Scielo RSS <![CDATA[African Journal of Health Professions Education]]> vol. 15 num. 1 lang. es <![CDATA[SciELO Logo]]> <![CDATA[<b>Balancing responsibility-sharing in the simulated clinical skills setting: A strategy to remove barriers to feedback engagement as a new concept to promote a growth-enhancing process</b>]]> BACKGROUND. When feedback is provided in a formative context, it must be used effectively by learners. Many barriers prevent medical students from meaningfully engaging with feedback in the clinical learning environment. OBJECTIVE. To explore how medical students engage with feedback in preclinical skills training. METHODS. Using an exploratory qualitative methodology, data from five focus groups, including 25 purposively selected third-year medical students, were iteratively analysed and identified and key themes were clarified. RESULTS. The data revealed barriers that inhibit the use of feedback, ranging from students' difficulties with decoding feedback, to their unwillingness to expend effort. Thematic analysis revealed four major themes related to the barriers to feedback receptivity and utilisation. CONCLUSION. Without collaboration, neither clinical educators nor students are empowered to fully remove the abovementioned barriers. Promoting a student's learning is often framed as predominantly the task of their clinical educators. With a move towards constructivism, competency-based medical education claims that effective learning requires students to complement and significantly share in their educator's responsibilities for their academic growth. Developing a responsibility-sharing culture in the giving and receiving of feedback ensures that students benefit fully from the feedback received through proactive engagement, leading to effective and sustainable clinical educator's feedback practices. With minimal discussion on the concept of responsibility-sharing in the context of assessment feedback in medical education, it is necessary to further analyse and discuss this critical issue by considering certain expectations that should reinforce such a culture, along with the practicalities of creating this cultural shift within the preclinical skills setting. <![CDATA[<b>MB ChB fifth-year student response to e-learning in orthopaedic surgery during COVID-19</b>]]> BACKGROUND. With the onset of the COVID-19 pandemic and the subsequent country-wide lockdown, South African (SA) universities were forced to quickly adapt to teaching that minimised or eliminated in-person contact. The pandemic period necessitated rapid changes to the way in which learning occurs and resulted in significant shifts in the academic environment. There is limited evidence in the literature to support e-learning in undergraduate orthopaedic training. This is the first study of its kind evaluating e-learning in orthopaedic surgery in a middle-to-low-income country. OBJECTIVES. To identify the University of Cape Town fifth-year MB ChB cohort's attitudes towards the e-learning component of blended learning during the COVID-19 pandemic. It also aimed to investigate whether e-learning facilitates comparable levels of confidence and results among students and face-to-face methods. METHODS. Multi-year cross-sectional survey analysis was completed by retrospectively analysing the students' end-of-block evaluations and end-of-block marks. Responses from the cohorts between 2016 and 2020 were compared. RESULTS. Regarding course definition, workload, course organisation, intended preparation and course presentation, the 2020 cohort's responses were similar to those of previous years. The 2020 cohort agreed that the e-learning material was relevant; this response was higher than in previous years. They also agreed that the online practical sessions were useful and that the course stimulated more interest. Significantly, they also strongly agreed that the online course was easier to attend and participate in than in previous years. The 2020 cohort perceived the end-of-block assessment to be somewhat unreasonable; however, this cohort yielded similar grades compared with previous cohorts. Subjectively, the students' responses to e-learning were positive, as many of them welcomed the usefulness and stimulation of online media as a study tool. Students felt that more time should be made available to work through online material and that there was incongruity between the content taught and the content of the end-of-block assessments. CONCLUSION. Subjectively, the students' responses to e-learning were positive, as many of them welcomed the usefulness and stimulation of online media. With comparable outcomes in terms of student confidence and final marks (compared with traditional teaching only), it further encouraged a move towards formulating a novel blended learning curriculum. With these positive findings, we were able to explore the possibilities of developing an e-learning course curriculum incorporating international blended learning practices, using locally sourced SA evidence-based literature to provide orthopaedic teaching relevant to our unique setting. <![CDATA[<b>Student knowledge and perceptions of climate change and environmental sustainability at the Faculty of Health Sciences, University of Cape Town, South Africa</b>]]> BACKGROUND. Climate change and polluting healthcare systems are significant threats to public health. Education about planetary health and environmentally sustainable healthcare is needed to equip health professionals to meet these challenges. OBJECTIVES. To assess the knowledge, perceptions and understanding of climate change and environmental sustainability among undergraduate health sciences students at the Faculty of Health Sciences (FHS), University of Cape Town (UCT). METHODS. Two student-led focus groups helped to design a cross-sectional survey of all undergraduate health sciences students. The survey findings were analysed quantitatively and thematically. RESULTS. The 264 respondents included 211 medical and 53 health and rehabilitation students. Two-thirds of respondents (64.4%) claimed awareness