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Navigating the troubled waters of higher education – a phenomenological study on the needs and challenges of first‐year clinical associate students in South Africa 在高等教育的困境中前行--关于南非一年级临床助理医师学生的需求和挑战的现象学研究
Pub Date : 2024-04-16 DOI: 10.7196/ajhpe.2024.v16i1.847
C. Nel, MPhysT J E BPhysT, Wolvaardt, M. P. P. P. H. D. BCur, Toit, B. Ba
Background. Clinical associates (ClinAs) are educated in decentralised learning platforms where they gain skills and a concrete understanding of the fundamental challenges of healthcare in remote and poverty-stricken districts of South Africa. Due to the decentralised nature of the programme, these students seldom have access to ‘on-campus’ academic and psychosocial support. A peer mentorship programme has proved useful in this regard in other settings.Objective. To explore the unique academic and psychosocial challenges and needs of first-year clinical associate (ClinA) students and describe the views of the research participants on the perceived enablers and constraints of a ClinA peer mentorship programme.Methods. A phenomenological research design was used. The population included ClinA students and academic members of staff. Five appreciative inquiry interviews and two focus group discussions were conducted.Results. Four themes were identified: (i) flailing like a fish out of water (challenges experienced by ClinA students); (ii) floating devices (benefits of peer support programmes); (iii) the life saver (perceived enablers of peer support programmes); and (iv) rip currents (perceived constraints of peer support programmes).Conclusion. Unique challenges identified were: (i) the teaching and learning strategy implemented by the facilitator of the programme; (ii) the decentralised learning platforms; and (iii) the absence of institutional support at clinical learning centres. All participants agreed that peer mentor support is beneficial and essential for ClinA students, but that the peer mentor programme needs to be bespoke to address the limited access to academic and psychosocial on-campus support and the profile of the students, who are of rural origin and first-generation students.
背景。临床助理(ClinAs)是在分散的学习平台上接受教育的,他们在这里学习技能,具体了解南非偏远贫困地区医疗保健所面临的基本挑战。由于课程的分散性,这些学生很少有机会获得 "校内 "的学术和心理支持。在其他情况下,同伴指导计划在这方面被证明是有用的。探讨临床助理医师(ClinA)一年级学生在学业和社会心理方面面临的独特挑战和需求,并描述研究参与者对临床助理医师朋辈辅导计划的促进因素和限制因素的看法。采用现象学研究设计。研究对象包括临床助理医师学生和学术人员。共进行了五次赞赏式调查访谈和两次焦点小组讨论。确定了四个主题:(i) 如鱼得水(ClinA 学生经历的挑战);(ii) 漂浮装置(同伴支持计划的益处);(iii) 救生员(同伴支持计划的促进因素);(iv) 激流(同伴支持计划的制约因素)。确定的独特挑战有(i) 计划主持人实施的教学和学习策略;(ii) 分散的学习平台;(iii) 临床学习中心缺乏机构支持。所有参与者都认为,朋辈导师的支持对临床助理医师学生有益且必不可少,但朋辈导师计划需要量身定制,以解决学生在校内获得学术和社会心理支持的机会有限的问题,以及农村出身和第一代学生的特点。
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引用次数: 1
Engagement of stakeholders in the development of generic medical and nursing curricula in Tanzania through media outlets and social media 通过媒体渠道和社交媒体,让利益攸关方参与坦桑尼亚通用医学和护理课程的编制工作
Pub Date : 2024-04-16 DOI: 10.7196/ajhpe.2024.v16i1.828
D. Mloka, E. Tarimo, N. Sirili, PhD A Kulanga, O. Nyongole, H. Mtui, A. Mteta, MMed Bartlett, S. Mshana, PhD E Kaaya, PhD M Moshi, PhD BPharm
Background. The Catholic University of Health and Allied Health Sciences, Kilimanjaro Christian Medical University College and Muhimbili University of Health and Allied Sciences teamed up to address gaps in the training curricula for medical doctors and nurses with the aim of developing harmonised curricular templates that would be comprehensive and suit national objectives.Objectives. To share experiences and lessons learned in engaging stakeholders using social media as an additional method to collect information on curricular gaps and ideas to develop harmonised medical and nursing curricula.Methods. Pictures, newsprint extracts, and videos of face-to-face events in the curriculum development process and project and a curriculum advert were posted on Facebook, Twitter and YouTube and used to engage stakeholders, including regulatory bodies, health professional councils, graduates, students, practitioners, health training institutions, private and public employers, internship supervisors, faculty and the public. Reactions, comments and post insights from stakeholder postings, in both Swahili and English, were analysed manually and categorised into four types of messages: congratulatory, comments on the process and expected outcomes, curricular gaps, and faculty development needs to implement new curricula.Results. A total of 69 290 stakeholders were engaged via Facebook and 229 via Twitter. A total of 13 553 (19.6%) Facebook and 179 (78.2%) Twitter comments were directly related to gaps in current curricula and graduate competencies. Other inputs received through social media were on faculty development needs to implement harmonised curricula and the project in general.Conclusion. This was the first attempt to engage curriculum stakeholders using social media for the development of harmonised curricula in Tanzania. The impact of social media in providing relevant inputs for curriculum development was significant. Use of social media, with multiple language options, is an economical and efficient way to reach a large number of stakeholders for curriculum quality improvement.
