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Mabuza LH, Moshabela M. What are the experiences of medical students and their trainers regarding undergraduate training in primary health care at four South African medical schools? A qualitative study. Front Med (Lausanne) 2024; 11:1337140. [PMID: 38957301 PMCID: PMC11217328 DOI: 10.3389/fmed.2024.1337140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 06/04/2024] [Indexed: 07/04/2024] Open
Abstract
Background In 1978, the World Health Organization (WHO) adopted primary health care (PHC) as the most effective strategy to meet the healthcare needs of communities. This raises the question as to the extent and nature of the training that undergraduate (UG) medical students receive in medical schools regarding PHC, following this statement. Aim The study aim was to explore the experiences of UG medical students and their trainers regarding training in PHC in their institutions. Methods A qualitative study was conducted among UG medical students (MBChB 4-6) and their trainers at four conveniently selected South African medical schools. A total of 16 focus group discussions (FGDs) and 27 in-depth interviews were conducted among students and their trainers, respectively. The MAXQDA 2020 (Analytics Pro) software program was used to arrange the data, resulting in 2,179 data segments, from which categories, sub-themes and themes were derived. Results Both the UG medical students and their trainers regarded PHC as mainly an approach to health rather than a level of care. Students were trained by specialists and generalists, received training in the undifferentiated patient, coordinated, comprehensive and continuity of care. The training in tertiary centers, conducted mainly by specialists, the implicitness of the training and the inadequacy of trainers at the PHC settings presented challenges. Conclusion Students and their trainers experienced UG student training in PHC in line with the internationally recognized principles on the subject. The view by students and their trainers that PHC is an approach rather than a level of care enhanced its training across disciplines. The implicitness of the training and the tertiary learning platforms were the main challenges experienced. For optimum PHC training, more time should be dedicated to distributed training platforms with supportive specialist outreach programs in the South African medical schools.
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Affiliation(s)
- Langalibalele Honey Mabuza
- School of Medicine, Clinical Integrated Programs, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Mosa Moshabela
- Research and Innovation Department, University of KwaZulu-Natal, Durban, South Africa
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Mabuza LH, Moshabela M. What do medical students and their clinical preceptors understand by primary health care in South Africa? A qualitative study. BMC MEDICAL EDUCATION 2023; 23:785. [PMID: 37864172 PMCID: PMC10589924 DOI: 10.1186/s12909-023-04751-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/05/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND The definition of Primary Health Care (PHC) issued by the World Health Organisation in 1978 indicated that essential health care should be made accessible to individuals and their communities close to where they live and work. In 1992 Starfield articulated the four pillars of PHC: the patient's first contact with healthcare, comprehensive care, coordinated care and continuous care. Using this literature guidance, this study sought to explore what undergraduate medical students and their clinical preceptors understood by PHC in four South African medical schools. METHODS A qualitative study using the phenomenological design was conducted among undergraduate medical students and their clinical preceptors. The setting was four medical schools in South Africa (Sefako Makgatho Health Sciences University, Walter Sisulu University and the University of KwaZulu-Natal and the Witwatersrand University). A total of 27 in-depth interviews were conducted among the clinical preceptors and 16 focus group discussions among the students who were in their clinical years of training (MBChB 4-6). Interviews were digitally recorded and transcribed verbatim, followed by thematic data analysis using the MAXQDA 2020 (Analytics Pro) software. RESULTS Four themes were identified in which there were similarities between the students and their preceptors regarding their understanding of PHC: (1) PHC as the patient's first contact with the healthcare system; (2) comprehensive care; (3) coordination of care and (4) continuity of care. A further two themes were identified in which these two groups were not of similar understanding: (5) PHC as a level or an approach to healthcare and (6) the role of specialist clinical preceptors in PHC. CONCLUSIONS Medical students and their clinical preceptors displayed an understanding of PHC in line with four pillars articulated by Starfield and the WHO definition of PHC. However, there remains areas of divergence, on which the medical schools should follow the guidance provided by the WHO and Starfield for a holistic understanding of PHC.
