Masters Degrees (Centre for Health Professions Education)
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- ItemFactors influencing the decision-making process of clinician family physicians during workplace-based assessments in the Western Cape, South Africa(Stellenbosch : Stellenbosch University, 2024-03) Eksteen, Lawson Barry; De Villiers, Marietjie René; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Health Systems and Public Health.ENGLISH SUMMARY: The integration of Workplace-Based Assessment (WBA) methods into medical education has become more frequently used, bringing assessments into clinical settings. The decision-making process in WBA, crucial for shaping trainee performance and clinician Family Physicians judgments, is intricately influenced by several factors. Understanding these factors is pivotal for advancing assessment outcomes in Health Professions Education. This exploratory, descriptive qualitative research delves into the decision-making process of Family Physicians during mini Clinical Evaluation Exercise (mini-CEX) assessments on postgraduate trainee registrars in Family Medicine. Semi-structured interviews were conducted with six clinician family physicians based in district hospitals who regularly conduct WBA as part of clinical training. Registrars are trained in either small (one supervisor), medium (two supervisors) or large (three or more supervisors) training complexes, and some registrars would be assessed by the same supervisor for the whole training period. This study was conducted to gather in-depth insights into the perceptions that guide their decision-making. The results highlighted a diverse array of factors influencing the decision-making process of Family Physicians conducting mini-CEX evaluations on postgraduate registrars. Each clinician Family Physician has a unique perception of WBA, as well as a specific approach and framework when conducting WBA in the primary setting. Three overarching themes emerged from the data, namely context, relationships, and the educational environment. From these themes, the contextual background was most prominent, and especially the opportunity to use interruptions as learning opportunities. The unique relationship between the supervisor and trainee were also described as a significant factor, and although this can be multifaceted and challenging, it also gives opportunity for richer feedback and more extensive professional growth. The specific educational environment is also a major factor, where previous training, clinical complexity and the available academic time were most valid. These themes underscore the complexity of decision-making in WBA, and although intricate and diverse, hold a pivotal role in the decision-making dynamics, challenging the conventional view of variability as mere human error. These factors should not be viewed as a flawed human error of assessment, but rather different professional elements of clinical characteristics that takes assessment practices in the workplace to a deeper and richer degree of clinical competence.
- ItemTowards a faculty development guideline for nurse educators at Welwitchia health training centre : an exploratory study(Stellenbosch : Stellenbosch University, 2023-03) Petrus, Hambeleleni; Meyer, Rhoda; Van Schalkwyk, Susan Camilla; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: The main goal of higher education institutions is to enable learning. For educators to fulfill this goal effectively, they must be suitably trained to obtain the background of the role. The number of institutions in Health Professions Education (HPE), including nursing training institutions, has increased significantly in recent years. Due to the high demand for nurse educators, training facilities began hiring registered nurses to fill academic positions. Therefore, it is crucial that these nurse educators, who may not necessarily be prepared for a teaching role, receive support to enable a seamless transition from clinical nursing to nursing education Planning and implementing faculty development (FD) programmes is one way nursing institutions can assist these nurses in increasing their knowledge and teaching abilities. The goal of this study was to explore the perspectives of nurse educators at the Welwitchia Health Training Center (WHTC) about what FD initiatives could assist in strengthening their knowledge and comprehension of the teaching role and its practice. It was envisaged that the findings of this study would help in providing recommendations that would inform the future development of a FD guideline. The guideline might help WHTC build a programme that is appropriate for FD to serve the needs of nurse educators. In this exploratory qualitative study, semi-structured in-depth interviews were used to gather data. The process of data analysis was thematic analysis, which was derived from the work of Braun and Clark (2012). During the analytical process, it became clear that FD needed to be seen to extend beyond individual initiatives and training, and that it was influenced by a wide range of factors that spoke to an environment that was framed with appropriate policy and enabled the provision of support and human resources to enable educators to fulfil their teaching role. Three main themes were identified, and each theme had a subtheme that described related notions. Being a nurse educator is the first theme, becoming a nurse educator is the second theme, and strengthening the educator is the third theme. In the role as nurse educators, decisions are made every day about what to teach and how to teach it. These choices are influenced by a range of different factors and by how individuals identify themselves as teachers. These factors and identity perceptions chart out each educator’s ‘individual journey,’ centered on the nature of the role and the setting in which teaching occurs. Initiatives to support and strengthen the nurse educator requires not only focusing on what is required by each individual but will also need to take broader contextual concerns into account. In order to assist WHTC in supporting nurse educators to develop the requisite knowledge and teaching abilities, a set of guiding recommendations were developed. The goal of these recommendations is to provide guidance for the future development of the FD guidelines and to assist WHTC in creating an enabling environment and to develop a suitable FD programme that may help educators recognise and value their role as teachers.
