The contribution of South African curricula to prepare health professionals for rural or under-served areas in South Africa: A peer review evaluation

Abstract

The Collaboration for Health Equity through Education and Research (CHEER) was formed in 2003 to examine strategies that would increase the production of health professional graduates who choose to practise in rural and under-served areas in South Africa. It consists of an academic from each of nine universities in South Africa with a health science faculty, who is involved in communitybased education, service-learning or rural health, or similar activities that prepare students for rural and under-served areas. Literature reviews, 1,2 a qualitative study 3 and a case-control quantitative study 4 have been completed, around the same research question. An integral component has been peer reviews at each university in the collaboration, to identify in more detail how each faculty is preparing its students for service in rural or under-served areas. All nine participating institutions have held a review to date, and this article reports on the outcomes. Each university has a different approach and operates in a unique context. The reviews therefore amount to a series of case studies, each complete in itself. We report the insights, learning and recommendations arising from each peer review around common themes and assess these in terms of proposed best practices for South Africa. MethodologyA case study approach was used, with each peer review constituting a study in its own right. A standard protocol including tools was developed through the first two pilot project reviews. This protocol was drawn up using the literature, principally the 1987 World Health Organization (WHO) Report. 5 It was approved by each host university's ethics committee. The sample included all nine participating universities, but the host institution purposively selected the educational programmes to be reviewed according to their own priorities. Within each review, a further level of purposive sampling involved questionnaires and interviews with faculty or school leaders, key informants, relevant faculty staff, and final-year students in each programme who had completed at least one community-based module. Each research team comprised at least three reviewers, each from different universities excluding the university or faculty programme under review. Each review was conducted over at least three days on site. Document reviews, semi-structured interviews, focus group discussions, questionnaires and observations during site visits were used to collect data.A letter detailing the project, a questionnaire and a curriculum framework spreadsheet were sent to the participants before the visit. The questionnaire quantified issues that were subsequently qualified and finalised in the interviews. The sampling process determined the specific questionnaire respondents, drawn from faculty staff who chaired committees such as the faculty curriculum committee and curriculum implementation committee, and who were involved in community-based education and curriculum development or related fields. The interviews aimed to assist the research team in making a...

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