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Affiliation(s)
- Langalibalele Honey Mabuza
- School of Medicine, Clinical Integrated Programs, Sefako Makgatho Health Sciences University, 0012, Pretoria, South Africa.
| | - Mosa Moshabela
- Research and Innovation, University of KwaZulu-Natal, 4001, Durban, South Africa
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Dodsworth A, Munro K, Alberti H, Hirsh DA, Paes P, Illing J. Patient outcomes in a Longitudinal Integrated Clerkship: A systematic literature review. MEDICAL EDUCATION 2023; 57:820-832. [PMID: 36573064 DOI: 10.1111/medu.15013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/13/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
CONTEXT Patient-student relationships are at the heart of Longitudinal Integrated Clerkships (LICs). Outcomes for students and preceptors are beneficial, but patient outcomes remain unclear. This systematic literature review explored the current evidence base of patient outcomes in an LIC. Patient outcomes were defined as issues related to patient safety, clinical effectiveness or patient experience. METHODS Seven bibliographic databases were searched. A wider search strategy included a hand search of three medical education journals' previous issues and backward/forward citation searching of included studies and of a relevant systematic review. Included studies were quality appraised and assessed for their strength and level of evidence. A qualitative data synthesis was performed. RESULTS Databases searches identified 7237 titles. Following the removal of duplicates, titles and abstracts were reviewed against the inclusion criteria. Forty-eight studies had a full-text review. Nineteen met the inclusion criteria. Seven studies were included from the wider search strategy. From the 26 included studies, two major themes were identified. (1) 'A trusting patient-student relationship' contains the sub-themes: 'care and compassion', 'patient education and empowerment' and 'the loss of the student as 'my' doctor'. (2) 'The student acts as an agent of change for the patient' contains the sub-themes: 'patient advocacy', 'supporting the patient to navigate the healthcare system', 'communication between patient and healthcare professional' and 'enhancement of preceptors' care, healthcare services and communities'. CONCLUSIONS LICs provide educational continuity allowing the creation of a trusting patient-student relationship. This relationship leads to students becoming agents of change for patients by enhancing patient outcomes. This review provides further evidence on the benefits of having an LIC as part of the medical education curricula and implications for its successful delivery. Further research is needed to explore educationally induced benefits for patients and look at objective assessments of patient health outcomes.
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Affiliation(s)
- Alastair Dodsworth
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Northumbria General Practice Training Programme, Health Education England North East and Cumbria, Newcastle upon Tyne, UK
| | - Katie Munro
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Hugh Alberti
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - David A Hirsh
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Massachusetts Cambridge Health Alliance, Cambridge, Massachusetts, USA
| | - Paul Paes
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Jan Illing
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
- RCSI University of Medicine Health Sciences, Dublin, Ireland
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Davies ML, Ellis PK, Moses A, Lawson H, Akpalu A, Walker RW. Factors affecting family medicine programmes in Sub-Saharan Africa: a narrative review of recent literature. Ghana Med J 2022; 56:311-321. [PMID: 37575623 PMCID: PMC10416285 DOI: 10.4314/gmj.v56i4.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
Objective To identify the factors enabling and limiting family medicine (FM) programmes in Sub-Saharan Africa (SSA). Design A narrative review was conducted by searching a variety of databases. Papers focusing on the training, deployment, or contribution to healthcare systems of doctors with postgraduate training in FM in SSA, published in peer-reviewed journals from 2015 onwards and in English language were included. Included papers underwent qualitative analysis. Results Seventy-one papers were included in the review. 38% focussed on South Africa, while papers focussing on FM in a further 15 countries in SSA were identified. Key factors enabling FM programmes are support from key stakeholders, recognition of family practitioners (FP) as specialists, international collaboration, and dedicated FPs. Key factors limiting FM programmes are a lack of sufficient and well-trained faculty, inappropriate training settings, higher rates of trainee attrition, lack of FM in undergraduate curriculums, lack of career pathways, inappropriate deployment, and a lack of a critical mass. Conclusions Support from national stakeholders, the recognition of FPs as specialists, and sustainable international collaboration promote FM programmes. The absence of a defined role within the healthcare system, low numbers of FM faculty, a poor presence in undergraduate curriculum, high attrition rate of trainees and the lack of a critical mass limit FM programmes. The standardisation of the role of FM and the implementation of undergraduate and postgraduate FM programmes with national and international collaboration could enable FM to reach a critical mass and realise its full potential in strengthening primary healthcare in SSA. Funding None declared.
