Rural internship job preferences of final year medical students in South Africa: a discrete choice experiment

To achieve Sustainable Development Goal 3 in developing countries, Good health and wellbeing for all, the health workforce is vital however the unpopularity of rural medical practice results in widening healthcare inequalities between urban and rural areas. This study determined the heterogeneity in valuations for rural facility attributes by final year medical students at one South African public university to inform cost-effective recruitment policy recommendations. Focus groups conducted identified facility attributes, a D-efficient design was generated with 15 choice sets, each with two rural hospital alternatives and no opt-out option. An online, unlabelled discrete choice experiment (DCE) was conducted, the results effects coded, and mixed logit models applied. The final sample size was 193 (86,16% of the class), majority female 130 (66.33%), with urban origins 176 (89.80%), unmarried 183 (93.37%) and without children 193 (98.47%). Most had undergraduate rural medicine exposure 110 (56.12%) and intended to specialise 109 (55.61%). The main-effects mixed logit found advanced practical experience, hospital safety, correctly fitted personal protective equipment (PPE) and availability of basic resources the highest weighted attributes with their mean utilities increasing by 0.82, 0.64, 0.62 and 0.52 respectively (p=0.000). In contrast, increases in rural allowance and the provision of housing provided smaller mean utility increases of 0.001 (p<0.01) and 0.09 (p<0.05) respectively. The interaction terms; female, general practise and prior rural medicine exposure, were associated with higher weighting for hospital safety, mean utility increases 1.59, 1.82, 1.42 respectively (p=0.000). Participants were willing to pay ZAR 2636.45 monthly (95%CI: 1398.55;3874.355) to gain advanced practical experience (equivalent to 65.91% of current rural allowance). Medical students’ facility preferences have been found to be influenced by their gender, career aspirations and prior experienced with rural medicine. The policy recommendations derived from this research include publicising rural health facility “draw-cards” among medical graduates, such as the opportunity to gain practical experience, improving the physical and occupational safety at rural health facilities and providing greater transparency about rural facility attributes to medical graduates

Factors that influence the reporting of child sexual abuse amongst primary school teachers in South Africa: an application of the theory of planned behaviour

Child sexual abuse is a prevalent problem in South Africa – one in every three children is sexually abused before the age of 18. Sexually abused children have serious psychological, physical and social problems which cause further difficulties into adulthood. Most abusers are known to their victims and thus, victims do not always disclose the abuse. Therefore, the law compels the reporting of child sexual abuse suspicions by third parties. However, past research shows that mandated reporters do not always report child sexual abuse suspicions. This study aimed to investigate the factors related to the mandatory reporting of child sexual abuse amongst primary school teachers in South Africa. A cross-sectional research study, using self-administered survey questionnaires, was conducted amongst foundation phase teachers in the Western Cape province of South Africa. Grounded on the theory of planned behaviour, this study investigated the relationships between various independent variables with the teacher's intention to report child sexual abuse. The independent variables tested included the teachers' attitude towards reporting, subjective norm, perceived behavioural control, knowledge on mandatory reporting, past reporting behaviour and socio-demographic characteristics of teachers. From a total population of 1118 public primary schools (and estimated 9542 foundation phase teachers), using stratified random sampling, a total of 2032 questionnaires were hand-delivered to 200 schools randomly selected across the Western Cape. A total of 399 foundation phase teachers participated in this study, representing a 20% response rate. This study found that about 25% of teachers had reported at least one case of child sexual abuse during their teaching career. About 7% of the teachers in this study had encountered instances in which they had failed to report suspected child sexual abuse. Subjective norm and perceived behavioural control (but not attitude towards reporting) was found to predict intention to report amongst teachers. A teacher who reported child sexual abuse in the past as well as a teacher with more accurate knowledge on mandatory reporting, was more likely to have intention to report in the future. Contrary to that posited by the theory of planned behaviour, attitude towards reporting did not mediate the relationship between past reporting behaviour and intention to report nor the relationship between knowledge on mandatory reporting and intention to report. The study further found that older teachers with more years teaching experience, although having a lower education level, were more likely to report their suspicions. Younger teachers, with less teaching experience, although better educated than their older counterparts, indicated less likelihood of reporting. The theory of planned behaviour, although significant, could not on its own effectively be applied to teachers' intention to report child sexual abuse and further investigation identified other explanatory factors that influenced teachers' intention to report. Given the high prevalence of child sexual abuse, the results have important implications. Whilst the teachers' age, years teaching experience or past reporting behaviour cannot be controlled, teachers must be adequately trained and supported. Knowing how to recognize and report child sexual abuse must be integrated into the tertiary education qualifications of student teachers as well as in continuing in-service training initiatives of current teachers. Furthermore, schools and the entire child protection system, must be supportive to teachers in their reporting duties

