Masters Degrees (Centre for Health Professions Education)

Permanent URI for this collection

https://scholar.sun.ac.za/handle/10019.1/4777

Browse

Now showing 1 - 20 of 95

Alienation and engagement as framework for characterizing registrars’ perceptions of their learning environment: an exploratory qualitative study
(Stellenbosch : Stellenbosch University, 2016-12) Ooko, Francis Okelo; Van Schalkwyk, Susan Camille; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
ENGLISH SUMMARY : Alienation and engagement as framework for characterizing registrars’ perceptions of their learning environment: an exploratory qualitative study. Research into students’ learning experiences in higher education has often focussed on what has been described as surface, deep or strategic approaches to learning. The approaches theory has been critiqued because it does not account for the influence of the learning environment (Webb, 1997). The concepts of alienation and engagement may be used to characterize student learning experiences in postgraduate medical training as they incorporate the influence of the learning environment and socio-cultural characteristics (Mann, 2001). The purpose of the present study was to explore the registrars’ perceptions of their learning environment through the lens of alienation and engagement. An exploratory qualitative study comprising twelve semi-structured interviews was conducted among registrars at the University of Limpopo, Faculty of Health Sciences between June and October 2015. Qualitative methods were used to analyse the results. Different degrees of alienation and/or engagement could be discerned from the registrars’ perception of their educational environment with regard to: the curriculum design and implementation; integration of theoretical and practical teaching; support from the supervisors, the university, and the teaching hospitals; and inter-professional relationships at the hospitals. This research points to a number of suggestions for future practice including that fostering closer relationships between the institutions’ administrative systems and the registrars could enhance engagement and reduce alienation.
Alignment of current graduate attributes required of medical graduates of the University of Botswana to the expressed needs of users of the Botswana Health Service
(Stellenbosch : Stellenbosch University, 2018-03) Sepako, Enoch; Snyman, Stefanus; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
ENGLISH SUMMARY : Traditionally, the design of health professions curricula was often guided by traditions, values and priorities of academics. This, however, has led to a mismatch of graduates’ competencies to patient and population needs, prompting a push for curricula design that aligns the goals of professional education with the needs of society. Unsurprisingly, needs assessment for curriculum design should include societal needs (expressed by the communities served and derived from health statistics). Others are perceived needs (identified by students/graduates), observed needs (identified by experts and academics) and organisation needs (identified by invested organisations). This research aimed to determine the extent to which graduate attributes of the University of Botswana Bachelor of Medicine, Bachelor of Surgery (MBBS) programme reflect expressed societal needs. There were two research objectives: Firstly, to determine the expressed needs of users of Botswana health service regarding care received from medical doctors. Secondly, to determine how the MBBS graduate attributes are aligned with the identified expressed needs. There is substantial literature on organisational and observed needs, some data on perceived needs and societal needs derived from health statistics to inform the review of the MBBS curriculum. However, there is no documented evidence of expressed societal needs. This gap in the literature served as the rationale for this study. An interpretivist research paradigm and qualitative approach were adopted. Interviews were conducted using the Critical Incident Technique and twelve participants described their good and bad consultation experiences with medical doctors. A purposive sample was selected through village development committees and patient advocacy groups. Eleven themes were identified as expressed societal needs, which include being respectful, empowering, humble, focused, empathetic, unprejudiced, trustworthy, welcoming, humane, thorough and personal. On the contrary, a number of these identified themes do not align with the defined MBBS graduate attributes, including being focused, unprejudiced, trustworthy, welcoming and thorough. This research, even though limited in the context of this assignment, points to the importance of reconsidering the MBBS graduate attributes with a view to making changes that reflect expressed societal needs.
All in a day's work : student nurses' perceptions of their clinical learning experiences in a corporate workplace context
(Stellenbosch : University of Stellenbosch, 2009-12) Volschenk, Mariette; Van Heerden, B. B.; University of Stellenbosch. Faculty of Health Sciences. Centre for Health Science Education.
