Browsing by Author "Van Heerden, B."

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    Academic achievement of final-year medical students on a rural clinical platform : can we dispel the myths?
    (Health & Medical Publishing Group, 2015) Van Schalkwyk, S.; Kok, N.; Conradie, H.; Van Heerden, B.
    ENGLISH SUMMARY : Background: There is a growing body of literature relating to the establishment of rural clinical training platforms for medical students describing many positive outcomes, particularly in the case of extended placements. However, students’ fears about their academic achievement while at these sites remain a key concern. Objectives: The study set out to compare the academic achievement in end-of-rotation assessments and final examinations of final-year medical students at a rural clinical school (RCS) with those of their peers at the academic hospital complex (AHC). Methods. A cross-sectional study, comparing the marks of three successive cohorts of RCS and AHC students (2011 - 2013) using t-tests and confirmed with non-parametric rank-sum tests, was conducted. The consistency of the effect of these results across cohorts was assessed by fitting regression models with interaction terms between cohort and group, and tested for significance using F-tests. Independent t-tests were conducted to evaluate differences in the mark attained between the two groups. A p-value <0.05 was considered statistically significant. Results: Comparison of student marks attained across six of the disciplines offered at the RCS suggested there was no difference between the RCS and AHC in each of the three cohorts at baseline. A comparison of the end-of-rotation means showed that RCS students achieved significantly better results in some disciplines. A similar trend was observed for the final examination results across all seven disciplines. Conclusion: Despite small numbers, this study suggests that students who spend their final year at the RCS are not disadvantaged in terms of their academic achievement. Medical students’ concerns regarding academic achievement for those placed at rural clinical sites appear to be unfounded. Students who potentially could be placed at these sites should be made aware of this evidence.
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    'Going the extra mile' : supervisors’ perspectives on what makes a 'good' intern
    (Health & Medical Publishing Group, 2018-10) De Villiers, M.; Van Heerden, B.; Van Schalkwyk, S.
    Background: Much has been published on whether newly graduated doctors are ready for practice, seeking to understand how to better prepare graduates for the workplace. Most studies focus on undergraduate education as preparation for internship by investigating knowledge and skills in relation to clinical proficiencies. The conversion from medical student to internship, however, is influenced not only by medical competencies, but also by personal characteristics and organisational skills. Most research focuses largely on the interns’ own perceptions of their preparation. Supervisors who work closely with interns could therefore present alternative perspectives. Objectives: To explore the views of medical intern supervisors on the internship training context, as well as their perspectives on attributes that would help an intern to function optimally in the public health sector in South Africa (SA). This article intends to extend our current understanding of what contributes to a successful internship by including the views of internship supervisors. Methods: Twenty-seven semi-structured interviews were held with medical intern supervisors in 7 of the 9 provinces of SA. The data were thematically analysed and reported using an existing framework, the Work Readiness Scale. Results: The intern supervisors indicated that interns were challenged by the transition from student to doctor, having to adapt to a new environment, work long hours and deal with a large workload. Clinical competencies, as well as attributes related to organisational acumen, social intelligence and personal characteristics, were identified as being important to prepare interns for the workplace. Diligence, reliability, self-discipline and a willingness to work (‘go the extra mile’) emerged as key for a ‘good’ intern. The importance of organisational skills such as triage, prioritisation and participation was foregrounded, as were social skills such as teamwork and adaptability. Conclusions: This article contributes to our understanding of what makes a successful medical internship by exploring the previously uncanvassed views of intern supervisors who are working at the coalface in the public health sector. It is envisaged that this work will stimulate debate among the medical fraternity on how best to prepare interns for the realities of the workplace. Educational institutions, health services and interns themselves need to take ownership of how to instil, develop and support these important attributes.
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    Pica and the obsessive-compulsive spectrum disorders
    (Health & Medical Publishing Group, 1996) Stein, D. J.; Bouwer, C.; Van Heerden, B.
    Background. The concept of a spectrum of obsessive-compulsive related disorders may have clinical and research heuristic value in the approach to disorders similar to obsessive-compulsive disorder (OCD) in respect of phenomenology and psychobiology. Like other repetitive and ritualistic behaviours, pica may be postulated to fall at times on this spectrum. Methods. Five cases of pica seen at our clinics are presented here in order to test this hypothesis. Phenomenology, neurobiology (where available) and pharmacotherapy data are provided in order to consider a possible relationship with OCD and OCD spectrum disorders. Results. In 2 of the cases, pica appeared to be a compulsion and patients had additional symptoms which met diagnostic criteria for OCD. In 2 of the cases, the clinical picture and neurobiological data were reminiscent of an impulse control disorder. Four of the 5 patients responded to treatment with a serotonin re-uptake inhibitor (SRI). Conclusion. These results are consistent with a hypothesis that at least some cases of pica may usefully be conceptualised as lying within a compulsive-impulsive spectrum of symptoms and disorders.