Measuring adaptation to non-permanent employment contracts using a conjoint analysis approach

This study attempts to uncover the ‘real’ impact of temporary contracts on workers’ perceived job quality, prior to the psychological phenomena of adaptation, coping and cognitive dissonance coming into play. This is done by using a novel conjoint analysis approach that examines the ex ante preferences over different contract statuses of a newly generated sample of low-skilled employees from seven European countries. Other things equal, it is shown that the anticipated psychological ‘costs’ of moving from a riskless permanent contract to the insecurity of a temporary job or no work at all appear to be quite significant. In contrast, temporary employees, who have presumably already adapted to the circumstances surrounding a non-permanent contract, are found to be statistically indifferent between permanent and temporary employment, and request much smaller wage premiums in order to switch from one status to the other. The well-documented distress associated with joblessness is also confirmed in our data. The methodology developed here can provide policymakers with an alternative and relatively inexpensive method of quantifying the immediate impact of any shift in their employment policies.European Commissio

Experimenting with Realism in Software Engineering Team Projects: An Experience Report

Over Several years, we observed that our students were sceptical of Software Engineering practices, because we did not convey the experience and demands of production quality software development. Assessment focused on features delivered, rather than imposing responsibility for longer term `technical debt'. Academics acting as 'uncertain' customers were rejected as malevolent and implausible. Student teams composed of novices lacked the benefits of leadership provided by more experienced engineers. To address these shortcomings, real customers were introduced, exposing students to real requirements uncertainty. Flipped classroom teaching was adopted, giving teams one day each week to work on their project in a redesigned laboratory. Software process and quality were emphasised in the course assessment, imposing technical debt. Finally, we introduced a leadership course for senior students, who acted as mentors to the project team students. This paper reports on the experience of these changes, from the perspective of different stakeholders

An elicitation study of the condom use behaviour and intentions of migrants youth in South Africa

Includes bibliographical references.Cross border migration is an ordeal that forces migrants in vulnerable situation and compromise their ability to negotiate preventive health care choices. The purpose of this study is to explore the factors that influence behavioural intentions and attitudes of young migrants in Cape Town South Africa towards condom use. The study is a qualitative study that utilized purposive sampling and snow balling as its methodology to investigate and obtained findings to the intentions of migrants’ behaviour. It employed in-depth open-ended questions developed for interviews in English. Participants consisted of 20 young migrants in the 18-35year cohort. The 20 respondents are from Cameroon and the Democratic Republic of Congo respectively. The 20 samples consisted of; 13 males and seven females; 10 singles and 10 married; nine single males and one single female; six married females and 4 married males

Expert knowledge elicitation in the firefighting domain and the implications for training novices

