extend undergraduate health sciences training into an under-resourced part of the country, where there is no medical school. During 2019, the first year of implementation, four final year medical students undertook a longitudinal integrated clerkship at this site, while final year students from other programmes undertook short 5-week rotations, with plans for extending rotations and including more disciplines in 2020. The aim of this study was to understand stakeholder perceptions regarding the development of Upington as a rural clinical training site and how this influenced existing services, workforce sustainability and health professions education. Methods: An iterative thematic analysis of qualitative data collected from 55 participants between January and November 2019 was conducted as part of the case study. A constructivist approach to data collection was utilized to explore participants’ perceptions, experiences and understanding of the new training site. Triangulation of data collection and reflexive thematic analysis contributed to the trustworthiness of the data and credibility of the findings. Findings: The perceptions of three key groups of stakeholders are reported: (1) Dr. Harry Surtie Hospital and Academic Programme Managers; (2) Supervising and non-supervising clinical staff and (3) Students from three undergraduate programs of the Faculty. Five themes emerged regarding the development of the site. The themes include the process of development; the influence on the health service; workforce sustainability; a change in perspective and equipping a future workforce. Discussion: This case study provides data to support the value of establishing a rural clinical training platform in a resource constrained environment. The influence of the expansion initiative on the current workforce speaks to the potential for improved capacity and competence in patient management with an impact on encouraging a rural oriented workforce. Using this case study to explore how the establishment of a new rural clinical training site is perceived to influence rural workforce sustainability and pathways, may have relevance to other institutions in similar settings. The degree of sustainability of the clinical training initiative is explored.