Improving South African medical curricula related to traditional health systems

Abstract

An unexamined educationSouth African (SA) medical curricula on traditional health systems remain a largely unexamined topic, despite millions of South Africans using traditional healthcare daily. Chitindingu et al. 's [1] 2014 study outlined the major formal elements of the traditional healing curricula, as described by administrators at each of SA's eight medical schools. Our study aims to answer their call for better understanding of this topic from the perspective of medical students' experience of the curricula -not that of the administrators. Specifically, our study objectives were to determine the hidden curriculum surrounding traditional medicine (TM) in SA medical schools, and how students describe the impact of this hidden curriculum on their perceptions of TM. We define the hidden curriculum as an interpersonal/social concept and a contextual/cultural concept, based on student descriptions of interactions and cultural norms experienced during medical training. [2] Finally, we provide recommendations to mitigate the hidden curriculum's harmful effects, while promoting its more positive aspects. Broad efforts at integrationGlobally, the use of TM is widespread. [3] In SA, TM use is increasingly recognised as an essential element of and opportunity to improve the health of the nation. [4][5][6] Traditional health practitioners (THPs) have various roles in the healthcare system outside of healing, including spiritual protectors, counsellors and cultural repositories. [5,7] Furthermore, THPs represent an area of under-utilised potential in the fight against HIV/AIDS, particularly due to their overwhelming willingness to engage in HIV/AIDS training and refer patients to biomedical facilities when necessary. [6,8] Discouragingly, however, the tension between biomedicine and TM, largely due to historical injustices, gaps in scientific evidence and mistrust, has resulted in a fragmented and inefficient health system. [6,9,10] Medical schools provide a prime location to combat these challenges, ideally fostering understanding and integration of the two health systems. [1,11] A recent study in Uganda argued that training medical students in the principles of TM was feasible and may improve health outcomes; therefore, integration should not be delayed. [12] Curricular reformsHealth professions education systems in SA, due to their roots in imperialism, colonialism and apartheid, often produce providers who are incompletely equipped to properly care for many patients, specifically the black African population. [13] Recognition of this deficit has led to a movement to decolonise the nation's graduate education system, including medical schools. [13] Our research aims to look at how we can progress towards decolonisation via integration of traditional health education in medical schools. Although Background. Increased co-ordination and co-operation between traditional and biomedical health systems in South Africa (SA) is a national priority. To improve care, practitioners in both systems must learn to recognise th...

Allopathic Medicine Practitioners’ perspectives on facilitating disclosure of traditional medicine use in Gauteng, South Africa: a qualitative study

“…This finding contradicts a recent study which includes South Africa as one of the countries in Sub-Saharan Africa that provide formal TM education [ 58 ]. Other research has reported AM students training at various universities in South Africa requesting training that includes teaching about the fundamentals of TM, how to empathise with patients who use TM, and how to approach such patients during a consultation [ 59 ]. Furthermore, it is acknowledged that the solution entails not only modifying curricula and student understanding but also changing faculty mindsets in this regard [ 59 ].…”

Challenging power and unearned privilege in physiotherapy: lessons from Africa

“…Pillay and Kathard (25) described students' exposure to longitudinal community engagement as a means to promote context-specific learning and decolonization of health education. This can also overcome some of the deficits in the content of health sciences curricula that often fail to integrate traditional medicine approaches in the management of African patients and where assessment tools have been developed within a colonial framework and for Eurocentric populations (26).…”

Hidden Curriculum Upgrade in Nursing and Medical Education: A Scoping Review

“…In Iran, most studies have adopted a qualitative approach to examine the experience of nursing and medical students with the HC [13,14]. However, there has been limited studies on HC upgrade [6,15] as the central topics have been improving the learning environment, tackling the negative effects of the HC, identifying the positive and negative in uences of the HC, facilitating HC learning, and the in uences of the HC in nursing and medical education [8,[16][17][18][19][20].…”