Introduction: Exposure to the clinical learning environment forms an essential part of nursing education. Individual student perceptions of this multi-dimensional context can greatly influence their clinical learning experiences. Insight into these perceptions may assist nurse educators in facilitating optimal learning outcomes. Aim: The aim of this study was to promote an awareness of the possible impact of various aspects of the clinical learning environment and nursing students’ perceptions thereof, on their learning experiences; and to generate guidelines for facilitating optimal learning outcomes. Methods: A qualitative, interpretive study, investigating nine individual second-year nursing students, was undertaken in a private hospital in South Africa. Interview transcripts were thematically analyzed. Results: Four themes and eleven sub-themes emerged, highlighting the impact of student nurses’ perceptions of the various aspects of the clinical learning environment on their learning experiences. Discussion: The impact of students’ perceptions of the clinical learning environment on their learning experiences is discussed. Recommendations are provided for measures to increase the focus on student-centered learning in the selected clinical context. Conclusion: The challenge remains to best prepare students for the complexities and dynamics of the workplace learning environment, while at the same time modifying this environment to effectively meet students’ learning needs.
An analysis of the experiences of HCWs in improving their performance in the workplace following a multi-method training intervention in a resource-limited setting
(Stellenbosch : Stellenbosch University, 2021-12) Proudfoot, Ian Graham; Blitz, Julia; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
ENGLISH SUMMARY : Introduction: The educational outcomes of training initiatives are usually measured against the achievement of specific quantifiable objectives. This study sought instead to analyse the impact on changed workplace performance of a training curriculum through the personal experiences of the healthcare workers themselves. The three-week training intervention was a combination of classroom, bedside and workplace-based education, aiming to upskill a group of twenty hospital- and primary care-based clinicians in the management of advanced HIV in a rural community in Homa Bay in Western Kenya. The intention of the study was to understand more deeply what elements facilitated improved workplace performance and what challenged it. In so doing, it was hoped that lessons would be learnt to guide the further development of this and other short training curricula of this nature in similar low- and middle-income settings. Methods: Following a phenomenological line of enquiry, in-depth, semi-structured interviews were conducted fourteen months after the training intervention on a convenience sample of twelve of the twenty participants in the training course. The open-ended questions probed the factors leading to success and those challenging improvement in workplace performance, whilst opportunity was also created for free expression of other elements considered relevant. The interview data were analysed following standard interpretive, phenomenological analysis procedures, with the data finally classified into core themes, within two broad categories of factors that promoted improved performance and those that challenged it. CME - Continuing medical education MOH - Ministry of health HCW - Healthcare worker MSF - Médecins Sans Frontières MIV - Menslike immuniteitsgebreksvirus TLU - Teaching and learning unit LMIC - Low- and middle-income countries NGO - Non-governmental organisation Results: Three core areas of workplace performance were impacted positively by the training intervention, namely, clinical skills, teaching competence, and program development. Contributing to this were a number of different elements, including the classroom teaching strategies, the reference texts provided, the bedside teaching, and the engagements with a variety of colleagues in the workplace over the subsequent months. The challenges to improved performance fit into two broad categories: weaknesses in the healthcare system, and the negative influences of people, including senior colleagues, ministry of health counterparts, junior colleagues, or the patients themselves. Conclusions: Similar to the roles played by a sports coach, the role of the educator is not only to facilitate improved technical skills but also to recognise and further develop the individual agency of the players and to build resilience to thrive, even in adversity. Drawing on the established learning theories of adult learning, situated learning and social constructivism, further augmented by a wealth of empiric evidence in health education studies in low- and middle-income countries, the teaching and learning strategies were shown to contribute significantly to improved workplace performance. The individual agency of the healthcare workers, especially in teaching and program management roles in primary care was a surprise finding, pointing us, as educators, to a greater focus in the future towards not only anticipating this but also taking specific steps to harness this potential. Finally, in the face of the numerous challenges to improved workplace performance, all too frequently encountered in these rural settings, attention needs to be focused in the future on building greater resilience and capacity to manage these challenges.