Background/Purpose: Experienced fireground commanders are often required to make important decisions in time-pressured and dynamic environments that are characterized by a wide range of task constraints. The nature of these environments is such that firefighters are sometimes faced with novel situations that seek to challenge their expertise and therefore necessitate making knowledge-based as opposed to rule-based decisions. The purpose of this study is to elicit the tacitly held knowledge which largely underpinned expert competence when managing non-routine fire incidents. Design/Methodology/Approach: The study utilized a formal knowledge elicitation tool known as the critical decision method (CDM). The CDM method was preferred to other cognitive task analysis (CTA) methods as it is specifically designed to probe the cognitive strategies of domain experts with reference to a single incident that was both challenging and memorable. Thirty experienced firefighters and one staff development officer were interviewed in-depth across different fire stations in the UK and Nigeria (UK=15, Nigeria=16). The interview transcripts were analyzed using the emergent themes analysis (ETA) approach. Findings: Findings from the study revealed 42 salient cues that were sought by experts at each decision point. A critical cue inventory (CCI) was developed and cues were categorized into five distinct types based on the type of information each cue generated to an incident commander. The study also developed a decision making model — information filtering and intuitive decision making model (IFID), which describes how the experienced firefighters were able to make difficult fireground decisions amidst multiple informational sources without having to deliberate on their courses of action. The study also compiled and indexed the elicited tacit knowledge into a competence assessment framework (CAF) with which the competence of future incident commanders could potentially be assessed. Practical Implications: Through the knowledge elicitation process, training needs were identified, and the practical implications for transferring the elicited experts’ knowledge to novice firefighters were also discussed. The four component instructional design model aided the conceptualization of the CDM outputs for training purposes. Originality/Value: Although it is widely believed that experts perform exceptionally well in their domains of practice, the difficulty still lies in finding how best to unmask expert (tacit) knowledge, particularly when it is intended for training purposes. Since tacit knowledge operates in the unconscious realm, articulating and describing it has been shown to be challenging even for experts themselves. This study is therefore timely since its outputs can facilitate the development of training curricula for novices, who then will not have to wait for real fires to occur before learning new skills. This statement holds true particularly in this era where the rate of real fires and therefore the opportunity to gain experience has been on a decline. The current study also presents and discusses insights based on the cultural differences that were observed between the UK and the Nigerian fire service

How being appreciative creates change – theory in practice from health and social care in Scotland

This paper develops understanding of appreciative action research that generates curiosity and motivation as a better platform for collaborative change. Blending theory and practice it draws on the example of the My Home Life leadership programme in Scotland that explores the concepts and approaches of ‘Caring Conversations’ and ‘playful provocation’ in care homes for older people. The paper shows how they expand notions of appreciation and help people to deepen inquiry, explore values, acknowledge and express emotion without dispute or judgement, articulate tacit knowledge and give voice to things previously thought to be ‘unsayable’. We explore how these generative approaches act as a powerful positive ‘disruption’ that brings existing relationships to life, supports a positive attitude to risk-taking and helps to devise new approaches to the local design and testing of approaches to problems. Ultimately these approaches play an important part in developing understanding of how to do appreciative action research to enhance relationships and more strengths or assets-based and collaborative ways of working and so, to develop new possibilities for changing social systems and a more future-making orientation to action research

A holistic model of emergency evacuations in large, complex, public occupancy buildings

Evacuations are crucial for ensuring the safety of building occupants in the event of an emergency. In large, complex, public occupancy buildings (LCPOBs) these procedures are significantly more complex than the simple withdrawal of people from a building. This thesis has developed a novel, holistic, theoretical model of emergency evacuations in LCPOBs inspired by systems safety theory. LCPOBs are integral components of complex socio-technical systems, and therefore the model describes emergency evacuations as control actions initiated in order to return the building from an unsafe state to a safe state where occupants are not at risk of harm. The emergency evacuation process itself is comprised of four aspects - the movement (of building occupants), planning and management, environmental features, and evacuee behaviour. To demonstrate its utility and applicability, the model has been employed to examine various aspects of evacuation procedures in two example LCPOBs - airport terminals, and sports stadiums. The types of emergency events initiating evacuations in these buildings were identified through a novel hazard analysis procedure, which utilised online news articles to create events databases of previous evacuations. Security and terrorism events, false alarms, and fires were found to be the most common cause of evacuations in these buildings. The management of evacuations was explored through model-based systems engineering techniques, which identified the communication methods and responsibilities of staff members managing these events. Social media posts for an active shooting event were analysed using qualitative and machine learning methods to determine their utility for situational awareness. This data source is likely not informative for this purpose, as few posts detail occupant behaviours. Finally, an experimental study on pedestrian dynamics with movement devices was conducted, which determined that walking speeds during evacuations were unaffected by evacuees dragging luggage, but those pushing pushchairs and wheelchairs will walk significantly slower.Open Acces