A self-determination theory perspective on student success in attaining an emergency care degree

Background. While student enrolment has increased in the South African (SA) higher education system, the undergraduate  throughput rate has been abysmal. Consequently, the literature has largely focused on the negative discourse of understanding the hindrance of student success in higher education.Objectives. To take a positive discourse viewpoint of understanding student success in the Bachelor of Emergency Medical Care  (BEMC) degree in SA. The paper uses Deci and Ryan’s self-determination theory to explore students’ motivation to succeed in attaining the BEMC degree in SA.Methods. Participants were BEMC students recruited from 4 universities. Third- and fourth-year students who had not repeated a module/subject while studying for the BEMC degree were purposively sampled and invited to join the focus group discussions. These groups were conducted at the respective institutions during the participants’ free time. The audio recordings were transcribed to produce a written text of the focus group discussions. Thematic analysis was used to analyse the data with the aid of NVivo 11 (Microsoft, USA).Results. The thematic analysis yielded two themes, i.e. intrinsic and extrinsic motivation. Some students were intrinsically motivated to complete the degree in the minimum time. It is more likely that students’ intrinsic motivation increased with continued success in the programme and that it also satisfied their feeling of competence. Some students succeeded owing to extrinsic motivational factors – to prove some people wrong or because of the financial implications of failure.Conclusion. The emergency care departments need to assist students to maintain motivation, which may satisfy their feelings of autonomy and competence. Addressing students’ motivation may allow for more continued success in the academic programme

Outcomes following prehospital airway management in severe traumatic brain injury

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Synthesis of inside-out core-shell perovskite-type oxide nanopowder

Background. Several studies have made it possible to predict outcome in severe traumatic brain injury (TBI) making it beneficial as an aid for clinical decision-making in the emergency setting. However, reliable predictive models are lacking for resource-limited prehospital settings such as those in developing countries like South Africa. Objective. To develop a simple predictive model for severe TBI using clinical variables in a South African prehospital setting. Methods. All consecutive patients admitted at two level-one centres in Cape Town, South Africa, for severe TBI were included. A binary logistic regression model was used, which included three predictor variables: oxygen saturation (SpO2), Glasgow Coma Scale (GCS) and pupil reactivity. The Glasgow Outcome Scale was used to assess outcome on hospital discharge. Results. A total of 74.4% of the outcomes were correctly predicted by the logistic regression model. The model demonstrated SpO2 (p=0.019), GCS (p=0.001) and pupil reactivity (p=0.002) as independently significant predictors of outcome in severe TBI. Odds ratios of a good outcome were 3.148 (SpO2 ≥90%), 5.108 (GCS 6 - 8) and 4.405 (pupils bilaterally reactive). Conclusion. This model is potentially useful for effective predictions of outcome in severe TBI