背景。天主教卫生与联合健康科学大学、乞力马扎罗基督教医科大学学院和穆欣比利卫生与联合科学大学联手解决医生和护士培训课程中存在的差距,目的是制定全面且符合国家目标的统一课程模板。分享利用社交媒体吸引利益相关者参与的经验和教训,将其作为收集有关课程差距的信息以及开发统一的医学和护理课程的想法的补充方法。在 Facebook、Twitter 和 YouTube 上发布课程开发过程和项目中面对面活动的图片、新闻纸摘录和视频以及课程广告,用于吸引利益相关者参与,包括监管机构、卫生专业委员会、毕业生、学生、从业人员、卫生培训机构、私营和公共雇主、实习主管、教师和公众。对利益相关者以斯瓦希里语和英语发布的帖子中的反应、评论和帖子见解进行了人工分析,并将其分为四类信息:祝贺信息、对过程和预期成果的评论、课程差距以及实施新课程的师资发展需求。共有 69 290 名利益相关者通过 Facebook 和 229 名利益相关者通过 Twitter 参与了活动。共有 13 553 条(19.6%)Facebook 评论和 179 条(78.2%)Twitter 评论与当前课程和毕业生能力差距直接相关。通过社交媒体收到的其他意见涉及实施统一课程的师资发展需求和整个项目。这是坦桑尼亚首次尝试利用社交媒体吸引课程利益相关者参与统一课程的开发。社交媒体在为课程开发提供相关投入方面产生了重大影响。使用具有多种语言选项的社交媒体是一种经济、高效的方式,可以接触到大量利益相关者,以提高课程质量。
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引用次数: 0
Postgraduate Master of Medicine student perspectives on data access and record-keeping for research 医学硕士研究生对研究数据访问和记录保存的看法
Pub Date : 2024-04-16 DOI: 10.7196/ajhpe.2024.v16i1.829
S. Prahladh, J. M. V. Wyk, PhD D MEd, Naidoo, PhD Masters OT
Background. Registrars in specialisation training programmes encounter numerous difficulties in completing the research component of the Master of Medicine degree. Poor patient record-keeping hinders the research process.Objectives. To investigate current types of medical patient record-keeping systems (electronic v. paper) in training health facilities, and the effect data accessibility has on specialist training and research.Methods. This was a mixed-methods study that included both descriptive and analytical components. Of 610 postgraduate students enrolled in the University of KwaZulu-Natal College of Health Sciences Master of Medicine programme, 168 completed a cross-sectional survey to collect data and 11 did follow-up interviews. The survey and interviews explored issues related to medical record-keeping in the participants’ department or hospital, emphasising their experiences with data access while conducting research. The quantitative data were analysed using descriptive statistics, and the qualitative data were analysed thematically. Ethical approval was obtained from the institution’s Biomedical Research Ethics Committee.Results. Of the 168 participants, 94 (56%) reported that problems with data access hindered their research, while 56 (33%) indicated that data access did not affect their research. Only 30 participants (18%) had no difficulty in obtaining data for their research, while the rest (n=138; 82%) experienced varying degrees of difficulty. A total of 110 participants (65%) indicated that paper-based record-keeping was mainly being used in their department or hospital, while electronic record-keeping was reported by the rest (n=58; 35%). Many (n=125; 74%) expressed the need to improve hospital data management practices, and 39 (23%) reported that plans were being implemented to improve these practices. Participants expressed frustration with regard to accessing data even in departments that used electronic systems, and they raised concerns regarding data security.Conclusion. The migration to electronic patient record-keeping has not yet been implemented in many hospitals, with poor patient record-keeping affecting training and research.