Approaches, perceptions and conceptions of 3rd year physiotherapy students in a problem-based learning module
(Stellenbosch : University of Stellenbosch, 2010-12) Keiller, Lianne; Louw, A. J. N.; University of Stellenbosch. Faculty of Health Sciences. Centre for Health Sciences Education.
Aim: The aim of this study was to investigate the approaches, conceptions and perceptions toward learning of undergraduate Physiotherapy students in a PBL module in order to inform curriculum development and enhance facilitation of learning at the Stellenbosch University Division of Physiotherapy. Methodology: A mixed-method, descriptive study was conducted during 2010. Physiotherapy students currently in their 3rd year of the course, completed the Revised Two-factor Study Process Questionnaire (R-SPQ-2F) at the commencement of the academic year and again at the end of the first semester. The aim of this questionnaire is to determine the deep and surface approach toward learning of participants. Students also completed a perception of learning questionnaire and participated in focus group discussions to evaluate their perceptions and conceptions of learning in the module. Results of the three data instruments were analysed statistically, descriptively and phenomenographically, respectively. Results: There was a 100% response rate to the R-SPQ-2F and perception questionnaires, with only 6 out of 16 participants responding to invitations for focus group interviews. There were a statistically significant greater number of students who adopted a deep approach toward learning at the commencement of the academic year. An increase in those with a deep approach and a decrease in those with a surface approach toward learning were seen at the end of the first semester. This shift was however not significant. Students showed a trend toward an increase in their intrinsic interest in the learning material as the module progressed. Clinical reasoning and internalizing information were seen as two of the advantages of the instructional approach. Conversely, the disadvantages of the module included the perception that the instructional approach used is time consuming and concerns regarding quality and accuracy of learning material. The presence of dysfunctional group dynamics also plays a role in students perceptions of disadvantages in APT. Students conceived the module to have an effect on their approach toward learning and both personal and professional skills. Conclusion: The Applied Physiotherapy 373 module had no significant effect on students‟ approach toward learning. The results of this study however are not conclusive on why and how this lack of significant effect is present. Further research is needed to determine the long-term changes in approach toward learning and the possible determinants of these changes. This should be done in conjunction with implementation of quality assurance mechanisms for learning material, introduction of multi-media into PBL sessions and earlier preparation of students for the change in learning environment.
Assessment of professional behaviour in occupational therapy education: investigating assessors’ understanding of constructs and expectations of levels of competence.
(Stellenbosch : Stellenbosch University, 2012-03) Snyman, Margaretha Alberta; Cilliers, F.; Beukes, S.; Stellenbosch University. Faculty of Health Sciences. Centre for Health Sciences Education.
ENGLISH ABSTRACT: The development of professional behaviour is one of the core components of occupational therapy education. The assessment of professional behaviour poses a problem as the constructs and expectations are not clearly defined; this results in compromised inter-rater reliability. The purpose of the study was to investigate assessors’ understanding of the constructs and the expectations deployed during the assessment of professional behaviour of third and fourth year occupational therapy students during clinical practice. A case study design was used in the qualitative study. Clinical supervisors were involved in: (1) a focus group interview to scrutinise the usefulness of the current assessment instrument and (2) a participatory discussion to determine their understanding of the constructs of professional behaviour and the level of expectations to be set for third and fourth year students respectively. This study confirms that the development of effective assessment of professional behaviour entails a number of pivotal steps that include developing a shared definition of the constructs thereof and the expectations at different levels of undergraduate training, the refinement of the assessment instrument and training of assessors in the use of this assessment instrument.