- ItemKnowledge, attitudes and perceptions of fifth-year medical students at a South African university regarding their public health course(Stellenbosch : Stellenbosch University, 2022-12) Ledibane, Tladi Daniel; De Villiers, Marietjie Rene; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: The coronavirus epidemic has put public health in the spotlight like never before, with daily reports regarding epidemiological modelling and the control of the disease outbreak. The public has become more aware of public health practices and the role of the public health profession in the fight to fight the pandemic. The renewed interest places the responsibility on academics in public health to equip students with the necessary knowledge and skills. In this way, competent and effective clinicians can be trained who can play a significant role in the fight against the current and future pandemics. Public health theories and practical modules are offered worldwide in undergraduate curricula of most medical schools. However, the content and period of exposure regarding teaching and learning in public health differ drastically between local medical schools and internationally. The study aimed to understand fifth-year medical students' knowledge, attitudes, and perceptions regarding their public health course to inform curriculum renewal for this course. A mixed-methods study design was used for this study. The study design for the quantitative and qualitative phases was descriptive cross-sectional with a phenomenological design. A five-point Likert scale questionnaire was used to gather data from the fifth-year medial students regarding their knowledge, attitudes and perceptions related to their public health curriculum. A focus group interview was conducted with student representatives as key informants. The qualitative and quantitative data were analysed in parallel. The results from each approach were used to cross-validate the findings. This study showed that most students were conversant regarding relevant public health topics that should be included in the public health curriculum. However, most students were not satisfied with the public health course. The students felt that the learning opportunities in public health and research were limited and inadequate and did not include service or practical learning. In addition, the students felt that teaching strategies employed by the department were ineffective. Finally, most students had positive perceptions of public health as discipline and felt it was an essential aspect of clinical medicine and should be part of medical training. In conclusion, the study highlights the need to involve medical students in the curriculum renewal process, as well as to understand their attitudes and perspectives. This knowledge can be used in the future to help the curriculum developers to compile core curricula. In this way, their public health learning experience and medical school training can be improved. Curriculum developers should consider integrating the disciplinary underpinnings of public health in clinical disciplines and employing experiential learning and interactive strategies to teach public health.
- ItemExploring the perceptions of physiotherapy students on their preparedness to include exercise in the treatment of cancer patients(Stellenbosch : Stellenbosch University, 2022-04) Williams, Leone Geraldine; Van Schalkwyk, Susan Camilla; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: Undergraduate health professions curricula should equip students with the requisite knowledge, skills and attitudes to manage patients within their local communities. Given the ever increasing incidence of cancer in South Africa, it could be argued that responsive curricula should include cancer-related content. Current literature, however, indicates that qualified physiotherapists have had limited undergraduate education on exercise for cancer patients. This study aimed to explore the perceptions of undergraduate physiotherapy students at Stellenbosch University regarding their preparedness to include exercise in the management of cancer patients. A qualitative research design was used. The study was conducted in the interpretivist paradigm with a phenomenological research approach. Purposive sampling was employed to recruit fourth year physiotherapy students with exposure to the management of cancer patients. Focus groups were used for data collection. An experienced, independent facilitator guided the two focus group discussions, using a semi-structured interview guide. Thirteen students provided written informed consent to participate in the study. Ethical approval was obtained to conduct this study. Thematic analysis was used to analyse the data. Four themes were identified namely: i) students’ perspectives of cancer; ii) students’ knowledge of cancer in the context of physiotherapy; iii) students’ response to providing treatment; and iv) students’ perspectives on the implications for the curriculum. Cancer was regarded as a comorbidity, and students preferred to focus their management on the familiar signs and symptoms patients presented with. Physiotherapy students reported limited knowledge of cancer and expressed uncertainty about their role in the management of cancer patients. Students were perplexed by the use of exercise for cancer patients and were concerned about worsening the patient’s condition. Students reported an array of distressing emotions during the management of cancer patients, with no reports of debriefing mechanisms. Suggestions for improvement of the curriculum included focused time on cancer-related content, specific skills training and equitable allocation of cancer patients during clinical rotations. The study findings highlight the interplay between the study participants’ learning needs and their identity development as physiotherapists during the management of cancer patients. Study participants suggested that the curriculum could better prepare them for the management of cancer patients by creating opportunities for them to learn through collaboration, exposure to cancer patients and community of practice. Curriculum developers should reconsider foci and time allocation to better prepare undergraduate physiotherapy students to manage cancer patients.
- ItemThe role of pathology in the development of clinical expertise and practice in an integrated undergraduate medical curriculum : a final-year medical student perspective(Stellenbosch : Stellenbosch University, 2022-04) De Wet, Daniel Rudolph; Volschenk, Mariette; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Health Professions Education.ENGLISH SUMMARY: The international move towards increased integration of undergraduate medical curricula has revealed a number of unintended consequences, such as insufficient depth of learning, fragmentation of knowledge and reduced perception of the importance of specific discipline knowledge such as pathology. The current curriculum renewal process of the undergraduate MBChB programme in the Faculty of Medicine and Health Sciences presented the ideal opportunity to review whether the curriculum is achieving its teaching and learning outcomes from a student’s perspective. One of these outcomes is developing clinical reasoning, which is essential. Thus, the aim of this study was to explore final-year medical students’ perceptions of the role of pathology in the development of their clinical expertise and practice (thus clinical reasoning), as well as the contributing and limiting factors of the integrated pathology curriculum in the development of their perception. The study design was interpretivist and situated within a qualitative, methodological framework. Semi-structured interviews were conducted with eight students. Interpretative data analysis was done, with four themes emerging from the data, namely conceptions of pathology and what pathologists do; understanding pathology; application of pathology; and student-identified curricular influences and considerations. The latter theme was divided into three subthemes, namely the placement of pathology; pathologists on the clinical platform; and methods of teaching pathology. In conclusion, the findings of this study confirm that final-year medical students, with their varied conceptions of pathology, realized the important role that pathology played in developing their clinical expertise and practice. Understanding of pathology concepts enabled transfer of knowledge to clinical reasoning more effectively, and within an integrated curriculum, the need was identified to recognize the importance of the placement of pathology, teaching methods employed and visibility of pathologists as teachers on the clinical platform. All these findings should inform the current renewal process of the pathology curriculum.