背景。专科培训课程的注册医师在完成医学硕士学位的研究部分时会遇到许多困难。病人记录保存不善阻碍了研究进程。调查培训医疗机构中现有的各类医疗患者记录保存系统(电子版与纸质版),以及数据可获取性对专科培训和研究的影响。这是一项混合方法研究,包括描述和分析两个部分。在夸祖鲁-纳塔尔大学健康科学学院医学硕士课程的 610 名研究生中,168 人完成了横向调查以收集数据,11 人进行了后续访谈。调查和访谈探讨了参与者所在科室或医院保存医疗记录的相关问题,强调了他们在开展研究时获取数据的经验。定量数据采用描述性统计进行分析,定性数据则采用专题分析。研究结果获得了该机构生物医学研究伦理委员会的伦理批准。在 168 名参与者中,94 人(56%)表示数据访问问题阻碍了他们的研究,56 人(33%)表示数据访问没有影响他们的研究。只有 30 名参与者(18%)在为其研究获取数据方面没有遇到困难,而其余参与者(n=138;82%)则遇到了不同程度的困难。共有 110 名参与者(65%)表示,他们所在的部门或医院主要使用纸质记录,而其他参与者(n=58;35%)则表示使用电子记录。许多人(n=125;74%)表示需要改进医院的数据管理方法,39 人(23%)表示正在实施改进这些方法的计划。即使是在使用电子系统的部门,与会者也对访问数据表示沮丧,并对数据安全表示担忧。许多医院尚未实施向电子病历保存的迁移,病历保存不善影响了培训和研究。
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引用次数: 0
Exploring medical curriculum leadership and management training: Perspectives of doctors and medical educators in Botswana 探索医学课程领导力和管理培训:博茨瓦纳医生和医学教育工作者的观点
Pub Date : 2024-04-16 DOI: 10.7196/ajhpe.2024.v16i1.851
A. Turner, D. Prozesky, M. Kebaetse, J. Wolvaardt
Background. The University of Botswana Faculty of Medicine (UB FOM) is the only medical school in Botswana, and was opened to address shortages that other workforce strategies were not achieving at a sufficient rate. The UB FOM programme involves early patient contact at all levels of healthcare. Newly-graduated doctors are expected to perform managerial responsibilities, a role which few medical curricula include formal training for.Objectives. To explore the perceptions of graduates and medical educators (MEs) on the leadership and management training in the medical curriculum in Botswana.Methods. A non-theory driven qualitative study using thematic analysis was conducted. Twelve MEs and graduates from UB FOM were interviewed. Semi-structured interviews were conducted until data saturation was reached. Data were transcribed and analysed.Results. Two themes were developed: Starting small to be tall and Planting the seeds. Theme 1 describes the explicit messages of being future managers and leaders unaccompanied by formal training. Theme 2 acknowledges the insufficient training and describes the call for scaffolded longitudinal leadership and management teaching, and enhanced interprofessional education.Conclusion. Elements of leadership and management training are already included within the curriculum. The health system expectation that these graduates will immediately assume leadership and management responsibilities necessitates the strengthening of these aspects. The inclusion of critical content and further expansion of interprofessional education can be considered. The UB FOM is in a position to actualise its identified leadership and management competencies to serve the needs of its graduates and those in their care.
