Centre for Health Professions Education

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https://scholar.sun.ac.za/handle/10019.1/4775

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Browsing Centre for Health Professions Education by browse.metadata.advisor "De Villiers, Marietjie René"

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    Clinical teaching on an expanding training platform : designing a fit-for-purpose faculty development framework for emerging clinical teachers in a resource-constrained environment
    (Stellenbosch : Stellenbosch University, 2018-12) Blitz, Julia; Van Schalkwyk, Susan Camille; De Villiers, Marietjie René; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
    ENGLISH SUMMARY: The research presented in this dissertation was catalysed by a preliminary phase of research which described the journey undertaken by specialist clinicians as they took on the role of clinical teacher. This gave rise to the question of how other clinicians might be assisted on a similar journey, particularly in the context of an under-resourced environment and an expanding clinical training platform. Training in the clinical environment forms a crucial part of medical curricula. Particularly in the later years of the curriculum, it is the component in which students may develop their identity as doctor. Clinicians involved in this phase play a crucial role in the training of medical students. Medical schools are needing to expand their clinical training platforms in order to provide opportunities for greater numbers of students, as well as to offer clinical training that covers the full spectrum of healthcare. In this expansion, medical schools have an obligation to maintain the quality of teaching in the clinical context. Faculty development is a means to strengthen such clinical teaching. In a resource-constrained environment, it is incumbent upon us to consider how best to design faculty development offerings for these emerging clinical teachers. This research was approached from an interpretivist stance, therefore qualitative methods were used. Based on Kern’s six step approach to curriculum development, the targeted needs of emerging clinical teachers were identified by using four different data sets to develop an understanding of current clinical teaching and strategies used to strengthen it. Senior medical students, clinical teachers and staff responsible for faculty development were interviewed and clinical teaching episodes were recorded. Each data set was analysed individually and thereafter all four sets of findings were synthesized and presented as the situational analysis. The findings informed the development of a fit-for-purpose faculty development framework for emerging clinical teachers. The outcome of the study is a fit-for-purpose faculty development framework that is based on four constituent elements. The first is that faculty development be situated within the network of clinical practice, involving not only individuals, but also their clinical practice community and their academic discipline. The second addresses clinical teaching as supervision; the offering of affordances. The third emphasises clinical learning as student engagement, with an essential interplay between the offering of affordances, and the development and exercising of student agency for engagement. The fourth is to tailor-make faculty development offerings that are informed by students’ evaluations of clinical teaching effectiveness. Learning in the workplace needs to be mirrored by teaching in the workplace. This fit-forpurpose framework is offered as a means to assist those responsible for faculty development to meaningfully assist clinicians on the journey to becoming confident clinical teachers.
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    Factors influencing the decision-making process of clinician family physicians during workplace-based assessments in the Western Cape, South Africa
    (Stellenbosch : Stellenbosch University, 2024-03) Eksteen, Lawson Barry; De Villiers, Marietjie René; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Health Systems and Public Health.
    ENGLISH SUMMARY: The integration of Workplace-Based Assessment (WBA) methods into medical education has become more frequently used, bringing assessments into clinical settings. The decision-making process in WBA, crucial for shaping trainee performance and clinician Family Physicians judgments, is intricately influenced by several factors. Understanding these factors is pivotal for advancing assessment outcomes in Health Professions Education. This exploratory, descriptive qualitative research delves into the decision-making process of Family Physicians during mini Clinical Evaluation Exercise (mini-CEX) assessments on postgraduate trainee registrars in Family Medicine. Semi-structured interviews were conducted with six clinician family physicians based in district hospitals who regularly conduct WBA as part of clinical training. Registrars are trained in either small (one supervisor), medium (two supervisors) or large (three or more supervisors) training complexes, and some registrars would be assessed by the same supervisor for the whole training period. This study was conducted to gather in-depth insights into the perceptions that guide their decision-making. The results highlighted a diverse array of factors influencing the decision-making process of Family Physicians conducting mini-CEX evaluations on postgraduate registrars. Each clinician Family Physician has a unique perception of WBA, as well as a specific approach and framework when conducting WBA in the primary setting. Three overarching themes emerged from the data, namely context, relationships, and the educational environment. From these themes, the contextual background was most prominent, and especially the opportunity to use interruptions as learning opportunities. The unique relationship between the supervisor and trainee were also described as a significant factor, and although this can be multifaceted and challenging, it also gives opportunity for richer feedback and more extensive professional growth. The specific educational environment is also a major factor, where previous training, clinical complexity and the available academic time were most valid. These themes underscore the complexity of decision-making in WBA, and although intricate and diverse, hold a pivotal role in the decision-making dynamics, challenging the conventional view of variability as mere human error. These factors should not be viewed as a flawed human error of assessment, but rather different professional elements of clinical characteristics that takes assessment practices in the workplace to a deeper and richer degree of clinical competence.