Attitudes and perceptions of first year students towards interprofessional education in the Faculty of Community and Health Sciences at the University of the Western Cape
(Stellenbosch : Stellenbosch University, 2012-12) Filies, Gerard C.; De Villiers, M.; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.; Thesis (MPhil)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: The setting for this study was the University of the Western Cape, Faculty of Community and Health Sciences, first year undergraduate students. All students who participated in the compulsory interprofessional programme were from the following disciplines: Occupational Therapy; Physiotherapy; Psychology; Social Work; Natural Medicine; Dietetics; Human Ecology; Sports Sciences and Nursing. The objectives of this study were to measure the attitudes and perceptions of first year students who participated in an undergraduate interprofessional programme. The attitudes and perceptions were further measured in relation to the specific lecturers involved, the age of the students, their gender, race, background as well their specific discipline. This was primarily a quantitative study incorporating two qualitative questions in which 657 students were issued with a questionnaire designed to determine their attitudes and perceptions towards interprofessional education. A sample size of 264 students resulted in 95% confidence intervals with a maximum precision of 5%. The questionnaire was adapted, with permission, from Cameron; Rennie; DiProspero; Langlois & Wagner (2009). MS Excel was used to capture the data and STATISTICA version 9 (StatSoft Inc. (2009) STATISTICA (data analysis software system), www.statsoft.com.) was used to analyze the data from the questionnaires. Descriptive statistics was used to describe the main features of the sample of this study and summary statistics was further used to summarize the findings of this study in order to communicate the bulk of the information as simple as possible. Two open-ended questions were included at the end of the questionnaire and this was used to triangulate the data. The Kruskal-Wallace test was used to measure the results, whereby a p-value of <0.05 indicated statistical significance. Of all the factors used to measure the attitudes and perceptions of students, the following three were significant: Gender; Race and Discipline. No other factors impact on the attitudes and perceptions of students towards interprofessional education. Student attitudes and perceptions towards interprofessional education were found to be very positive. The findings revealed that the most significant factor in the study was the lack of understanding of various disciplines participating in the programme and their understanding of the relevance of the teaching approach (interprofessional) as well as their specific role in the health care team. This clearly illustrated the need to recommend to the co-ordinating unit of the programme that this be defined more clearly for the students and specifically the Sports Sciences students.
Best practices for teaching healthcare workers about infection prevention and control : a systematic review
(Stellenbosch : Stellenbosch University, 2016-03) Aucamp, Magdalena C.; Van Schalkwyk, Susan; Mehtar, Shaheen; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
ENGLISH ABSTRACT: Background: Education and training of healthcare workers (HCWs) in the theory and practice of infection prevention and control (IPC) is widely regarded as a pivotal measure to reduce the risk of healthcare-associated infection (HAI). Although IPC programmes in healthcare facilities devote much time and effort to teach HCWs about IPC, the education methods may not always be effective to establish immediate and long-term changes in IPC practices. Aim of the study: The aim of the study is to determine which teaching strategies have been used with success to teach HCWs about IPC and to recommend a set of best practices for effective IPC education and training. Method: The researcher conducted a systematic review of primary studies on IPC education interventions published from 1990 to 2013. A total of 76 studies were eventually selected from sources identified by means of an extensive electronic literature search in several databases. Data was extracted and then analysed using a combination of qualitative and quantitative methods. Finally the data was synthesized and the limitations in the methodology acknowledged. Results: The interventions mostly employed a combination of two or more teaching methods and made a conscious attempt to actively engage students in the learning process. There was a strong focus on behaviour change and reinforcement of learning to ensure long-term compliance with IPC standards. Assessment of learning and e-learning was left mostly underutilized and unexplored. No new or useful insights could be obtained from interventions done in resource-poor healthcare facilities. Limitations: Only interventions published in English were reviewed. Most of the interventions were done in resource-rich settings and in urban tertiary education facilities. Conclusion: IPC education strategies require careful consideration, perhaps in equal measure to the subject matter that is being taught, to facilitate effective learning that will result in a change in behaviour and practice in the long term. The systematic review revealed that the approach to IPC education and training needs to be holistic: Apart from the teaching content, consideration must be given to the context within which the teaching will provided, as well as teaching methods that will actively engage HCWs in the learning process and stimulate behaviour change. There should be continuous reinforcement of learning by various means. These considerations and more are included in a set of recommended best practices for in-service education and training in IPC. Recommendations are made for future research projects.
Caring 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.