背景:博茨瓦纳大学医学院(UB FOM)是博茨瓦纳唯一一所医学院。博茨瓦纳大学医学院(UB FOM)是博茨瓦纳唯一的一所医学院,开设该学院是为了解决其他人才战略无法解决的人才短缺问题。博茨瓦纳大学医学院的课程涉及各级医疗保健部门与患者的早期接触。新毕业的医生有望履行管理职责,而医学课程中很少有针对这一职责的正式培训。探讨毕业生和医学教育者(ME)对博茨瓦纳医学课程中领导力和管理培训的看法。采用主题分析法进行了一项非理论驱动的定性研究。对博茨瓦纳大学 FOM 的 12 名医学教育者和毕业生进行了访谈。进行了半结构化访谈,直至数据达到饱和。对数据进行了转录和分析。形成了两个主题:从小到大和播下种子。主题 1 描述了成为未来管理者和领导者的明确信息,但没有得到正规培训。主题 2 承认培训不足,并呼吁开展支架式纵向领导和管理教学,以及加强跨专业教育。课程中已经包含了领导力和管理培训的内容。卫生系统希望这些毕业生能立即承担领导和管理职责,因此有必要加强这些方面的培训。可以考虑纳入关键内容并进一步扩展跨专业教育。UB FOM 有能力实现其确定的领导和管理能力,以满足毕业生及其护理人员的需求。
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引用次数: 0
The use of the Delphi technique as part of the process of developing a tool to evaluate physiotherapy clinical education programmes 在开发物理治疗临床教育课程评估工具的过程中使用德尔菲技术
Pub Date : 2023-12-22 DOI: 10.7196/ajhpe.2023.v15i4.1670
V. Naidoo, PhD A Stewart, PhD D Maleka
Objectively evaluating the quality and effectiveness of a physiotherapy clinical education programme has been unsuccessful to date, due to its complexity and the lack of a standardised tool. We undertook to develop a standardised programme evaluation tool and used the Delphi method to obtain consensus (set at 80%) to determine the face and content validity of the items and domains of the tool, the scoring system and a name for the tool. Academics, clinical physiotherapists and clinical physiotherapy educators participated in the Delphi rounds. Three Delphi rounds ensued: in Delphi round 1, a 71% response rate was obtained and 49 questions obtained 80% consensus. In Delphi round 2, a 91% response rate was obtained and 59 questions obtained 80% consensus. In Delphi round 3, a 42% response rate was obtained, several names were suggested, and the scoring system was established. The provisional tool of 85 items ultimately emerged as the Vaneshveri Naidoo Clinical Programme Evaluation Tool (VN-CPET).
客观评估物理治疗临床教育项目的质量和有效性,由于其复杂性和缺乏标准化工具,迄今为止一直未能成功。我们着手开发了一种标准化的课程评估工具,并采用德尔菲法达成共识(设定为 80%),以确定工具的项目和领域、评分系统以及工具名称的表面和内容效度。学者、临床物理治疗师和临床物理治疗教育工作者参加了德尔菲讨论。随后进行了三轮德尔菲讨论:在第一轮德尔菲讨论中,获得了 71% 的回应率,49 个问题获得了 80% 的共识。在德尔菲第二轮中,获得了 91% 的回应率,59 个问题获得了 80% 的共识。在德尔菲第三轮中,获得了 42% 的回复率,提出了几个名称,并建立了评分系统。由 85 个项目组成的临时工具最终成为 Vaneshveri Naidoo 临床项目评估工具 (VN-CPET)。
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引用次数: 0
Early Online Issue 4 早期在线第 4 期
Pub Date : 2023-10-17 DOI: 10.7196/ajhpe.2023.v15i4.326
J. H. Irlam, A. Dreyer, G. Filies, L. Govender, N. Jacob, J. Jayakumar, C. L. Lokotola, R. Naidoo, S. Reid, H-A Rother
Background. Climate change and environmental degradation have severe public health impacts. Education about planetary health (PH) and sustainable healthcare (SH), or the interdependence of health and healthcare and planetary ecosystems, is developing globally to enable health professionals to protect public health from these threats, and to build sustainable healthcare systems. Objective. To assess the status of PH and SH in health professions education in South African (SA) faculties of health sciences as a foundation for future work. Methods. Educators at all 24 SA faculties of health sciences were surveyed regarding undergraduate and postgraduate faculty courses with PH- and SH-related learning objectives and outcomes, learning activities and assessments. Pivot tables were constructed to analyse their responses. Results. Forty-one responses were received, representing 9 health professions from 15 of 24 faculties of health sciences in SA (62.5%). More than half (53.7%) were unaware of any courses with PH and SH content at their faculties. Nineteen respondents from 11 faculties reported 44 courses and provided data on 18 non-duplicate courses. Learning activities included advising patients about environmental and health co-benefits of their lifestyle choices (33.3%); written assignments (38.9%); oral presentations (55.6%); and community-based research (38.9%). Nine courses (50%) reported PH- and SH-related assessments, most commonly oral presentations (88.9%); reflective essays (77.8%); multiple-choice or short assessment questions (55.6%); and research outputs (55.6%). Conclusion. Education about PH and SH is starting to develop in SA faculties, although with a limited variety of learning activities and assessments. This study provides a useful baseline for curriculum development and assessment of progress.
