Background In this research paper we report on the quality of feedback provided in the logbooks of pre-clinical undergraduate students based on a model of ‘actionable feedback’. Feedback to clinical learners about their performance is crucial to their learning, which ultimately impacts on their development into competent clinicians. Due to students’ concerns regarding the inconsistency and quality of feedback provided by clinicians, a structured feedback improvement strategy to move feedback forward was added to the clinical skills logbook. The instrument was also extended for peer assessment. This study aims to assess the quality of feedback using the deliberate practice framework. Methods A feedback scoring system was used to retrospectively assess the quality of tutor and peer logbook feedback provided to second and third year medical students to identify deliberate practice components i.e. task, performance gap and action plan. The sample consisted of 425 second year and 600 third year feedback responses over a year. Results All three deliberate practice components were observed in the majority of the written feedback for both classes. The frequency was higher in peer (83%, 89%) than tutor logbook assessments (51%, 67%) in both classes respectively. Average tutor and peer task, gap and action feedback scores ranged from 1.84–2.07 and 1.93–2.21 respectively. The overall quality of feedback provided by the tutor and peer was moderate and less specific (average score < or = 2). The absence of the three components was noted in only 1% of the feedback responses in both 2nd and 3rd year. Conclusion This study found that adding in a feed-forward strategy to the logbooks increased the overall quality of tutor and peer feedback as the task, gap and action plans were described. Deliberate practice framework provides an objective assessment of tutor and peer feedback quality and can be used for faculty development and training. The findings from our study suggest that the ratings from the tool can also be used as guidelines to provide feedback providers with feedback on the quality of feedback they provided. This includes specifically describing a task, performance gap and providing a learning plan as feed-forward to enhance feedback given. Electronic supplementary material The online version of this article (10.1186/s12909-019-1547-5) contains supplementary material, which is available to authorized users.

Developing, low-income countries not only confront the challenge of resource constraints, an ageing population and urbanisation, but also face the double burden of communicable diseases such as HIV/ AIDS, which is currently the African continent's leading cause of death, and diabetes mellitus. [1] According to global estimations, it is predicted that by the year 2030, developing countries will experience as much as a 69% increase in the number of adults diagnosed with diabetes. [2] Diabetes caused more than 68 thousand deaths in South Africa (SA) in 2013. [3] Census information for the year 2013 indicates that in KwaZulu-Natal (KZN), a subtropical province of SA with the country's second-largest population, diabetes was the fourth-largest cause of death. [4,5] More than any other continent, Africa suffers from the combined presence and effects of diabetes together with HIV/AIDS and tuberculosis (TB). The interactions between these conditions and their treatment pose many challenges. Patients with diabetes have been found to have an increased general risk of infection and a two to three times increased risk of developing TB. HIV has been found to promote recurrence of latent TB and drastically increases the progression to active disease. [6] Some antiretrovirals cause glucose intolerance, predisposing the HIV-positive patient to developing diabetes. Drug interactions between the medications used to treat diabetes and TB reduce each other's effectiveness, making it difficult to treat both conditions in one patient. [7] The International Diabetes Federation's 2013 Diabetes Atlas [3] indicates that SA is home to more than two and a half million diagnosed diabetics, and an approximate further million who are undiagnosed. It has been estimated that another 2.6 million South Africans have impaired glucose tolerance, an early metabolic Background. The global increase in the prevalence of diabetes mellitus is most marked in African countries. The District Health Information System (DHIS) is the primary data collection system of the Department of Health in KwaZulu-Natal Province (KZN), South Africa. Data are routinely collected at all public healthcare facilities in the province and are aggregated per facility. Objective. To investigate the distribution, incidence and prevalence of diabetes in the public healthcare sector of KZN. Methods. Data collected by the DHIS for all patients with diabetes in KZN from 1 January 2010 to 31 December 2014 inclusive were analysed. Additional open-source databases were accessed to enable further exploration of the data collected. Results. The study showed that the majority (38.7%) of patients with diabetes on the public sector register were from the district of eThekwini. Positive correlations were found between the prevalence of diabetes, the mortality rate and the number of defaulters (patients with diabetes who did not return for regular treatment). Conclusions. Provincial estimates of the prevalence of diabetes in this study were higher than the known national prevalence. This may be ...

Background. Most instruments, including the well-known Motivated Strategies for Learning Questionnaire (MSLQ), have been designed in western homogeneous settings. Use of the MSLQ in health professions education is limited. Objective. To assess the MSLQ and its association with the academic performance of a heterogeneous group of 1st-year medical students. Methods. Eighty-three percent of 1st-year medical students consented to participate in this quantitative study. The MSLQ consisted of a motivation strategies component with six subscales, while the learning strategies component had nine subscales. Demographic and academic achievement information of the students was also collected. Stata version 13 (StataCorp LP, USA) was used for the statistical analyses of all data. Results. Female students displayed significantly higher motivational scores. Students with prior educational experience and those who attended peermentoring sessions had significantly higher learning strategy scores. Significant but moderate relationships were found between academic performance and the motivation strategies subsumed within the categories 'task value' and 'self-efficacy for learning performance' . In terms of the 'learning strategy component' , 'critical thinking' , and 'time and study environment' , the composite score was significantly but poorly correlated to academic performance. Conclusion. Overall, limited correlations were found between the MSLQ scores and academic performance. Further investigation of the use of the MSLQ and its association with academic achievement is recommended, with greater focus on specific learning events than on course outcomes. This study highlights the importance of evaluating an instrument in a specific context before accepting the findings of others with regard to the use of the instrument and its correlation with academic performance.

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health professionals were pushed to the front line of a global health crisis unprepared and resource constrained, which affected their mental well-being.Aim: This study aimed to investigate the effectiveness of a brief online mindfulness-based intervention (MBI) on stress and burnout for health professionals training and working in South Africa during the COVID-19 crisis.Setting: The context of the study is the overburdened, under-resourced health care system in South Africa during a global pandemic.Methods: A mixed method framework was adopted for this study. The quantitative data was analysed using descriptive analysis and the participants’ qualitative experiences were interpreted using interpretative phenomenological analysis.Results: Forty-seven participants took part in this study. The study found a statistically significant (p 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment after the intervention. The participants’ shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness because of COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness.Conclusions: The study found that a brief online MBI can be associated with reduced levels of stress and burnout as well as an increased sense of control and empowerment, felt both personally and professionally, during a global crisis.Contribution: The impact of an online MBI for health care professionals amidst a pandemic has not been previously documented.

Collaborative approaches such as Problem Based Learning (PBL) may provide the opportunity to bring together diverse students but their efficacy in practice and the complications that arise due to the mixed ethnicity needs further investigation. This study explores the key advantages and problems of heterogeneous PBL groups from the students’ and teachers’ opinions. Focus groups were conducted with a stratified sample of second year medical students and their PBL teachers. We found that students working in heterogeneous groupings interact with students with whom they don’t normally interact with, learn a lot more from each other because of their differences in language and academic preparedness and become better prepared for their future professions in multicultural societies. On the other hand we found students segregating in the tutorials along racial lines and that status factors disempowered students and subsequently their productivity. Among the challenges was also that academic and language diversity hindered student learning. In light of these the recommendations were that teachers need special diversity training to deal with heterogeneous groups and the tensions that arise. Attention should be given to create ‘the right mix’ for group learning in diverse student populations. The findings demonstrate that collaborative heterogeneous learning has two sides that need to be balanced. On the positive end we have the ‘ideology’ behind mixing diverse students and on the negative the ‘practice’ behind mixing students. More research is needed to explore these variations and their efficacy in more detail.