Changes in attitudes, behaviour and practices following an educational intervention for midwives using reflective writing journals
(Stellenbosch : Stellenbosch University, 2019-12) Ray, Sunanda; Jacobs, Cecilia; Van Schalkwyk, Susan; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
ENGLISH SUMMARY: Introduction: Inclusion of transformative learning techniques into the education of midwives and other health professionals, creates opportunities for improving health outcomes. Women in public and private sector health facilities in Southern Africa have experienced abusive behaviour and neglect from midwives. Negative birth experiences may deter women from seeking institutional care during labour, and lead to poor obstetric outcomes such as delayed progress in labour, higher risk of instrumental and surgical interventions and postnatal depression. Complex relationships between midwives and women in labour give rise to dissonance between the midwives’ sense of identity and pride as professionals, and their apparently disrespectful behaviour in their workplace, leading to possible negative outcomes. The aim of the research study was to explore from the midwives’ perspective the influence of an educational intervention in changing the attitudes, behaviour and practices of a group of midwives in Zimbabwe, as evidenced by entries in their reflective writing journals augmented by facilitated group dialogue. Methods: The qualitative research study comprised two facets: firstly, a document analysis of eighteen reflective journals written by the midwives and secondly, member-checking of the thematic analysis of the journal entries during follow-up discussions and a one-day participative workshop held a year later. Data were analysed using a phenomenology approach, which looks at how individuals make sense of social phenomena in their lived experiences. Transformative learning theory was used as a conceptual framework to explore the learning journey of the midwives. The a priori analysis identified patterns of changes within the pre-determined domains of attitudes, behaviours and practices. The comments and insights of the midwives during the member-checking process contributed further data for analysis. Findings: Overall the midwives reported gains in professional pride and stronger identification as patient advocates. Their stories in their reflective writing journals gave several examples of treating women in labour with empathy and compassion. Categories were constructed within the three domains of attitudes, behaviours and practices. Some of these categories aligned directly with the ten phases of transformative learning theory, such as self-examination of prior experience, building of competence and self-confidence into new roles and relationships. Other categories related to improving communications and teamwork, providing role-models of good behaviour and demonstrating competence in management of complex cases. Changes in practices were specific to this context and relate to changes in practices related to involvement of birth companions and encouragement to use different positions in labour and delivery. Discussion: This study demonstrated that participatory approaches to training on respectful maternity care may lead to changed attitudes, behaviour and practices in this context. The beneficiaries of these changes will be the midwives, as well as the women they look after in maternal health, their colleagues and the health system at large. The midwives have shown that even in adverse circumstances, they are able to share a common vision for the quality of service they want to provide and to progress with improving health outcomes. Sustainability and reproducibility to achieve the same results depends on continued investment in the participatory methodology to train midwives in respectful maternity care, with skilled facilitation of the reflective writing and dialogic approach. Pre-service and in-service training for midwives and medical students in maternal health could benefit from these new approaches, using reflective writing journals and dialogue as part of their educational methods and curricula. Conclusion: Promoting Respectful Maternity Care as part of the educational process opens the door to more empathy and compassion in healthcare, with better health outcomes and more rewarding relationships with their patients. This study shows that innovative educational initiatives have the potential to significantly change the way midwives work together, how they can continue to learn from reflecting on their experiences and to develop life-long learning skills.
