RESEARCH ON RURAL HEALTH

From left: Dr Patrick McNeill, Dr Paula Diab and Professor Andrew Ross presented research at the Centre for Rural Health.

Three academics from the disciplines of Rural Health and Family Medicine at UKZN recently presented findings from a study in which they evaluated the District Based Learning (DBL) Project of final-year medical students who completed the “rural block” of their Family Medicine programme training at district-based hospitals affiliated to the University. 

The results of this research were not included in the final DBL close-out report delivered by the Centre for Rural Health (CRH) in 2011/2012. 

The review was presented at the CRH by Dr Patrick McNeill, Professor Andrew Ross and Dr Paula Diab who had identified the need to assess whether students completing the programme felt comfortable, competent and confident about working in rural settings as doctors in family medicine. 

The study followed the 2011 cohort of final-year MBChB students placed in the Church of Scotland Hospital, Eshowe Hospital, G J Crookes Hospital, Manguzi Hospital, Mosvold Hospital, Mseleni Hospital and Murchison Hospital. The researchers said the findings would lend themselves for careful consideration in curriculum design and ensuring that students who complete the new six-year MBChB programme in 2015 would have had a “holistic” training experience as doctors working in family medicine within a rural setting.

A total of 168 questionnaires were completed by students and 86 percent reported that what they had learnt in the MBChB programme prior to entering the community was very useful.  In certain instances some said they needed additional skills to what they already had, and others said having not received rosters at some hospitals left them feeling they were lacking guidance while progressing through the programme. 

The study found that 76 percent of the students rated the accommodation provided as average or above average. Issues of maintenance, upkeep and cleaning of these University facilities at distant rural sites was said to be an on-going challenge which needed attention. The vast majority of students used the University facilities with a small percent opting to make their own accommodation arrangements. 

It was a concern that the studies of some students suffered in the rural setting due to a lack of technical support such as access to computers, libraries, hospital intranet and telemedicine. However, students did have adequate access to formal teaching in the rural hospitals as well as other academic activities. The students said the practical experience was invaluable; they liked working in smaller groups, and rural doctors were willing to teach them. 

The research included interviews with supervisors at the hospitals, the majority of whom had been newly appointed in their roles as a supervisors. They saw their roles mainly as a liaison between the University and the hospital and expressed the desire to become more involved with University activities in order to better understand what was required of them as well as the students. 

The supervisors enjoyed the opportunity to interact with the students and that mutual learning opportunities were presented. They also mentioned that exposure of their hospital to students had positive effects for future recruitment of staff at the hospital. 

The researchers said it was important to understand the programme’s efficacy in training the students, saying there was always room for improvement. The study factored in the students’ preparation and skills training prior to entering the community, logistical issues, onsite teaching and supervision, accommodation, technical support available, benefits to the hospital, benefits to the students, and a review of their activities and learning experiences at the hospitals. 

They said this had implications on how the programme would be rolled out for family medicine and rural health in future, mentioning that it would help detect which hospitals were feasible to place students in.

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