Browsing by Author "Bezuidenhout, J."

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    Discourse of final-year medical students during clinical case presentations
    (Health and Medical Publishing Group (HMPG), 2011-06) Botha, H.; Van Schalkwyk, G. I.; Bezuidenhout, J.; Van Schalkwyk, S. C.
    Introduction: The need for medical students to adopt a discourse appropriate to the field is repeatedly emphasised by teaching staff during lectures and ward rounds. The acquisition of such discourse is often not assessed, resulting in inconsistency between the levels used among students of similar academic backgrounds. Objective: The aim of this study was to determine the extent to which appropriate discourse was adopted by 9 medical students early in their final year during clinical case presentations, and to compare this usage with the students’ final results. Methods: Transcriptions of recorded case presentations by 9 students were assessed by 2 experts and a peer evaluator, using a rubric which drew on prior research in medical discourse, and included the prominent themes of terminology and thematic staging. These were then compared with their academic results. Results: Our findings show that most students are able to use the appropriate terminology when they reach their final year of study. However, our data also support the hypothesis that students with similar academic backgrounds may display considerable variation in their level of discourse. Although it appears as if the students were all beginning to shift towards a more mature form of medical discourse, the degree to which this occurs is sporadic. The apparent absence of a relationship between discursive competencies and academic achievement may suggest that the ability of assessment to encourage the adoption of disciplinary discourse is perhaps not being optimally applied, although further research is required.
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    An evaluation of the diagnostic adequacy and immunocytochemistry of manual liquid-based smears in breast aspirates
    (Medpharm Publications, 2013) Shibemba, A. L.; Wright, C. A.; Bezuidenhout, J.; Schubert, P. T.
    The aim of this study was to determine if the Syner-Med®/Cell-Solutions® liquid-based cytology (LBC) technique would provide adequate diagnostic material when applied to breast fine-needle aspiration biopsy (FNAB) specimens and to determine its suitability for immunocytochemistry. A prospective study was undertaken of 38 consecutive patients who underwent FNAB of breast masses in the Fine Needle Aspiration Clinic at Tygerberg Hospital, Cape Town, over a period of six months. Conventional smear cytology slides (CSC) were formulated and the material that remained in the needle was used to prepare the LBC Syner-Med®/Cell-Solutions® slides. The CSC and LBC slides were evaluated by two pathologists. The assessed parameters were cellularity, background and representative diagnostic material. Immunocytochemical stains for pancytokeratin (MNF-116) and oestrogen receptor were performed in each case. In 33 cases (87%), LBC compared favourably with CSC. Adequacy rates of 84.2% for CSC and 76.3% for LBC were found. A diagnosis was made in 78.9% of the CSC cases and in 71% of the LBC cases. The LBC slides showed excellent results, with immunocytochemical staining for MNF-116 and oestrogen receptor. The Syner-Med®/Cell-Solutions® LBC fixative and preparation method provides an alternative technique for obtaining well fixed and prepared slides that are suitable for diagnostic cytology and immunocytochemistry.
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    Making use of an existing questionnaire to measure patient-centred attitudes in undergraduate medical students : a case study
    (Health & Medical Publishing Group, 2014-09) Archer, E.; Bezuidenhout, J.; Kidd, M.; Van Heerden, B. B.
    Background. Patient-centred care is widely acknowledged as important to achieve improved patient outcomes in healthcare. Therefore, it is vital that medical schools should foster this attitude in their students. Studies report that students are becoming less patient-centred in the period between entry to medical school and graduation. Objective. To determine the shift in attitude towards patient-centredness in a group of South African undergraduate medical students. Simultaneously, the reliability and validity of the Patient-Practitioner Orientation Scale (PPOS) in our context were measured. Methods. A cross-sectional survey was undertaken by asking all the medical students from year 1 to year 6 to complete the PPOS. The mean PPOS score for each cohort was calculated using SPSS for Windows. Reliability and validity testing was conducted using Cronbach’s alpha and confirmatory and exploratory factor analysis. Results. The average return rate across the 6 years of study was 81%. The results indicated low initial scores on the PPOS and a decrease in scores over the years of study, with the most dramatic drop being from year 1 to year 2. The PPOS showed poor validity and reliability in our context. Conclusion. The study appears to indicate the same decrease in patient-centredness in our students as has been shown in other studies using this tool. However, the low reliability and validity of the PPOS in our environment means that the result should be interpreted with caution. Factors such as our medical students’ not having had first-hand experience of the doctor-patient relationship and second-language issues may play a role. It is recommended that the PPOS not be used in our context without further exploration of the factors contributing to this loss of reliability and validity.