Clinical associate students’ perceptions of factors influencing their developing professional identity
(Stellenbosch : Stellenbosch University, 2019-04) Mgobozi, Aviwe Palesa; Couper, Ian; McNamee, Lakshini; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
ENGLISH SUMMARY : The Carnegie Foundation for the Advancement of Teaching and the Lancet Commission called for educational reforms to improve the preparation of 21st century healthcare professionals through strengthening of professional identity in medical education. The factors influencing professional identity amongst nurses and doctors emerge as role modelling, patient encounters, clinical experience, and professional practice. However, factors influencing professional identity within the clinical associate profession have not been described. The study explores clinical associate students’ perceptions of factors that influence their developing professional identity. The research question is positioned within the phenomenological research paradigm. The research inquiry used a qualitative descriptive interpretivist approach. The study was conducted at the University of Witwatersrand in Johannesburg. The population for the study were all undergraduate clinical associate students enrolled at the University of Witwatersrand in 2018. A non-probability convenience sampling technique was utilised. Sampling were done from first-year and the final-year group of students. Three focus group discussions were held per year of study. The focus group discussions were guided by the researcher utilising semi-structured interview questions. Focus group discussions were audio recorded. Ethics approval was received from Stellenbosch University and the University of Witwatersrand. Three themes emerged from the results, namely, individual factors, training related factors, and perceptions of identity. The focus on professional identity aims to provide formal educational opportunities to enhance factors that positively influence student professional identities and dispel negative factors. Strengthening professional identities produces healthcare professionals who embody the professional qualities, values and dispositions required in an effective profession. The study reveals clinical associate students’ perceptions of factors that influence their professional identity. The information suggests a need to increase marketing and advocacy of the profession, improve student selection into the programme, include inter-professional education and faculty development, and utilise clinical associate role models at clinical learning facilities.
Clinical 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.
Clinical occupational therapists' experience of their role as clinical educators during the fieldwork experience of occupational therapy students
(Stellenbosch : Stellenbosch University, 2012-03) Emslie, Brenda; Louw, A. J. N.; Bester, Juanita; Stellenbosch University. Faculty of Health Sciences. Centre for Health Sciences Education.
ENGLISH ABSTRACT: Fieldwork is an essential part of the occupational therapy student’s education, and optimal learning is dependent on effective facilitation by a clinical Occupational Therapist. This study explored the lived experience of the clinical Occupational Therapists in their role as clinical educators by means of a phenomenological inquiry. Ten semi-structured interviews were conducted with clinical Occupational Therapists involved in clinical education. The data was analysed by using thematic content analysis, and was discussed according to the Lived Experience of a Clinical Educator Model. The results indicated that the clinical OTs’ sense of self, which revealed strong humanistic values, acted as the core element influencing the way in which they related to others and were able to juggle many roles in order to perform their role as clinical educator. It furthermore influenced the ways in which they managed balance and harmony in the workplace, as well as the process of growth and development. Incongruence during the performance of their roles as clinical educators was mainly caused by insufficient collaboration between the clinical educators and the university, the prescriptive nature of the fieldwork curriculum, workload pressures, the students’ attitudes and their lack of knowledge, as well as insufficient training of new clinical educators. The results may be helpful in fostering a collaborative relationship between the university and the clinical Occupational Therapists, as well as renewed attention to growth and development, all of which will benefit the students’ education.
The core competencies required by toxicology students in order to function effectively in a poisons information centre : a Delphi study
(Stellenbosch : Stellenbosch University, 2020-03) Marks, Carine Johanna; Louw, A. J. N. (Alwyn Jacobus Nicolaas); Couper, Ian D.; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
ENGLISH ABSTRACT: The training of medical toxicologists in South Africa is inadequate. In developing countries, where accidental and intentional poisonings are problematic, a need exists for tuition in medical toxicology. Stellenbosch University (SU) developed a blended learning Post Graduate Diploma in Medical Toxicology (PGDip Tox) to bridge this knowledge gap. Prior to the development of the PGDip Tox, key learning outcomes were not well-defined and a need still existed to investigate the core competencies required by toxicology graduates to effectively operate in a poisons information centre. The purpose of this study was to contribute to the wider discipline of Medical Toxicology by clearly outlining the core competencies that underpin a medical toxicology curriculum. To reach consensus on what medical toxicology graduates must know (knowledge), what they must be able to do (skills) and what dispositions they must display (attitude), a structured communication survey was developed. With the survey, the Delphi technique was used and it included a set of carefully selected questions that were drawn from various sources. The