but little understanding of climate change, which was understood mainly as changes in weather and climate patterns (40%) as a result of human activities (96.6%). Most (72%) were aware of the concept of environmental sustainability, but with little understanding. Students' main sources of information about climate change were the internet (84.1%) and social media (77.3%). Two-thirds believed that climate change will highly impact their patients' health and quality of life. Most (58.3%) thought that health professionals can help to prevent climate change by educating patients and promoting sustainable lifestyles. Nearly half (47.3%) thought it important to teach climate change and environmental sustainability in the curriculum. CONCLUSION. Climate change and environmental sustainability have been poorly incorporated into current FHS, UCT curricula. Students acknowledged that these concepts are important and should be taught. The FHS should integrate planetary health and environmental sustainability into its curricula, in line with global efforts. <![CDATA[<b>Developing indicators for monitoring and evaluating the primary healthcare approach in health sciences education at the University of Cape Town, South Africa, using a Delphi technique</b>]]> BACKGROUND. The Faculty of Health Sciences (FHS), University of Cape Town (UCT) adopted the primary healthcare (PHC) approach as its lead theme for teaching, research and clinical service in 1994. A PHC working group was set up in 2017 to build consensus on indicators to monitor and evaluate the PHC approach in health sciences education in the FHS, UCT. OBJECTIVE. To develop a set of indicators through a Delphi technique for monitoring and evaluating the PHC approach in health sciences curricula in the FHS, UCT. METHODS. A national multidisciplinary Delphi panel was presented with 61 indicators of social accountability from the international Training for Health Equity Network (THEnet) for scoring in round 1. Nineteen PHC indicators, derived from a mnemonic used in the FHS, UCT for teaching core PHC principles, were added in round 2 to the 20 highest ranked THEnet indicators from round 1, on recommendation of the panel. Scoring criteria used were relevance (in both rounds), feasibility/measurability (round 1 only) and application of the PHC indicators to undergraduate and postgraduate teaching and assessment (round 2 only). RESULTS. Of the 39 indicators presented in the second round, 11 had an overall relevance score >85% based on the responses of 16 of 20 panellists (80% response rate). These 11 indicators have been grouped by learner needs (safety of learners - 88%, teaching is appropriate to learners' needs and context - 86%); healthcare user needs (continuity of care - 94%, holistic understanding of healthcare - 88%, respecting human rights - 88%, providing accessible care to all - 88%, providing care that is acceptable to users and their families - 87%, providing evidence-based care - 87%); and community needs (promoting health through health education - 88%, education programme reflects communities' needs - 86%, teaching embodies social accountability - 86%). CONCLUSION. The selected indicators reflect priorities relevant to the FHS, UCT and are measurable and applicable to undergraduate and postgraduate curricula. They provided the basis for a case study of teaching the PHC approach to our undergraduate students. <![CDATA[<b>A nominal group technique to review undergraduate medical students' training in emergency care</b>]]> BACKGROUND. The management of clinical emergencies is an essential skill for medical practitioners; therefore, proper training in these skills is crucial. This is a review of emergency care training by recent graduates of a medical programme to provide feedback on the usefulness of their training experience for entry into clinical practice. Academic clinicians working in the clinical environment, who provide the training, and academic managers who manage the training programme, could provide valuable inputs into reviewing the emergency care training programme contextualised for the uniquely South African challenges. OBJECTIVES. To obtain and prioritise experience-based and relevant suggestions for improving the current teaching and to invite comment on the suggestions from the relevant managers. METHODS. Research was conducted in three phases using a nominal group technique to review an undergraduate medical programme. In the first phase, recent graduates from the existing programme identified its strengths and weaknesses. In the second phase, academic clinicians and technical experts provided suggestions for addressing these challenges. In the third phase, data obtained were discussed with academic managers responsible for the undergraduate medical programme. RESULTS. Findings were grouped into thematic categories: skills and short courses, module structure and content, experiential learning opportunities, health professions educational practice and interprofessional education. Opportunities to gain experience in emergencies in different clinical fields and as a multi-professional team, both in simulation and real-life practice, were among the highlights of the findings. CONCLUSION. Many of the suggested improvements, such as a dedicated emergency care module, and more simulated and small-group case-based teaching, are achievable with the given resources. Additionally, with recent changes due to the COVID-19 pandemic and lockdown, an environment for change that benefits online content delivery was created. The creation of longitudinal themes will be an enhancement of the current programme. <![CDATA[<b>Qualitatively speaking: Deciding how much data and analysis is enough</b>]]> As I traverse my (post) doctoral journey, reworking my thesis into publications, I was immersed again in a debate around the utility of the concept of data saturation. I believe this debate to be emblematic of the process of unlearning and relearning that unfolded during my doctoral journey, coming from a biomedical sciences background into qualitative educational research.