Research Articles (Centre for Health Professions Education)

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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.
Advancing the science of health professions education through a shared understanding of terminology : a content analysis of terms for “faculty”
(Elsevier B.V., 2021-09-10) Teunissen, Pim W.; Atherle, Anique; Clelan, Jennifer J.; Holmboe, Eric; Hu. Wendy C. Y.; Durning, Steven J.; Nishigor, Hiroshi; Samaraseke, Dujeepa D.; Schuwirth, Lambert; Van Schalkwyk, Susan; Maggi, Lauren A.
Introduction: Health professions educators risk misunderstandings where terms and concepts are not clearly defined, hampering the field’s progress. This risk is especially pronounced with ambiguity in describing roles. This study explores the variety of terms used by researchers and educators to describe “faculty”, with the aim to facilitate definitional clarity, and create a shared terminology and approach to describing this term. Methods: The authors analyzed journal article abstracts to identify the specific words and phrases used to describe individuals or groups of people referred to as faculty. To identify abstracts, PubMed articles indexed with the Medical Subject Heading “faculty” published between 2007 and 2017 were retrieved. Authors iteratively extracted data and used content analysis to identify patterns and themes. Results: A total of 5,436 citations were retrieved, of which 3,354 were deemed eligible. Based on a sample of 594 abstracts (17.7%), we found 279 unique terms. The most commonly used terms accounted for approximately one-third of the sample and included faculty or faculty member/s (n = 252; 26.4%); teacher/s (n = 59; 6.2%) and medical educator/s (n = 26; 2.7%) were also well represented. Content analysis highlighted that the different descriptors authors used referred to four role types: healthcare (e.g., doctor, physician), education (e.g., educator, teacher), academia (e.g., professor), and/or relationship to the learner (e.g., mentor). Discussion: Faculty are described using a wide variety of terms, which can be linked to four role descriptions. The authors propose a template for researchers and educators who want to refer to faculty in their papers. This is important to advance the field and increase readers’ assessment of transferability.
Allied health professional rural education: Stellenbosch University learners’ experiences
(Health & Medical Publishing Group, 2016-10) Pillay, M.; Bester, J.; Blaauw, Renee; Harper, A.; Msindwana, A.; Muller, J.; Philips, L.
ENGLISH SUMMARY : Background: Rural clinical training is not widely established or documented for allied health sciences (AHS) learners. This article focuses on the experiences of AHS learners from Stellenbosch University’s uKwanda Rural Clinical School. Objective: To explore learners’ practices with regard to rural clinical training in the AHS. Methods: A total of 22 documented reflections and seven educator or learner semi-structured focus group discussions, using critical conversations, were analysed with methods such as textual and thematic analysis and qualitative research software (ATLAS.ti, Germany). Results: The perception of rural clinical training was reported as an overwhelmingly positive experience. Practices positioned ‘rural’ as a catalyst for developing learners’ emerging identities as policy brokers, and as best when delivered by team participation. Professional education curricula were reported as dependant on: (i) context; (ii) educators; and (iii) how time was managed. Conclusion: Rural-based learning is a humanising experience for health science learners.
Applying empathic communication skills in clinical practice : medical students' experiences
(AOSIS, 2021-02) Archer, Elize; Meyer, Ilse S.