questionnaire was distributed to participants that had a medical background as well as extensive knowledge in medical toxicology, and who were highly respected by colleagues nationally and internationally. In three iterative rounds, participants rated the relative importance of individual topics and suggested new ideas. Consensus was reached when a topic on the competency list was rated 70% or more. Forty-eight panellists (n=48) were invited to participate in the survey. A total of 134 competencies were selected for the three rounds. In the end, consensus was reached on 118 (88%) items. Panel members agreed that 113 (96%) of these items should be incorporated into a medical toxicology curriculum, and that five (4%) should be excluded. All panellists (100%) agreed that it is important for medical toxicology graduates to: 1.be able to effectively use information technology to access, evaluate and interprettoxicology information 2.know where to look first when managing a poisoning query (databases, books, journalsetc.) 3.be able to communicate effectively (verbally and in writing) with healthcare providersin a manner that they understand 4. be able to identify limitations of knowledge within themselves (e.g. when to refer an enquiry). In summary, while knowledge forms the foundation of the toxicology service, the ultimate cornerstone of a poisons information service is communication. It is important for the medical toxicology curriculum to include a training package aimed at teaching toxicology students the skill of communication. Self-regulatory teaching should also be incorporated into the curriculum as to ensure that graduates have a better understanding of their responsibility towards patients and peers. When planning a new, or changing an existing course, a developer should not start with the curriculum design and measurable educational objectives, but instead use a consensus-based learning outcomes model. Establishing the core competencies in terms of knowledge, skills and attitude, will direct the choice of curriculum content and educational objectives. In conclusion, the outcomes of this study can be used in future studies to assess medical toxicology curricula and to investigate if there is an alignment and synergy between goals of the educator, the needs of the students, the curriculum, the learning milieu, the teaching strategies, and the assessment procedures. Health care workers should consider the incorporation of meaningful outcomes into all future education programmes.
Development of an aptitude test that measures language and visual-spatial abilities to identify potential academic vulnerability of students in anatomy
(Stellenbosch : Stellenbosch University, 2017-03) Humphries, Petro; Louw, Alwyn Jacobus Nicolaas; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health professions education
ENGLISH SUMMARY : Students first entering the university, struggle not only with the culture, but more importantly with studying in a language that is not their first / home language. Students at Sefako Makgatho Health Sciences University (SMU) come from areas where they had little or no prior exposure to the ancient European languages, from which all medical terms are derived. It has been my experience that the students do not only have to understand the new Anatomy language, but they also require the ability to transfer what they learn in two dimensions from their prescribed textbooks, to what they see in the dissection hall. It is my belief that students in the Anatomy Department at SMU, struggle with both the English language and with visualising and orientation of anatomical structures in space. This could be a serious stumbling block when attempting to grasp Anatomy as a subject. It is therefore important to ascertain to which extent these two factors play a role in academic success, and whether it could lead to being academically vulnerable in Anatomy. The aim of this study was three-fold. Firstly, to determine whether an internally developed aptitude test can be utilised to determine the language- and visual-spatial abilities of Anatomy students and thus predict academic vulnerability. The second aim was to determine the validity and internal consistency of the aptitude test. Lastly, the study aimed to determine whether there was any correlation between the results of the aptitude test and the first test in Anatomy. The aptitude test consisted of a section that tested language abilities (paragraph construction; sentence construction; comprehension; spelling, antonyms, synonyms and homophones; word relationships) and a section that tested visual-spatial skill (spatial ability; anatomical mental rotation; cause and effect). The results indicate that the aptitude test had the ability to distinguish which language- and visual-spatial abilities the students had difficulty in performing. Results indicated that students had trouble in writing a paragraph, as well as with the comprehension section of the test. Students did not seem to have difficulty in spelling of medically related words. Overall, the students performed better in the visual-spatial section of the test, than in the language section of the test. About thirty percent of students had difficulty in mentally rotating anatomical structures and in predicting the outcomes of nerve lesions and muscle attachments. The aptitude test had good content and predictive validity. The test also had a degree of internal consistency. No positive correlation could be made between the aptitude test and the first Anatomy test. In conclusion, answering essay type questions might be difficult for students. They might also struggle with drawing inferences from theory text and from pictures. Students are not supposed to have trouble in transferring knowledge between theory and spot test. However, they struggle with this and more research is needed into this phenomenon. The discrimination and difficulty indices and internal consistency indicated that the test requires some adaptation before its use in future, to accurately predict academic vulnerability.
