Background. With the new Mental Health Care Act in use, additional demands will be placed on general practitioners to provide adequate care for mental health patients. The College of Psychiatry of the Colleges of Medicine of South Africa awards a Postgraduate Diploma in Mental Health (PGDipMH) to medical doctors, but there is no standardised formal tuition or curriculum available to potential candidates. Objectives. A study was undertaken to design a postgraduate programme using a six-step process to assist medical practitioners in preparing for the PGDipMH. Methods. The Delphi research method, a nomi nal group technique for developing forecasts and trends based on the collective opinion of knowledgeable experts, was used. Data, obtained by means of closed items in a questionnaire, were analysed, and the opinions and ideas of the expert respondents were used to adapt the formulated set of criteria for each subsequent round of Delphi. This process was repeated until 80% consensus or stability had been reached. After the last round, a framework and final set of criteria were compiled. Results. The preferred mode of teaching was online distance learning utilising electronic learning and limited formal learning. The content of the curriculum was based on the findings of the Delphi study experts. The programme as a complete entity contains six steps. Conclusion. Using the recommendations and findings of the Delphi panel, a comprehensive programme was developed, which shows an appreciation for the interfaces between the different role-players (the patient/so-called mental healthcare user and the doctor as learner), outcomes-based education and distance learning.
Communication skills is a topic which is usually addressed in all departments of the Faculty of Health Sciences so that learners have at their disposal a comprehensive knowledge of communication and the doctor-patient relationship. At the School of Medicine of the University of the Free State the learners used to receive a lecture on communication skills as part of community based education where the students witnessed a consultation and had to report on the communication process. This consultation was not standardised and as the assessor was not present at the consultation he/she could not give a valid or appropriate comment on the remark/report of the learner. An additional problem for some learners was that often the consultation took place in a language they could not understand and therefore could not assess the communication process. The above problems were solved by developing a computer-based courseware and a video of a simulated consultation for instruction in communication skills.In the computer-based courseware learners first attend formal lectures on communication skills. The contents include: effective communication; factors influencing communication; communicating with patients; doctor-patient relations, communication, co-operation; inter-professional communication; and patient-centred medical care. After the lectures they have to complete the computer-based part during scheduled hours/or in their own time. The computer-based courseware consists of 3 tasks and a test. The student interface is hosted in WebCT. The aim and instructions, tasks and test, as well as the memorandum for the test, are placed as links on the main page.Task 1 is a summary of the formal lecture. The learners must read the summary to refresh their memory on good communication techniques and what should preferably be avoided.Task 2 is a summary in the form of a flow chart of the crucial elements in the lecture for quick reference. The learners must use the summary to revise what they have read and heard.Test 1 follows the two tasks and a questionnaire must be completed for which the learners must earn at least 60% before they can continue with the courseware to the video assignment. This ensures that the learners have sufficiently mastered the communication process. Marks obtained are instantly available to the learners and they have 3 opportunities to pass
South Africa is the country with the highest incidence of HIV / AIDS in the world. In order to understand the complex phenomenon experienced by people infected and affected by HIV/AIDS in South Africa, the diverse cultural landscape, amongst other factors, needs to be explored. In a qualitative study, the authors explore the impact of this phenomenon on marriage. Using psychiatric texts and by employing the method of Discourse Analysis on two case studies, different ways of dealing with HIV/AIDS in marriage and the way it dramatically influences marriage are analysed. The impact of these previously untold stories of HIV/AIDS in marriage is seen especially in the lives of spouses who respond differently when managing this problem. In coping with the trauma of HIV/AIDS, spirituality plays a role. Using the biopsychosocial/spiritual-model within a post-modern view of therapy, the role of spirituality is described. The research, viewed through a culture-sensitive lens, acknowledges the different ethical dilemmas involved. Certain limitations in the research methodology are discussed and the need for further research is highlighted.
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