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Affiliation(s)
- Matthew L Davies
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX. United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear NE29 8NH. United Kingdom
- National Hospital Abuja, Department of Family Medicine, Abuja, Federal Capital Territory, NG
- Ghana College of Physicians and Surgeons, Family Medicine Unit, Dept of Community Health, Accra, Greater Accra, GH
- Korle Bu, Medicine, PO Box 4236, Accra, GH Box 77
| | - Penelope K Ellis
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX. United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear NE29 8NH. United Kingdom
- National Hospital Abuja, Department of Family Medicine, Abuja, Federal Capital Territory, NG
- Ghana College of Physicians and Surgeons, Family Medicine Unit, Dept of Community Health, Accra, Greater Accra, GH
- Korle Bu, Medicine, PO Box 4236, Accra, GH Box 77
| | - Akin Moses
- National Hospital Abuja, Department of Family Medicine, Abuja, Federal Capital Territory, NG
| | - Henry Lawson
- Ghana College of Physicians and Surgeons, Family Medicine Unit, Dept of Community Health, Accra, Greater Accra, GH
| | | | - Richard W Walker
- Population Health Sciences Institute, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX. United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear NE29 8NH. United Kingdom
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Purea P, Brumpton K, Kumar K, Pinidiyapathirage J. Exploring the learning environment afforded by an Aboriginal Community Controlled Health service in a rural longitudinal integrated clerkship. EDUCATION FOR PRIMARY CARE 2022; 33:214-220. [PMID: 35343387 DOI: 10.1080/14739879.2022.2054371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Despite the extensive literature regarding longitudinal integrated clerkships (LICs), there is very little evidence about this model in non-traditional settings, such as Aboriginal Community Controlled Health Organisations (ACCHOs). This study explored the key elements of the learning experience in a rural LIC programme, within an ACCHO from the perspective of multiple stakeholders including medical students, the general practice supervisory team, Aboriginal health workers (AHWs) and cultural mentors. METHODS The study was conducted using a qualitative case-study design. Participants included Year 3 medical students and the health care team (general practitioners, practice nurse, AHWs, and a practice manager in the role of cultural mentor) from an ACCHO in regional Queensland. Data was collected through semi-structured interviews and analysed using inductive thematic analysis. RESULTS Three key features were identified within the learning experience of students undertaking an LIC in the ACCHO setting. This study showed it was a safe context for learners to learn about 'culturally safe practice', 'putting relationships at the centre', and to 'try new things', reinforcing ACCHO as an invaluable site for learning. CONCLUSION The extended clinical placement in an ACCHO setting afforded an increase in the number of opportunities to develop students' cultural safety, communication skills and relationships with patients and the supervisory team, including AHWs and cultural mentors.
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Affiliation(s)
- Paul Purea
- Rural Medical Education Australia, Toowoomba, QLD, Australia
| | - Kay Brumpton
- Rural Medical Education Australia, Toowoomba, QLD, Australia
- School of Medicine and Dentistry, Griffith University Gold Coast Campus, QLD, Australia
| | - Koshila Kumar
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Janani Pinidiyapathirage
- Rural Medical Education Australia, Toowoomba, QLD, Australia
- School of Medicine and Dentistry, Griffith University Gold Coast Campus, QLD, Australia
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Erumeda NJ, Jenkins LS, George AZ. Perceptions of postgraduate family medicine supervision at decentralised training sites, South Africa. Afr J Prim Health Care Fam Med 2022; 14:e1-e13. [PMID: 35384683 PMCID: PMC8991043 DOI: 10.4102/phcfm.v14i1.3111] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/30/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Specialist training in family medicine (FM) is growing rapidly in sub-Saharan Africa. The strong emphasis on workplace-based learning for speciality training makes it vital to gain in-depth insights into registrar supervision. Previous studies have explored aspects of supervision at decentralised sites in high-income countries, however, little is known about the benefits and constraints of decentralised postgraduate supervision in low- to middle-income countries, especially in Africa. Aim This study aimed to explore family physicians’ and registrars’ perceptions of the strengths and challenges of clinical and educational supervision across decentralised training sites. Setting The study was conducted across two provinces at five decentralised training sites affiliated with the University of the Witwatersrand, Johannesburg. Methods This qualitative study involved semi-structured interviews with a purposive sample of 11 FPs and 11 registrars. The data were thematically analysed. Results Two of the four themes identified, ‘supervision is context-specific and supervisor-dependent’, and ‘the nature of engagement matters’, involved strengths and challenges. The other two, ‘supervision is not ideal’ and ‘the training environment is challenging’, focussed on challenges. Conclusion Supervisors and registrars described the postgraduate FM supervision as context-specific and supervisor-dependent. Supervisors displayed good clinical-teacher characteristics and supervisory relationships. However, several challenges, including registrars’ workload, resource shortages and a lack of standardisation across training sites, need to be addressed. Regular faculty development is essential for supervisors to be aware of relevant aspects of, and current trends in, postgraduate training.