The dual role of a clinical educator as mentor and assessor : influence on the teaching-learning relationship
(Stellenbosch : Stellenbosch University, 2013-12) Meyer, Ilse S.; Louw, Alwyn; Erntszen, Dawn; Stellenbosch University. Faculty of Medicine & Health Sciences. Centre for Health Professions Education.
ENGLISH ABSTRACT: At the core of clinical education, within the allied health professions, is the teaching-learning relationship between the clinical educator and the student which is reinforced by and grounded in the explanatory theories of socio-constructivism, experiential learning and positioning. A good teaching-learning relationship is fundamental to the success of the students’ learning in the clinical environment. Clinical educators fulfil a dual role as mentors and assessors to students. The purpose of this study is to explore the students’ and clinical educators’ perceptions of the dual role of a clinical educator of students in the physiotherapy clinical environment, and how the perceptions of both parties influence the teaching-learning relationship. By following a phenomenological qualitative research approach with an interpretivist paradigm the researcher obtained data from focus groups and individual interviews. Data analysis involved a contextualised interpretive content analysis paradigm. The perceptions of the participants in the teaching-learning relationship, their particular expectations, challenges and preferences, reflect their experiences and are presented in the findings of the study. The findings of this study are comprehensively discussed and recommendations are made to transform the teaching-learning relationship by repositioning the participants (both students and clinical educators) in order to enhance the quality of the clinical learning experience within the physiotherapy clinical environment.
Effectiveness of small-group sessions in enhancing students generic skills at the Shifa College of Nursing, Islamabad, Pakistan
(Stellenbosch : Stellenbosch University, 2013-12) Daredia, Afshan Saleem; Bezuidenhout, Juanita; Van Heerden, Ben
ENGLISH ABSTRACT: There is no dearth of evidence of the importance of facilitation for the effectiveness of small-group teaching. However, there is hardly any local literature on the knowledge of untrained facilitators and how they apply this knowledge to develop generic skills in students. Needs identified through this study have provided an insight into the areas requiring formal training that could be useful for developing nursing-faculty development programmes.
Evaluation 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.
Evaluation of an undergraduate psychiatric clinical rotation : exploring student perceptions
(Stellenbosch : Stellenbosch University, 2019-12) Smit, Inge-Marli; Volschenk, Mariette; Koen, Liezl; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.
ENGLISH SUMMARY: Globally, there has been an increasing focus on equipping medical graduates with the competencies to adequately address the growing health needs of society. Working from the premise that this can be achieved by appropriately transforming medical training programmes, the Faculty of Medicine and Health Sciences at Stellenbosch University (SU), South Africa, embarked on a major institutional programme renewal initiative in 2017. The Department of Psychiatry used this opportunity to review its current teaching and learning practices in the psychiatry late clinical rotation (PLCR) and our study reports on this process. By way of two focus groups we generated qualitative data by using the “voice” of the participants to explore and understand the students’ perceptions of the PLCR at SU. Four main themes were identified; “learning in the clinical context” (with two subthemes, “clinical environment” and “patient interviews”), “gaining knowledge”, “generational needs” and “competence”. Several suggestions were made to potentially improve on current practices, but participants still strongly endorsed that the PLCR does prepare them adequately to manage psychiatric patients as competent interns working under supervision. Keeping in mind that these perceptions are from a group of millennials, the insights arising from the context of “generational needs” were especially valuable. In order to bridge the generational gap and develop a curriculum that will not only meet the standards expected by educators but also achieve acceptance from learners, future research on clinical teachers’ perceptions is needed.
Evaluation 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.

Browse

Browsing Masters Degrees (Centre for Health Professions Education) by Title

Results Per Page

Sort Options