背景。气候变化和环境退化严重影响公众健康。全球正在开展有关地球健康(PH)和可持续医疗保健(SH)或健康和医疗保健与地球生态系统相互依存关系的教育,以使医疗专业人员能够保护公众健康免受这些威胁,并建立可持续的医疗保健系统。目标。评估南非(SA)卫生科学院卫生专业教育中 PH 和 SH 的现状,为今后的工作奠定基础。方法。对南非所有 24 个健康科学学院的教育工作者进行了调查,了解他们在本科生和研究生课程中与 PH 和 SH 相关的学习目标和成果、学习活动和评估情况。制作了数据透视表来分析他们的回答。结果。南澳大利亚 24 个健康科学学院中的 15 个学院(62.5%)共收到 41 份回复,代表 9 个健康专业。半数以上(53.7%)的受访者不知道自己所在的学院开设了任何包含 PH 和 SH 内容的课程。来自 11 个学院的 19 位受访者报告了 44 门课程,并提供了 18 门不重复课程的数据。学习活动包括向病人提供有关其生活方式选择的环境和健康共同效益的建议(33.3%)、书面作业(38.9%)、口头报告(55.6%)和社区研究(38.9%)。九门课程(50%)报告了与 PH 和 SH 相关的评估,其中最常见的是口头报告(88.9%)、反思性论文(77.8%)、多项选择或简短评估问题(55.6%)和研究成果(55.6%)。结论。南澳大学各院系已开始开展 PH 和 SH 教育,但学习活动和评估的种类有限。本研究为课程开发和进度评估提供了有用的基准。
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引用次数: 0
Early Online: Issue 4 早期在线第 4 期
Pub Date : 2023-10-10 DOI: 10.7196/ajhpe.2023.v15i4.830
R. Prakaschandra, R. Meyer, R. Bhagwan
Background. The COVID-19 pandemic had a significant influence on all spheres of society. This influence was particularly apparent in healthcare and in the training of health professionals within an already resource-constrained country such as South Africa. The purpose of this study was to explore the challenges and opportunities for learning from the point of view of students undertaking the Bachelor of Health Sciences (BHSc) in Clinical Technology programme, which is a specialised and distinctive field, as well as the academics involved in this programme. Objective. To explore how the clinical training practice component of the undergraduate programme was affected by the COVID-19 pandemic. Methods. A qualitative, exploratory research design was used. A non-probability purposive sampling method was selected. Students and academics were recruited and sampled. The first sample comprised 15 students from each of the 17 clinical departments where clinical training was undertaken. The second sample included 4 academics who were involved in teaching and supervising the placement of students at various healthcare institutions. Data were gathered using in-depth, semi-structured interviews on an adapted version of Gibbs’ cycle of reflection. Six questions were presented to each participant, underpinned by the findings from the literature review and modified specifically to the context of this study. Results. Four broad themes emerged: support for teaching during the COVID-19 pandemic; impact of the pandemic on students’ mental wellbeing; transitioning to the online learning space; and finding opportunities in the time of crisis. Conclusion. This study highlights the issues of preparedness for crisis situations by higher education institutions, academics and students and underscores the need for curricula to be more responsive to student and societal needs.
背景。COVID-19 大流行对社会各个领域都产生了重大影响。在南非这样一个资源已经十分紧张的国家,这种影响在医疗保健和卫生专业人员培训方面尤为明显。本研究的目的是从攻读临床技术专业健康科学学士(BHSc)课程的学生以及参与该课程的学者的角度出发,探讨学习所面临的挑战和机遇。目的探讨 COVID-19 大流行对本科课程临床培训实践部分的影响。方法。采用定性探索性研究设计。采用非概率目的性抽样方法。对学生和学者进行了招募和抽样。第一个样本包括来自 17 个临床培训所在临床科室的 15 名学生。第二个样本包括 4 名在不同医疗机构参与教学和指导学生实习的学者。数据收集采用了半结构式深度访谈,以吉布斯的反思周期为基础进行改编。根据文献综述的结论,并结合本研究的具体情况,向每位参与者提出了六个问题。研究结果出现了四个广泛的主题:在 COVID-19 大流行期间对教学的支持;大流行对学生心理健康的影响;向在线学习空间的过渡;以及在危机时刻寻找机会。结论本研究强调了高等教育机构、学术界和学生在危机情况下的准备问题,并强调了课程需要更好地满足学生和社会的需求。
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引用次数: 0
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African Journal of Health Professions Education
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