On borders, boundaries and being a chameleon: Metaphors for reframing the academic project

Susan van Schalkwyk, MPhil PhD, is Professor in Health Professions Education and Director of the Centre for Health Professions Education in the Faculty of Medicine and Health Sciences (FMHS) at Stellenbosch University, where she is involved in supervision of Master’s and PhD students, and faculty development. Her research interests cover a range of aspects relating to teaching and learning, with a specific focus on postgraduate studies and academic writing. In this context, Susan regularly contributes to the FMHS pre-doctoral programme as well as the African Doctoral Academy’s winter and summer schools. In addition, she has facilitated more than ten writing workshops and retreats, across South Africa as well as in several sub-Saharan countries. She is a founding member of the Bellagio Global Health Education Initiative, an interdisciplinary, multinational effort to advance global health education worldwide. Susan is active in health professions education, both nationally and internationally, and is currently a member of the AMEE (Association of Medical Educationalists) Research Committee, the Best Evidence Medical Education Review Committee, on the editorial board of MedEdPublish, and an associate editor for BMC Medical Education and the African Journal of Health Professions Education. In 2016, she received a National Research Foundation rating and has authored or co-authored more than 50 peer-reviewed articles and book chapters

The influence of context on the teaching and learning of undergraduate nursing students: A scoping review

BACKGROUND. The role that context plays in the teaching and learning space has been well documented.OBJECTIVES. To synthesise perspectives from previous studies related to the influence of context on teaching and learning among undergraduate nursing students.METHODS. This study was guided by the stages for review proposed by Arksey and O'Malley. Six databases were searched, generating 1 164 articles. Based on the eligibility criteria, the articles were screened through several processes, resulting in 55 articles being included in the final review.RESULTS. Five themes were identified, including the organisational space, the nature of interactions in the healthcare team, the role of the nurse manager, the role of the educator and the academic institution-hospital engagement.CONCLUSION. While there are many studies of the role of context in teaching and learning, this review highlights the interconnectedness of the various factors within the learning context, providing a framework that can inform decision-making when seeking to enhance teaching and learning in nursing education

Teaching Medical Students in a New Rural Longitudinal Clerkship: Opportunities and Constraints

Background: Medical schools in Africa are responding to the call to increase numbers of medical graduates by up-scaling decentralized clinical training. One approach to decentralized clinical training is the longitudinal integrated clerkship (LIC), where students benefit from continuity of setting and supervision. The ability of family physician supervisors to take responsibility for the clinical training of medical students over a longer period than the usual, in addition to managing their extensive role on the district health platform, is central to the success of such training. Objective: This study investigated the teaching experiences of family physicians as clinical supervisors in a newly introduced LIC model in a rural sub-district in the Western Cape, South Africa. Method: Nine semi-structured interviews were conducted with six family physicians as part of the Stellenbosch University Rural Medical Education Partnership Initiative (SURMEPI) five-year longitudinal study. Code lists were developed inductively using Atlas.ti v7, they were compared, integrated, and categories were identified. Emerging common themes were developed. Findings: Three overarching themes emerged from the data, each containing subthemes. The rural platform was seen to be an enabling learning space for the LIC students. The family physicians’ experienced their new teaching role in the LIC as empowering, but also challenging. Lack of time for teaching and the unstructured nature of the work emerged as constraints. Despite being uncertain about the new LIC model, the family physicians felt that it was easier to manage than anticipated. Conclusion: The centrality of the rural context framed the teaching experiences of the family physicians in the new LIC, forming the pivot around which constraints and opportunities for teaching arose. The African family physician is well positioned to make an important contribution to the upscaling of decentralized medical training, but would need to be supported by academic institutions and health service managers in their teaching role

Using Free Open Access Medical Education (FOAMed) for Emergency Medical Service education

Background: Continuous professional development (CPD) is a registration requirement for all healthcare professionals in South Africa. The shift-driven work environment of emergency and critical care providers often means it is logistically impractical to attend CPD events. FOAMed and online learning could make CPD activities more accessible. The aim of the study was to determine to what extent available FOAMed resources could be used to supplement the outcomes for successful completion of a CPD course. Methods: A retrospective content analysis was used to review FOAMed resources posted within a two-month period for their ability to cover outcomes of the Ambulance Emergency Assistant (AEA) refresher course (a CPD course). Data were subject to a three-step process of content analysis that was matched to 17 identified course outcomes (themes). Results: A total of 441 FOAMed posts were reviewed during a two-month period. Of the 441 posts, 269 (61%) were excluded, and 172 (39%) FOAMed posts were determined relevant to cover the 17 identified themes of the AEA refresher course. The two most frequently observed themes were related to (i) professionalism, with 45 (26.2%) posts, and (ii) other general medical emergencies, with 39 (22.7%) posts. The remaining 15 themes had 88 (51.1%) posts distributed between them. Conclusion: The study highlights the potential of FOAMed resources to supplement the delivery of education, such as a CPD course. Given that the outcomes were unequally represented, educational institutions should be aware that despite the value of FOAMed, due caution must be given to the critiques and limitations of this educational approach

Decentralised Training for Medical Students: A Scoping Review.