Background: Studies have demonstrated that empathic communication improves patient outcomes and helps doctors to deliver accurate symptom reports and diagnoses. These benefits emphasise the need for medical students to apply empathic communication skills during their interactions with patients. Focussed empathic communication skill workshops were introduced into the undergraduate medical students’ training at the Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. This study aimed to explore students’ perceptions of applying these empathic communication skills during their clinical practice. We were interested in determining the factors that might influence the development of empathic communication skills. The findings could help curriculum developers to optimise these workshops for inclusion in a formal medical curriculum. Methods: This study followed a qualitative, descriptive enquiry, exploring the perceptions of medical students through focus-group discussions. The students (N = 18) were selected using convenience sampling techniques. Recordings were transcribed, and the data were thematically analysed. Results: The two main themes identified relate to the students and the clinical learning environment. The students valued the knowledge and skills they acquired. However, feelings of emotional vulnerability, a lack of language proficiency and inadequate role modelling were highlighted as challenges when applying empathic communication during clinical practice. Conclusion: The students reported positively on the workshops as these improved both their patient and personal interactions. However, for students to develop these skills further for clinical practice, they need more intentional and supervised opportunities to practise, reflect and receive constructive feedback. These learning opportunities could help medical schools deliver graduates who can competently communicate with their patients in an empathic manner.
Building a research agenda in health professions education at a Faculty of Medicine and Health Sciences : current research profile and future considerations
(Health & Medical Publishing Group, 2014-10) Bezuidenhout, Juanita; Van Schalkwyk, Susan; Van Heerden, Ben; De Villiers, Marietjie
Background. To generate evidence in and for health professions education (HPE) that can enable reform and establish new relevance, a comprehensive HPE research foundation is required. Gaps identified in the sub-Saharan Africa (SSA) HPE literature should be addressed, while a need for more clarificatory and collaborative research to strengthen evidence has been expressed. Relatively few HPE centres exist in SSA. At Stellenbosch University’s Faculty of Medicine and Health Sciences (FMHS) the Centre for HPE was established in 2006, followed by an HPE Research Unit in 2011. Objectives. To determine and analyse the current status of educational research in the FMHS, thereby contributing to conversations around an HPE research agenda for Africa. Methods. A database of all HPE-related research was compiled, followed by a desktop analysis of all documents pertaining to current educational research projects in the FMHS in 2012, categorising projects according to: general information; sites where research was conducted; research focus; and research purpose. All data were recorded in an Excel spreadsheet and a descriptive analysis was performed. Results. There were 106 projects, mostly aimed at undergraduate programmes. More than half focused on teaching and learning, while a few focused on assessment. A number of projects were community-based or involved national and/or international collaborations. Only 20% of projects were classified as clarification research. Discussion. Educational research appears healthy in the FMHS, but more clarificatory and macro-projects are required. The profile of research is similar to the SSA profile. A research strategy relevant and feasible in our context has to be established with a shift to areas beyond our professional/ institutional boundaries, posing HPE questions of relevance to South Africa and the African continent.
Consequences, conditions and caveats : a qualitative exploration of the influence of undergraduate health professions students at distributed clinical training sites
(BMC (part of Springer Nature), 2018-12-19) Van Schalkwyk, Susan; Blitz, Julia; Couper, Ian; De Villiers, Marietjie; Lourens, Guin; Muller, Jana; Van Heerden, Ben
Background: Traditionally, the clinical training of health professionals has been located in central academic hospitals. This is changing. As academic institutions explore ways to produce a health workforce that meets the needs of both the health system and the communities it serves, the placement of students in these communities is becoming increasingly common. While there is a growing literature on the student experience at such distributed sites, we know less about how the presence of students influences the site itself. We therefore set out to elicit insights from key role-players at a number of distributed health service-based training sites about the contribution that students make and the influence their presence has on that site. Methods: This interpretivist study analysed qualitative data generated during twenty-four semi-structured interviews with facility managers, clinical supervisors and other clinicians working at eight distributed sites. A sampling grid was used to select sites that proportionally represented location, level of care and mix of health professions students. Transcribed data were subjected to thematic analysis. Following an iterative process, initial analyses and code lists were discussed and compared between team members after which the data were coded systematically across the entire data set. Results: The clustering and categorising of codes led to the generation of three over-arching themes: influence on the facility (culturally and materially); on patient care and community (contribution to service; improved patient outcomes); and on supervisors (enriched work experience, attitude towards teaching role). A subsequent stratified analysis of emergent events identified some consequences of taking clinical training to distributed sites. These consequences occurred when certain conditions were present. Further critical reflection pointed to a set of caveats that modulated the nature of these conditions, emphasising the complexity inherent in this context. Conclusions: The move towards training health professions students at distributed sites potentially offers many affordances for the facilities where the training takes places, for those responsible for student supervision, and for the patients and communities that these facilities serve. In establishing and maintaining relationships with the facilities, academic institutions will need to be mindful of the conditions and caveats that can influence these affordances.