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Affiliation(s)
- Neetha J Erumeda
- Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Gauteng Department of Health, Ekurhuleni Health District Services, Germiston.
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Bonnie LHA, Cremers GR, Nasori M, Kramer AWM, van Dijk N. Longitudinal training models for entrusting students with independent patient care?: A systematic review. MEDICAL EDUCATION 2022; 56:159-169. [PMID: 34383965 PMCID: PMC9292729 DOI: 10.1111/medu.14607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/21/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The participation of students from both undergraduate medical education (UGME) and postgraduate medical education (PGME) in independent patient care contributes to the development of knowledge, skills and the professional identity of students. A continuing collaboration between students and their preceptor might contribute to opportunities for students to independently provide patient care. In this systematic review, we aim to evaluate whether longitudinal training models facilitate the independent practice of students and what characteristics of longitudinal training models contribute to this process. METHOD This systematic review was performed according to the PRISMA guidelines. In May 2020, we performed a search in three databases. Articles evaluating the impact of longitudinal training models on the independent practice of students from both UGME and PGME programmes were eligible for the study. A total of 68 articles were included in the study. Quality of the included studies was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). RESULTS Both UGME and PGME students in longitudinal training models are more frequently allowed to provide patient care independently when compared with their block model peers, and they also feel better prepared for independent practice at the end of their training programme. Several factors related to longitudinal training models stimulate opportunities for students to work independently. The most important factors in this process are the longitudinal relationships with preceptors and with the health care team. CONCLUSION Due to the ongoing collaboration between students and their preceptor, they develop an intensive and supportive mutual relationship, allowing for the development of a safe learning environment. As a result, the professional development of students is fostered, and students gradually become part of the health care team, allowing them the opportunity to engage in independent patient care.
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Affiliation(s)
- Linda H. A. Bonnie
- Department of General PracticeAmsterdam UMC Location AMCAmsterdamThe Netherlands
| | - Gaston R. Cremers
- Department of General PracticeAmsterdam UMC Location AMCAmsterdamThe Netherlands
| | - Mana Nasori
- Department of General PracticeAmsterdam UMC Location AMCAmsterdamThe Netherlands
| | - Anneke W. M. Kramer
- Department of Public Health and Primary Care MedicineLeiden UniversityLeidenThe Netherlands
| | - Nynke van Dijk
- Department of General PracticeAmsterdam UMC Location AMCAmsterdamThe Netherlands
- Faculty of Health and the Faculty of Sports and NutritionAmsterdam University of Applied SciencesAmsterdamThe Netherlands
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Hense H, Harst L, Küster D, Walther F, Schmitt J. Implementing longitudinal integrated curricula: Systematic review of barriers and facilitators. MEDICAL EDUCATION 2021; 55:558-573. [PMID: 33099784 DOI: 10.1111/medu.14401] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/07/2020] [Accepted: 10/19/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE The increase of longitudinal integrated curricula in medical schools worldwide represents the shift towards an outcome-oriented education. This novel model allows comprehensive student-patient interactions over time and integrates the educational content across disciplines. According to quantitative research, students, patients, doctors and communities benefit from this educational model in terms of participant satisfaction, learning outcomes and clinician recruitment. However, quantitative research does not provide detailed information on programme implementation processes. Therefore, this review aims to summarise facilitators and barriers of programme implementation reported in qualitative and mixed methods studies. METHOD The authors reviewed the literature about facilitators and barriers for the implementation of longitudinal integrated curricula in undergraduate medical education programmes. The systematic search was conducted in MEDLINE, Embase and PsycINFO on 2 December 2019. The authors used the CASP checklist for qualitative research for the critical appraisal and summarised the results across studies using thematic content analysis. RESULTS The authors screened 1682 reports. Twenty studies examining 17 different curricula met the inclusion criteria. Most curricula were implemented in the United States (n = 6/17), Australia (n = 5/17) or Canada (n = 4/17). Programme implementation is facilitated and hampered by its educational components (eg continuity of supervision, safe learning environments), organisational structures (eg community involvement) and participating students' and staff' motivation and personality. The critical appraisal revealed that several studies lacked transparent documentation and adequate reflection on the researcher-participant relationship (n = 20/20), data collection instruments (n = 12/20) and recruitment strategy (n = 4/20). CONCLUSIONS The authors derived practical recommendations for the implementation of undergraduate, patient-centred, integrated medical curricula. Programme managers need to define and communicate common objectives with all participants. They should clarify the implementation of the objectives in all processes in a transparent and structured manner. Considering reporting guidelines, future studies in this field should document more transparently the methods used to gain qualitative insights and the researchers' personal involvement.
