44 research outputs found

    Training of workplace-based clinical trainers in family medicine, South Africa : before-and-after evaluation

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    CITATION: Mash, R., et al. 2018. Training of workplace-based clinical trainers in family medicine, South Africa : before-and-after evaluation. African Journal of Primary Health care & Family Medicine, 10(1):a1589, doi:10.4102/phcfm.v10i1.1589.The original publication is available at https://phcfm.org/index.php/phcfmPublication of this article was funded by the Stellenbosch University Open Access Fund.Background: The training of family physicians is a relatively new phenomenon in the district health services of South Africa. There are concerns about the quality of clinical training and the low pass rate in the national examination. Aim: To assess the effect of a five-day course to train clinical trainers in family medicine on the participants’ subsequent capability in the workplace. Setting: Family physician clinical trainers from training programmes mainly in South Africa, but also from Ghana, Uganda, Kenya, Malawi and Botswana. Methods: A before-and-after study using self-reported change at 6 weeks (N = 18) and a 360-degree evaluation of clinical trainers by trainees after 3 months (N = 33). Quantitative data were analysed using the Statistical Package for Social Sciences, and qualitative data were analysed thematically. Results: Significant change (p < 0.05) was found at 6 weeks in terms of ensuring safe and effective patient care through training, establishing and maintaining an environment for learning, teaching and facilitating learning, enhancing learning through assessment, and supporting and monitoring educational progress. Family physicians reported that they were better at giving feedback, more aware of different learning styles, more facilitative and less authoritarian in their educational approach, more reflective and critical of their educational capabilities and more aware of principles in assessment. Despite this, the trainees did not report any noticeable change in the trainers’ capability after 3 months. Conclusion: The results support a short-term improvement in the capability of clinical trainers following the course. This change needs to be supported by ongoing formative assessment and supportive visits, which are reported on elsewhere.https://phcfm.org/index.php/phcfm/article/view/1589Publisher's versio

    Decentralised Training for Medical Students: A Scoping Review.

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    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

    Decentralised training for medical students: Towards a South African consensus

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    Introduction: Health professions training institutions are challenged to produce greater numbers of graduates who are more relevantly trained to provide quality healthcare. Decentralised training offers opportunities to address these quantity, quality and relevance factors. We wanted to draw together existing expertise in decentralised training for the benefit of all health professionals to develop a model for decentralised training for health professions students.Method: An expert panel workshop was held in October 2015 initiating a process to develop a model for decentralised training in South Africa. Presentations on the status quo in decentralised training at all nine medical schools in South Africa were made and 33 delegates engaged in discussing potential models for decentralised training.Results: Five factors were found to be crucial for the success of decentralised training, namely the availability of information and communication technology, longitudinal continuous rotations, a focus on primary care, the alignment of medical schools’ mission with decentralised training and responsiveness to student needs.Conclusion: The workshop concluded that training institutions should continue to work together towards formulating decentralised training models and that the involvement of all health professions should be ensured. A tripartite approach between the universities, the Department of Health and the relevant local communities is important in decentralised training. Lastly, curricula should place more emphasis on how students learn rather than how they are taught

    Kinematic Distances to Molecular Clouds identified in the Galactic Ring Survey

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    Kinematic distances to 750 molecular clouds identified in the 13CO J=1-0 Boston University-Five College Radio Astronomy Observatory Galactic Ring Survey (BU-FCRAO GRS) are derived assuming the Clemens rotation curve of the Galaxy. The kinematic distance ambiguity is resolved by examining the presence of HI self-absorption toward the 13CO emission peak of each cloud using the Very Large Array Galactic Plane Survey (VGPS). We also identify 21 cm continuum sources embedded in the GRS clouds in order to use absorption features in the HI 21 cm continuum to distinguish between near and far kinematic distances. The Galactic distribution of GRS clouds is consistent with a four-arm model of the Milky Way. The locations of the Scutum-Crux and Perseus arms traced by GRS clouds match star count data from the Galactic Legacy Infrared Mid-Plane Survey Extraordinaire (GLIMPSE) star-count data. We conclude that molecular clouds must form in spiral arms and be short-lived (lifetimes < 10 Myr) in order to explain the absence of massive, 13CO bright molecular clouds in the inter-arm space

    Teaching family medicine - what, why and where.

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    Implications for faculty development for emerging clinical teachers at distributed sites : a qualitative interpretivist study

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    CITATION: Blitz, J., De Villiers, M. & Van Schalkwyk, S. 2018. Implications for faculty development for emerging clinical teachers at distributed sites : a qualitative interpretivist study. Rural and remote health, 18(2):4482, doi:10.22605/RRH4482.The original publication is available at https://www.rrh.org.auIntroduction : Medical faculties have the responsibility to graduate competent health professionals and a consequent obligation to assure the quality and effectiveness of their students’ clinical teaching. Many institutions are responding to rural workforce needs by extending clinical training from the traditional academic teaching hospital to include rural and remote sites distributed away from the central training institution. It is incumbent upon medical schools to consider how this might impact on the faculty development of these clinicians as teachers. The research reported here sought to develop an understanding of how clinicians working at distant resource-constrained and new training sites view their early experiences of having been delegated the task of clinical teaching. This was with a view to informing the development of initiatives that could strengthen their role as teachers. Methods: Qualitative research using an interpretive approach was used to reach an understanding of the views and subjective experiences of clinicians taking on the role of clinical teaching. Participants were emerging clinical teachers at distant peri-urban, rural and remote sites in South Africa. They were deemed to be emerging by virtue of either having recently taken on the role of clinical teacher, or working at sites newly used for clinical teaching. In-depth interviews were conducted with all nine clinicians meeting these criteria. The interviews were coded inductively looking for underlying meanings, which were then grouped into categories. Results: The findings clustered into three inter-related themes: relationships, responsibilities and resources. The clinicians take pleasure in developing learning relationships that enable students to have a good experience by participating actively in the clinical environment, value what students bring from the medical school in terms of clinical advances and different perspectives, and in the contribution that they feel they are making to creating a more appropriately trained future healthcare workforce. However, they yearn for a closer relationship with the medical school, which they think could acknowledge the contributions they make, while also offering opportunities for them to become more effective clinical teachers. They also feel that they have a role to play in both curriculum re-alignment and student evaluation. These clinicians felt that the medical school has a responsibility to let them know if they are doing ‘the right thing’ as clinical teachers. Interestingly, these participants see trusted clinical colleagues and mentors as a resource when needing advice or mentorship concerning clinical teaching. Conclusion: This study adds to an understanding around designing faculty development initiatives that meet the needs of clinicians at distant sites that take on the role of clinical teaching. There remains the need to impart particular strategies to support the learning of particular kinds of knowledge that is commonly dealt with in faculty development. However, there may be an additional need for faculty developers to embrace what is known about rural doctor social learning systems by overtly designing for incorporation of the foundational three Rs: relationships, responsibilities and resources.https://www.rrh.org.au/journal/article/4482Publisher's versio