Core competencies required by toxicology graduates in order to function effectively in a Poisons Information Centre : a Delphi study
(Elsevier, 2020) Marks, C. J.; Louw, A. J. N.; Couper, I.
Introduction: The availability of trained Medical Toxicologists in developing countries is limited and education in Medical Toxicology remains inadequate. The lack of toxicology services contributes to a knowledge gap in the management of poisonings. A need existed to investigate the core competencies required by toxicology graduates to effectively operate in a Poisons Information Centre. The aim of this study was to obtain consensus from an expert group of health care workers on these core competencies. This was done by making use of the Delphi technique. Methodology: The Delphi survey started with a set of carefully selected questions drawn from various sources including a literature review and exploration of existing curricula. To capture the collective opinion of experts in South Africa, Africa and also globally, three different groups were invited to participate in the study. To build and manage the questionnaire, the secure Research Electronic Data Capture (REDCap) web platform was used. Results: A total of 134 competencies were selected for the three rounds and in the end consensus was reached on 118 (88%) items. Panel members agreed that 113 (96%) of these items should be incorporated in a Medical Toxicology curriculum and five (4%) should be excluded. Discussion: All participants agreed that effective communication is an essential skill for toxicology graduates. The curriculum can address this problem by including effective pedagogy to enhance oral and written communication skills. Feedback from panellists indicated that the questionnaires were country-specific and not necessarily representative of all geographical locations. This is an example of the ‘battle of curriculum design’ where the context in which the curriculum will be used, will determine the content. Conclusion: The Delphi method, based on three iterative rounds and feedback from experts, was effective in reaching consensus on the learning outcomes of a Medical Toxicology curriculum. The study results will ultimately improve education in Medical Toxicology.
The critical care society of Southern Africa consensus statement on ICU triage and rationing (ConICTri)
(Health & Medical Publishing Group, 2019) Joynt, G. M.; Gopalan, D. P.; Argent, A. A.; Chetty, S.; Wise, R.; Lai, V. K. W.; Hodgson, E.; Lee, A.; Joubert, I; Mokgokong, S.; Tshukutsoane, S.; Richards, G. A.; C., Menezes; Mathivha, R. L.; Espen, B.; Levy, B.; Asante, K.; Paruk, F.
Background. In South Africa (SA), intensive care is faced with the challenge of resource scarcity as well as an increasing demand for intensive care unit (ICU) services. ICU services are expensive, and practitioners in low- to middle-income countries experience daily the consequences of limited resources. Critically limited resources necessitate that rationing and triage (prioritisation) decisions are frequently necessary in SA, particularly in the publicly funded health sector. Purpose. The purpose of this consensus statement is to examine key questions that arise when considering the status of ICU resources in SA, and more specifically ICU admission, rationing and triage decisions. The accompanying guideline in this issue is intended to guide frontline triage policy and ensure the best utilisation of intensive care in SA, while maintaining a fair distribution of available resources. Fair and efficient triage is important to ensure the ongoing provision of high-quality care to adult patients referred for intensive care. Recommendations. In response to 14 key questions developed using a modified Delphi technique, 29 recommendations were formulated and graded using an adapted GRADE score. The 14 key questions addressed the status of the provision of ICU services in SA, the degree of resource restriction, the efficiency of resource management, the need for triage, and how triage could be most justly implemented. Important recommendations included the need to formally recognise and accurately quantify the provision of ICU services in SA by national audit; actively seek additional resources from governmental bodies; consider methods to maximise the efficiency of ICU care; evaluate lower level of care alternatives; develop a triage guideline to assist policy-makers and frontline practitioners to implement triage decisions in an efficient and fair way; measure and audit the consequence of triage; and promote research to improve the accuracy and consistency of triage decisions. The consensus document and guideline should be reviewed and revised appropriately within 5 years. Conclusion. In recognition of the absolute need to limit patient access to ICU because of the lack of sufficient intensive care resources in public hospitals, recommendations and a guideline have been developed to guide policy-making and assist frontline triage decision-making in SA. These documents are not a complete plan for quality practice but rather the beginning of a long-term initiative to engage clinicians, the public and administrators in appropriate