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Affiliation(s)
- Helene Hense
- Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Lorenz Harst
- Research Association Public Health, Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Denise Küster
- Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Felix Walther
- Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jochen Schmitt
- Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Bartlett M, Couper I, Poncelet A, Worley P. The do's, don'ts and don't knows of establishing a sustainable longitudinal integrated clerkship. PERSPECTIVES ON MEDICAL EDUCATION 2020; 9:5-19. [PMID: 31953655 PMCID: PMC7012799 DOI: 10.1007/s40037-019-00558-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
INTRODUCTION The longitudinal integrated clerkship is a model of clinical medical education that is increasingly employed by medical schools around the world. These guidelines are a result of a narrative review of the literature which considered the question of how to maximize the sustainability of a new longitudinal integrated clerkship program. METHOD All four authors have practical experience of establishing longitudinal integrated clerkship programs. Each author individually constructed their Do's, Don'ts and Don't Knows and the literature that underpinned them. The lists were compiled and revised in discussion and a final set of guidelines was agreed. A statement of the strength of the evidence is included for each guideline. RESULTS The final set of 18 Do's, Don'ts and Don't Knows is presented with an appraisal of the evidence for each one. CONCLUSION Implementing a longitudinal integrated clerkship is a complex process requiring the involvement of a wide group of stakeholders in both hospitals and communities. The complexity of the change management processes requires careful and sustained attention, with a particular focus on the outcomes of the programs for students and the communities in which they learn. Effective and consistent leadership and adequate resourcing are important. There is a need to select teaching sites carefully, involve students and faculty in allocation of students to sites and support students and faculty though the implementation phase and beyond. Work is needed to address the Don't Knows, in particular the question of how cost-effectiveness is best measured.
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Affiliation(s)
- Maggie Bartlett
- Education in General Practice, Dundee University School of Medicine, Dundee, UK.
| | - Ian Couper
- Faculty of Medicine and Health Sciences, Ukwanda Centre for Rural Health, Stellenbosch University, Stellenbosch, South Africa
| | - Ann Poncelet
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Paul Worley
- Department of Health, GPO Box 9848, 2601, Canberra, Australian Capital Territory, Australia
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van Schalkwyk S, Couper I, Blitz J, Kent A, de Villiers M. Twelve tips for distributed health professions training. MEDICAL TEACHER 2020; 42:30-35. [PMID: 30696315 DOI: 10.1080/0142159x.2018.1542121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Increasing numbers of health professions students are being trained in healthcare facilities that are geographically removed from central academic hospitals. Consequently, studies have evaluated this distributed training, assessed the impact that it has on student learning as well as on the facilities where the training occurs, and explored factors that enable and constrain successful clinical training at such sites. The 12 tips presented in this article have been developed from a longitudinal project that has focused on developing a framework for effective distributed health professions training through an extensive review of the literature and a national consultative process. These 12 tips should, therefore, have applicability across multiple contexts. The purpose of this article is to assist people in implementing, adapting, upscaling, maintaining, and evaluating the distributed training of students in the health professions.
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Affiliation(s)
- Susan van Schalkwyk
- Centre for Health Professions Education, Stellenbosch University, Cape Town, South Africa
| | - Ian Couper
- Ukwanda Centre for Rural Health, Stellenbosch University, Cape Town, South Africa
| | - Julia Blitz
- Centre for Health Professions Education, Stellenbosch University, Cape Town, South Africa
| | - Athol Kent
- Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa
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