South African podiatry students' perceptions of feedback given as part of clinical training

Challenges faced by nurses in managing patients with foot pathologies at primary healthcare clinics in Johannesburg-South Africa

BACKGROUND

Foot health (podiatric) services remain inaccessible in many primary healthcare clinics across South Africa. As first-line contact practitioners at primary health care clinics, nurses manage all patients, including those presenting with foot pathologies. Anecdotal evidence suggests that nurses have challenges and are limited in their capability to assess the foot. In most cases, they do not assess the foot as part of the routine patient assessment. The primary aim of this study was to investigate the challenges nurses face in managing patients presenting with foot pathologies at primary healthcare clinics.

METHODS

The study used a qualitative design to explore nurses' challenges in managing patients presenting with foot complaints. A purposive sampling strategy was used to select participants from primary health care clinics in Johannesburg to participate in a focus group discussion. Data were analysed using Giorgi's qualitative thematic analysis to reveal themes based on similarities and relationships between the collected data.

RESULTS

Six PHC nurses participated in the focus group discussion. Participants confirmed challenges in managing patients presenting with foot pathologies. These include poor guidelines, limited training, consultation times, and a lack of defined referral pathways for patients with foot pathologies. Nurses indicated that due to challenges at the PHC level, foot assessment is not a mandatory part of patient assessment. All participants agreed on the need for structured foot health services.

CONCLUSION

Primary healthcare nurses have challenges in managing patients with foot pathologies. There is a need for structured foot health services and training for nurses to coordinate care for this patient group effectively. Further studies should establish the need and demand for podiatric services to distribute the limited podiatry resources equitably, such as placement of podiatrists at community healthcare centres which serve as the first referral point for primary healthcare clinics.

Becoming a podiatrist: an exploration of the practices and processes which underpin the acquisition of a professional identity

BACKGROUND

Undergraduate podiatry degrees are designed to enable students to become professional podiatrists. To be successful students must manage academic and practical activity to ultimately acquire a professional identity. Little is known about the practices and processes which underpin the acquisition of a professional podiatry identity. It is the aim of this paper to begin to address this absence of knowledge. Community of Practice theory, arguably the dominant contemporary learning theory, represents identity shift as an interaction of imagination, engagement and alignment which enables students to successfully participate in higher education, and ultimately, the professional context. This success is underpinned through assisting students to develop an enabling identity in their learning and doing.

METHODS

Here we present findings that emerged from a yearlong ethnography in a successful higher education podiatry department. The project followed students and staff in the classroom and the clinic and explored their experiences through interviews.

RESULTS

The findings suggest that the journey to professional identity is facilitated through meaningful learning relationships between staff and students and clarity around professional practices. Here we discuss how those relationships form and enable undergraduates to become podiatrists.

CONCLUSIONS

Our findings offer a model for the transition from student to professional and highlight the importance of relationship and experience in becoming a podiatrist. There is a paucity of research around not only podiatry but also other allied health professions around this topic and given the increasing emphasis around employability skills in HE, more research in a range of contexts is needed.