Designing faculty development : lessons learnt from a qualitative interpretivist study exploring students’ expectations and experiences of clinical teaching
(BMC (part of Springer Nature), 2019) Blitz, Julia; De Villiers, Marietjie; Van Schalkwyk, Susan
Background: Clinical teaching plays a crucial role in the transition of medical students into the world of professional practice. Faculty development initiatives contribute to strengthening clinicians’ approach to teaching. In order to inform the design of such initiatives, we thought that it would be useful to discover how senior medical students’ experience of clinical teaching may impact on how learning during clinical training might be strengthened. Methods: This qualitative study was conducted using convenience sampling of medical students in the final two months of study before qualifying. Three semi-structured focus group discussions were held with a total of 23 students. Transcripts were analysed from an interpretivist stance, looking for underlying meanings. The resultant themes revealed a tension between the students’ expectations and experience of clinical teaching. We returned to our data looking for how students had responded to these tensions. Results: Students saw clinical rotations as having the potential for them to apply their knowledge and test their procedural abilities in the environment where their professional practice and identity will develop. They expected engagement in the clinical workplace. However, their descriptions were of tensions between prior expectations and actual experiences in the environment. They appreciated that learning required them to move out of their “comfort zone”, but seemed to persist in the idea of being recipients of teaching rather than becoming directors of their own learning. Students seem to need help in participating in the clinical setting, understanding how this participation will construct the knowledge and skills required as they join the workplace. Students did not have a strong sense of agency to negotiate participation in the clinical workplace. Conclusions: There is the potential for clinicians to assist students in adapting their way of learning from the largely structured classroom based learning of theoretical knowledge, to the more experiential informal workplacebased learning of practice. This suggests that faculty developers could broaden their menu of offerings to clinicians by intentionally incorporating ways not only of offering students affordances in the clinical learning environment, but also of attending to the development of students’ agentic capability to engage with those affordances offered.
The development of research competence among specialist registrars in South Africa: Challenges and opportunities for research education and capacity development
(South African Medical Association, 2022-01) Moxley, K.
To equip physicians with the competencies that support evidence-based healthcare, curriculum frameworks for medical education often promote scholarly activity as an essential component of training. Many medical schools worldwide expect medical trainees to participate in some form of research during their undergraduate and postgraduate training. This requirement is especially important in Africa, where there is also much need to develop clinical research capacity and an evidence base that is contextualised to the specific healthcare challenges on the continent. In South Africa, the requirement for specialist trainees to complete a research project (as part of a Master of Medicine, MMed) was made mandatory from 2011 and has introduced several difficulties for many training centres. There is concern that institutions are failing to develop medical specialists who are competent in their role as scholars, particularly in their ability to conduct research. In this article, I review the South African literature that discusses the research component of medical specialist registration. In addition to summarising the challenges associated with MMed projects and recent efforts to address them, I interrogate whether the current status of MMed research education is likely to be contributing to the successful development of research competence among this unique group of postgraduates. By consolidating the current debate, I hope to encourage a point of departure between criticising the challenges and adopting proactive strategies to address them. There is a great need for medical educators to design innovative and learner-centred research education strategies that can better develop research competence among African healthcare professionals.