BACKGROUND: Increasingly, medical students are trained at sites away from the tertiary academic health centre. A growing body of literature identifies the benefits of decentralised clinical training for students, the health services and the community. A scoping review was done to identify approaches to decentralised training, how these have been implemented and what the outcomes of these approaches have been in an effort to provide a knowledge base towards developing a model for decentralised training for undergraduate medical students in lower and middle-income countries (LMICs). METHODS: Using a comprehensive search strategy, the following databases were searched, namely EBSCO Host, ERIC, HRH Global Resources, Index Medicus, MEDLINE and WHO Repository, generating 3383 references. The review team identified 288 key additional records from other sources. Using prespecified eligibility criteria, the publications were screened through several rounds. Variables for the data-charting process were developed, and the data were entered into a custom-made online Smartsheet database. The data were analysed qualitatively and quantitatively. RESULTS: One hundred and five articles were included. Terminology most commonly used to describe decentralised training included \u27rural\u27, \u27community based\u27 and \u27longitudinal rural\u27. The publications largely originated from Australia, the United States of America (USA), Canada and South Africa. Fifty-five percent described decentralised training rotations for periods of more than six months. Thematic analysis of the literature on practice in decentralised medical training identified four themes, each with a number of subthemes. These themes were student learning, the training environment, the role of the community, and leadership and governance. CONCLUSIONS: Evident from our findings are the multiplicity and interconnectedness of factors that characterise approaches to decentralised training. The student experience is nested within a particular context that is framed by the leadership and governance that direct it, and the site and the community in which the training is happening. Each decentralised site is seen to have its own dynamic that may foreground certain elements, responding differently to enabling student learning and influencing the student experience. The insights that have been established through this review have relevance in informing the further expansion of decentralised clinical training, including in LMIC contexts

Medical education departments: a study of four medical schools in Sub-Saharan Africa

Background Many African countries are investing in medical education to address significant health care workforce shortages and ultimately improve health care. Increasingly, training institutions are establishing medical education departments as part of this investment. This article describes the status of four such departments at sub-Saharan African medical schools supported by the Medical Education Partnership Initiative (MEPI). This article will provide information about the role of these institutional structures in fostering the development of medical education within the African context and highlight factors that enable or constrain their establishment and sustainability. Methods In-depth interviews were conducted with the heads or directors of the four medical education departments using a structured interview protocol developed by the study group. An inductive approach to analysis of the interview transcripts was adopted as the texts were subjected to thematic content analysis. Results Medical education departments, also known as units or centers, were established for a range of reasons including: to support curriculum review, to provide faculty development in Health Professions Education, and to improve scholarship in learning and teaching. The reporting structures of these departments differ in terms of composition and staff numbers. Though the functions of departments do vary, all focus on improving the quality of health professions education. External and internal funding, where available, as well as educational innovations were key enablers for these departments. Challenges included establishing and maintaining the legitimacy of the department, staffing the departments with qualified individuals, and navigating dependence on external funding. All departments seek to expand the scope of their services by offering higher degrees in HPE, providing assistance to other universities in this domain, and developing and maintaining a medical education research agenda. Conclusions The establishment of medical education departments in Sub-Saharan Africa is a strategy medical schools can employ to improve the quality of health professions education. The creation of communities of practice such as has been done by the MEPI project is a good way to expand the network of medical education departments in the region enabling the sharing of lessons learned across the continent

Mapping undergraduate exit-level assessment in a medical programme : a blueprint for clinical competence?

CITATION: Tan, C. P. L., et al. 2016. Mapping undergraduate exit-level assessment in a medical programme: a blueprint for clinical competence? African Journal of Health Professions Education, 8(1):45-49, doi:10.7196/AJHPE.2016.v8i1.546.The original publication is available at http://www.ajhpe.org.zaENGLISH SUMMARY : Background. Assessment is an essential component of a medical curriculum. High-stakes exit-level assessment used for licensing and certification purposes needs to be sound. Even though criteria for evaluating assessment practices exist, an analysis of the nature of these practices is first required. Objective. To map current exit-level assessment practices, as described in institutional documentation. Methods. This descriptive interpretive study centred on the document analysis of final-phase study guides of the undergraduate medical programme at Stellenbosch University, Cape Town, South Africa. Results. The key findings were: (i) there is a diversity of methods and approaches to assessment in the final-phase modules; (ii) modules using similar assessment methods applied different credit weightings; (iii) similar assessment methods were described differently across the study guides; and (iv) study guides varied in the amount of information provided about the assessment methods. Conclusion. There is a diverse range of assessment practices at exit level of the MB,ChB programme at Stellenbosch University. This in-depth analysis of assessment methods has highlighted areas where current practice needs to be investigated in greater depth, and where shifts to a more coherent practice should be encouraged. Assessment mapping provides a useful reference for programme co-ordinators and is applicable to other programmes.http://www.ajhpe.org.za/index.php/ajhpe/article/view/546Publisher's versio