Reconceptualising Health Professions Education in South Africa

doi:10.17159/assaf.2018/0021

Cited by 10 publications

(4 citation statements)

References 145 publications

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“…A global consensus document on the social accountability of medical schools [114] includes statements that resonate with the need to include gender-affirming health in curricula, such as: "The medical school recognizes the various social determinants of healthand directs its education, research and service delivery programs accordingly," and "the medical school recognizes the local community as a primary stakeholder and shares responsibility for a comprehensive set of health services to a defined population in a given geographical area, consistent with values of quality, equity, relevance". A South African report, "Reconceptualising Health Professions Education in South Africa" [115] states that "the ultimate goal of health professions education is to produce knowledgeable, competent, relevant, socially accountable health care professionals capable of confidently and collaboratively promoting health and addressing the country's burden of disease across the continuum of health care in the context of quality universal health coverage". To be socially accountable, medical educators need to include the health needs of TGD people in medical curricula [29,116].…”

Section: Argument For Including Tgd Health Care In Curriculamentioning

confidence: 99%

Debate: Why should gender-affirming health care be included in health science curricula?

2020

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Background: Every person who seeks health care should be affirmed, respected, understood, and not judged. However, trans and gender diverse people have experienced significant marginalization and discrimination in health care settings. Health professionals are generally not adequately prepared by current curricula to provide appropriate healthcare to trans and gender diverse people. This strongly implies that health care students would benefit from curricula which facilitate learning about gender-affirming health care. Main body: Trans and gender diverse people have been pathologized by the medical profession, through classifications of mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Disease (ICD). Although this is changing in the new ICD-11, tension remains between depathologization discourses and access to gender-affirming health care. Trans and gender diverse people experience significant health disparities and an increased burden of disease, specifically in the areas of mental health, Human Immunodeficiency Virus, violence and victimisation. Many of these health disparities originate from discrimination and systemic biases that decrease access to care, as well as from health professional ignorance. This paper will outline gaps in health science curricula that have been described in different contexts, and specific educational interventions that have attempted to improve awareness, knowledge and skills related to genderaffirming health care. The education of primary care providers is critical, as in much of the world, specialist services for gender-affirming health care are not widely available. The ethics of the gatekeeping model, where service providers decide who can access care, will be discussed and contrasted with the informed-consent model that upholds autonomy by empowering patients to make their own health care decisions. Conclusion: There is an ethical imperative for health professionals to reduce health care disparities of trans and gender diverse people and practice within the health care values of social justice and cultural humility. As health science educators, we have an ethical duty to include gender-affirming health in health science curricula in order to prevent harm to the trans and gender diverse patients that our students will provide care for in the future.

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Section: Argument For Including Tgd Health Care In Curriculamentioning

confidence: 99%

Debate: Why should gender-affirming health care be included in health science curricula?

2020

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“…Pertinent to this study are contemporary theories around adult learning (andragogy) which are popularly applied in health professional education. [15] Success in adult learning is a complex interaction of motivation (choice or compulsory participation), the task, available resources, and prior learning experiences, whether affirmative, sparse, limiting or negative.…”

Section: Discussionmentioning

confidence: 99%

How long does it take a registrar to complete the compulsory research project enabling specialist registration?

Grossman

2019

S Afr Med J

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Background. The 2011 Health Professions Council of South Africa mandate requires a research component in the form of an MMed degree to permit specialist registration. Registrars consider that the time required to complete an MMed interferes with clinical training, service delivery obligations, and study and exam time. Net research time to completion is difficult to establish because MMed research activity is often intermittent, starting and finishing anywhere within the 4-year clinical training period. Conversely, gross dissertation completion time (DCT) is easily calculated by subtracting the ethics approval date from the dissertation submission date. Objectives. To use gross DCT as a proxy to assess the time needed by registrars to finish the required research project. Additionally, the effect of four variables, namely dissertation format, clinical discipline, university research resources and the introduction of the 2011 ruling on gross DCT, was determined. Methods. The sample was 213 MMed dissertations, downloaded from the public domain. The dissertation submission date was subtracted from the ethics approval date to give the gross DCT in months. Descriptive analysis and χ 2 testing were used to determine the effects of the four variables on gross DCT, with significance set at p<0.05. A 12-month proposal preparation time was added to the gross DCT to fully reflect the MMed research timeline. Results. Sampled dissertations were from 2005 to 2017 and all eight MMed training universities were represented, as were 23 clinical disciplines. The mean (standard deviation) gross DCT was 31.0 (19.6) months, with a wide completion range of 0.2-109 months. When 12 months' proposal preparation time was added, gross mean research completion time rose to 43 months (31 + 12 = 43). A mere 41% of dissertations were sufficiently concluded to free up the final year for exam preparation. Gross DCT was not significantly affected by the 2011 requirement, university resources or clinical discipline. Dissertation format (publication ready v. monograph) significantly decreased gross DCT (p=0.01). Conclusions. Large standard deviations and a wide range of finishing times detract from the positive findings that most dissertations were completed within the 4-year clinical training time period. Publication-ready dissertations significantly shortened MMed completion time. Unique study and work commitments and lack of research experience challenge speedy MMed completion. Existing research and supervisory supportive structures should be remodelled to better suit the research needs of the andragogic specialist registrar.

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“…For pharmacy to be socially accountable in MCH, the priority health needs of the nation should underpin undergraduate curricula. 'Entry-level' pharmacists should be knowledgeable and appropriately skilled to offer essential services [23,24]. The study follows two previously published studies.…”

Section: Introductionmentioning

confidence: 99%

Comparative Evaluation of Pharmacy Students’ Knowledge and Skills in Maternal and Child Health: Traditional versus Integrated Curriculum

et al. 2022

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Reducing maternal and child mortality is a health priority in South Africa. Therefore, health professional education should produce graduates that can meet these needs. This study compared the maternal and child health (MCH) knowledge and skills of cohorts of final-year students exposed to a traditional (in 2017 and 2018) and integrated (2019) curriculum using a 34-item questionnaire. Between the 2019 and 2017 cohorts, ANOVA and post hoc analysis showed significant differences in the reproductive and sexual health component which was dispersed in the second and final years of study (p = 0.007, Mean Difference (MD) = 8.3) andneonatal and child care (p = 0.000, MD = 15). while it was only in maternal and antenatal care (p = 0.009, MD = 10.0) for the 2019 and 2018 cohorts. Significant differences were observed in participants’ average mean scores (p = 0.000 for 2018 and 2017). The highest mean scores were recorded by the 2019 cohort in the three assessments. A one-sample t-test showed the highest mean differences in the reproductive and sexual health components (p = 0.000; MD 2017 = 12.4, MD 2018 = 14.8, MD 2019 = 20.7). Overall, the integrated MCH curriculum and the longitudinal dispersion of content enhanced students’ knowledge and skills.

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Reconceptualising Health Professions Education in South Africa

Cited by 10 publications

References 145 publications

Debate: Why should gender-affirming health care be included in health science curricula?

Debate: Why should gender-affirming health care be included in health science curricula?

How long does it take a registrar to complete the compulsory research project enabling specialist registration?

Comparative Evaluation of Pharmacy Students’ Knowledge and Skills in Maternal and Child Health: Traditional versus Integrated Curriculum

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