The development, implementation and evaluation of a short course in objective structured clinical examination (OSCE) skills
(Medical & Pharmaceutical Publications (Pty) Ltd -- MedPharm Publications, 2012-02) De Villiers, A.; Archer, E.
Background: Objective structured clinical examination (OSCE) examiner training is widely employed to address some of the reliability and validity issues that accompany the use of this assessment tool. An OSCE skills course was developed and implemented at the Stellenbosch Faculty of Health Sciences and its influence on participants (clinicians) evaluated. Method: Participants attended the OSCE skills course, which included theoretical sessions concerning topics such as standard setting, examiner influence and assessment instruments, as well as two staged OSCEs, one at the beginning and the other at the end of the course. During the latter, each participant examined a student role-player performing a technical skill while being video recorded. Participants’ behaviour and assessment results from the two OSCEs were evaluated, as well as the feedback from participants regarding the course and group interviews with student role players. Results: There was a significant improvement in inter-rater reliability as well as a slight decrease in inappropriate examiner behaviour, such as teaching and prompting during assessment of students. Furthermore, overall feedback from participants and perceptions of student role players was positive. Conclusions: In this study, examiner conduct and inter-rater reliability was positively influenced by the following interventions: examiner briefing, involvement of examiners in constructing assessment instruments, as well as examiners viewing (on DVD) and reflecting on their assessment behaviour. This study proposes that the development and implementation of an OSCE skills course is a worthwhile endeavour in improving validity and reliability of the OSCE as an assessment tool.
Effect of curriculum changes to enhance generic skills proficiency of 1st-year medical students
(Health & Medical Publishing Group, 2016-05) Murdoch-Eaton, Debbie; Louw, Alwyn J. N.; Bezuidenhout, Juanita
ENGLISH SUMMARY : Background: Curriculum review is a dynamic, iterative process, and the effect of change may not always be wholly predictable. At Stellenbosch University, Cape Town, South Africa revision of the MB,ChB curriculum was undertaken to meet enhanced and changing educational and medical practice, and to provide opportunities to enhance optimal generic skills underpinning effective learning, implemented in 2008. Objective: To determine the extent to which the newly implemented revised curriculum had an effect on experience in necessary generic skills of students in their first year of study. Methods: Students provided annual formal end-of-module evaluation in addition to focus group interviews. Evaluation by teaching staff was conducted by individual in-depth interviews. A validated generic skills questionnaire completed at the end of each academic year monitored the effect on students’ generic learning skills experience. Results: Feedback from these different evaluation methods identified specific needs in the newly implemented revised curriculum, including contextualisation of interventions, unnecessary duplication of content and malalignment of assessment. This led to minor curriculum changes and an educational capacity-building programme. These responsive curriculum changes after evaluation had the intended positive effect on students’ self reported acquisition of generic learning skills. Conclusion: The objective of the curriculum evaluation was to monitor content output and the acquisition of crucial generic learning skills. Implementation of a revised curriculum combined with ongoing responsive changes aligned with careful multimodality evaluation can ensure that, in addition to scientific knowledge and skills, generic learning skills development of students is facilitated.
Empathy : an essential tool in any doctor’s skillset
(Health & Medical Publishing Group, 2019) Archer, Elize; Turner, Roseanne
No abstract available
Fresh simulation options in critical care nursing education
(Health and Medical Publishing Group (HMPG), 2010-12) Archer, Elize
Many forms of simulation, as a teaching strategy, have been used successfully over the last few decades. Some of the advantages thereof in health sciences education are that it is a learner-centered training modality that presents with no risks to patients and allows for facilitated repetition of learning until all students have achieved the required level of proficiency. Simulation may reduce time spent by students in clinical areas to master the necessary skills and it is therefore perceived as an efficient use of limited resources. Utilising the Clinical Skills Centre (CSC) for teaching of procedures may therefore facilitate the reduction in time allocated to the clinical areas. Critical care (CC)-trained nurses are expected to have the expertise to perform a variety of practical procedures on patients, but even more importantly, they should be able to integrate information about a patient in order to provide holistic and effective care. The practical component of the CC nursing programme at the specific university consists of two parts: the completion of practical procedures and case presentations. Some of the challenges associated with the teaching and assessment of these two components are important and will be discussed in this article.
'I have a chameleon-like existence' : a duoethnographic account of border crossing by two academic development practitioners
(HESA, 2016) Van Schalkwyk, S.; McMillan, W. J.
ENGLISH SUMMARY : The practice of situating academic development practitioners within faculties poses challenges for practitioners from outside the particular discipline. Literature highlights how discourse and culture create tensions amongst role-players in cross-disciplinary contexts. This duoethnographic account examines the experiences of two practitioners as insider-outsiders in a health sciences disciplinary space. Duoethnography is a collaborative methodology where researchers, in dialogue, critique the meanings they give to social and epistemological constructs. Drawing on border crossing as theoretical lens, the study signals how the insider-outsider location might be mediated to support quality teaching. Border crossing highlights the construct of frontiers and associated identity work. The study identified critical success factors for collaboration – physical presence over time; knowing what is valued; an established identity as scholar and competent practitioner; a community of practice; recognition and an acknowledgement by faculty management; and personal flexibility, sensitivity, approachability and willingness to change.
Implications for faculty development for emerging clinical teachers at distributed sites : a qualitative interpretivist study
(James Cook University, 2018) Blitz, Julia; De Villiers, Marietjie; Van Schalkwyk, Susan
Introduction : Medical faculties have the responsibility to graduate competent health professionals and a consequent obligation to assure the quality and effectiveness of their students’ clinical teaching. Many institutions are responding to rural workforce needs by extending clinical training from the traditional academic teaching hospital to include rural and remote sites distributed away from the central training institution. It is incumbent upon medical schools to consider how this might impact on the faculty development of these clinicians as teachers. The research reported here sought to develop an understanding of how clinicians working at distant resource-constrained and new training sites view their early experiences of having been delegated the task of clinical teaching. This was with a view to informing the development of initiatives that could strengthen their role as teachers. Methods: Qualitative research using an interpretive approach was used to reach an understanding of the views and subjective experiences of clinicians taking on the role of clinical teaching. Participants were emerging clinical teachers at distant peri-urban, rural and remote sites in South Africa. They were deemed to be emerging by virtue of either having recently taken on the role of clinical teacher, or working at sites newly used for clinical teaching. In-depth interviews were conducted with all nine clinicians meeting these criteria. The interviews were coded inductively looking for underlying meanings, which were then grouped into categories. Results: The findings clustered into three inter-related themes: relationships, responsibilities and resources. The clinicians take pleasure in developing learning relationships that enable students to have a good experience by participating actively in the clinical environment, value what students bring from the medical school in terms of clinical advances and different perspectives, and in the contribution that they feel they are making to creating a more appropriately trained future healthcare workforce. However, they yearn for a closer relationship with the medical school, which they think could acknowledge the contributions they make, while also offering opportunities for them to become more effective clinical teachers. They also feel that they have a role to play in both curriculum re-alignment and student evaluation. These clinicians felt that the medical school has a responsibility to let them know if they are doing ‘the right thing’ as clinical teachers. Interestingly, these participants see trusted clinical colleagues and mentors as a resource when needing advice or mentorship concerning clinical teaching. Conclusion: This study adds to an understanding around designing faculty development initiatives that meet the needs of clinicians at distant sites that take on the role of clinical teaching. There remains the need to impart particular strategies to support the learning of particular kinds of knowledge that is commonly dealt with in faculty development. However, there may be an additional need for faculty developers to embrace what is known about rural doctor social learning systems by overtly designing for incorporation of the foundational three Rs: relationships, responsibilities and resources.
Improving undergraduate clinical supervision in a South African context
(Health & Medical Publishing Group, 2011-12) Archer, Elize
Objectives: The Faculty of Health Sciences, Stellenbosch University, has undergraduate programmes for several disciplines; these programmes need clinical supervisors to teach their students in the clinical settings. The faculty does not have the resources to present different clinical supervision courses for each discipline; therefore a short course with an interprofessional focus was designed. Design: A qualitative study was done to determine the strengths and weaknesses of the course in order to re-curriculate as deemed necessary. Semi-structured individual interviews were held with 10 (n=18) course participants as well as the tutors involved in the development of the course. Ethical approval was obtained. Participation was voluntary and anonymity was guaranteed. The recorded and transcribed data were analysed. Setting: The health professionals acting as supervisors may be the experts in their fields, but they do not always have the necessary teaching skills. The Centre for Health Sciences Education (CHSE) at the faculty has developed a generic short course in undergraduate clinical supervision to address the above issue. Results and conclusion: The data were used to inform restructuring of the short course for the following year. The impact of this short course on clinical supervisors was that their interaction with students in the clinical setting improved. There was unanimous support for extending the short course to all clinical supervisors. The lecturers involved in developing the course were positive about the interprofessional cooperation among colleagues and students. They emphasised that the Faculty of Health Sciences has an obligation to provide opportunities for clinical supervisors to improve their skills to supervise students.
Influence of confidence and experience on the competency of junior medical students in performing basic procedural skills
(African Journal of Health Professions Education, 2011-06) De Villiers, Adele; Archer, Elize; Southern African FAIMER Regional Institute (SAFRI) Poster Day, Cape Town, March 2011; SA Association of Health Educationalists (SAAHE) Conference, Johannesburg, July 2010
ENGLISH ABSTRACT: Studies, mostly done with final-year medical students and doctors, show that the confidence level with which a clinical skill is performed is not a reliable benchmark of actual clinical competence. This inaccurate selfevaluation of proficiency has far-reaching implications, e.g. the inability to identify learning deficiencies and consequently to manage learning – both essential components of self-directed learning programmes.
Interventions aimed towards the development of patient-centredness in undergraduate medical curricula : a scoping review
(Health and Medical Publishing Group, 2018) Archer, E.; Meyer, I.
Background. Patient-centredness has been identified by most medical schools worldwide as a desired core graduate competence. Patient-centredness positions the patient at the centre of the consultation and, therefore, focuses on the patient instead of on the disease. The concept of patient-centredness is, however, multifaceted. The choice and development of approaches and interventions that can enhance or sustain the various dimensions of patient-centredness are challenges for undergraduate medical curriculum developers. Objectives. To determine what the extent and nature of published scientific literature on implemented interventions are and how these could assist in fostering the various constructs of patient-centredness in undergraduate medical curricula. Furthermore, to determine which of these interventions could potentially be applied and incorporated in the context of the undergraduate medical curriculum at the Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. Methods. The study followed the 6-step scoping review methodology framework. Four electronic databases were searched. Two independent reviewers screened citations for inclusion and performed the data abstraction. Results. Articles (N=581) were eligible for inclusion in this study. Information captured in the Excel spreadsheets resulted in 9 categories of teaching interventions, which could lead to the various constructs of patient-centredness. These included didactic sessions and workshops, simulated patients, reflection, small-group discussions, e-learning, peer role-play/drama/surrogate, narratives/storytelling/art, clinical experiences and mindfulness training. Conclusions. It is important to acknowledge that the development of patient-centredness in medical students is more than just a set of communication skills. Curricula need to provide learning opportunities for students to enhance knowledge, skills and attitudes related to patient-centredness to develop it as a strong competence. Furthermore, students need to be placed in clinical learning environments that foster a patient-centred approach, providing various opportunities where they can reflect on their learning, be more mindful of the needs of their patients and build caring relationships with them.
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.

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