Incorporation of nurse initiated management of antiretroviral treatment course within the undergraduate nursing programme North West province

Background: According to the 90-90-90 strategy, the focus is on 90% of people living with HIV and/or AIDS knowing their HIV status, initiated on antiretroviral treatment and achieving viral suppression. The challenge is that only 74% of people living with HIV and/or AIDS are on antiretroviral treatment, and HIV mortality still occurs. Literature recommends the incorporation of a Nurse Initiated Management of Antiretroviral Treatment (NIMART) course within the undergraduate nursing programme to capacitate new nurses to manage people living with HIV and/or AIDS immediately after completion of their training. However, the NIMART course is still not incorporated, and there is dearth of information on this topic in North West Province (NWP). Aim: To explore and describe nurse educators' perceptions regarding the incorporation of NIMART course within the undergraduate nursing programme in NWP. Setting: The setting of this research study was nursing education institutions of the NWP. Methods: Phenomenography qualitative research design was followed. Twelve nurse educators underwent purposive selection and unstructured individual interviews were conducted. The research co-coder verified the findings. There were ethical considerations and trustworthiness maintained throughout the study. Results: Main themes that emerged in this study depicted benefits and challenges associated with NIMART course incorporation within the undergraduate nursing programme as stated in Table 1. Conclusion: This study concluded that NIMART course incorporation within the undergraduate nursing programme is a good and relevant idea, which requires human and non-human resources.

Supporting undergraduate research capacity development: A process evaluation of an Undergraduate Research Office at a South African Faculty of Medicine and Health Sciences

Background. University-based research capacity development (RCD) mechanisms tend to focus on staff and postgraduate students, with few structures targeted at undergraduate students. Support for undergraduate research must be tailored to the unique requirements of research at this level, while maintaining links with relevant structures in both the RCD and teaching and learning domains. Objective. To conduct a process evaluation of the Undergraduate Research Office (URO) in the Faculty of Medicine and Health Sciences at Stellenbosch University, South Africa, using RCD and characteristics of excellence in undergraduate research criteria as benchmarks. Methods. A process evaluation of URO's first 6 years was conducted using a logic model of URO's inputs, activities, and outputs. Through a retrospective document review, a descriptive analysis of URO's inputs and activities (narrative) and URO's outputs (statistical) was conducted. Results. Following a description of inputs and activities, results present URO's outputs as a measure of the uptake of these activities. From 2015 to 2020, 259 undergraduate research projects were completed. Research consultations, workshops and undergraduate presentations at the faculty's Annual Academic Day have more than doubled since URO's inception. The Undergraduate Research Ethics Committee has reviewed 243 ethics applications since 2015, with a 1 - 2-week turnaround time. A total of 134 funding applications worth ZAR705 986 have been awarded for research project, conference presentation and publication costs. Conclusion. Results show the potential impact of a formal undergraduate research support entity on the undergraduate research outputs of a Faculty of Medicine and Health Sciences. This article highlights elements for success for formal undergraduate research support, and identifies gaps going forward.

The use of peer physical examination in undergraduate health professions education: Exploring the perceptions of students and educators in a multicultural, multiracial institution

Teaching clinical skills is core content of the medical and allied health curricula of the Faculty of Health Sciences (FoHS) at the University of the Free State (UFS) in South Africa. A major pedagogical tool used for this purpose across the faculty is peer physical examination (PPE). Objective. To investigate the lived experience and perceptions of students and educators on the use of PPE in undergraduate health professions education at a multicultural and multiracial institution. Suggestions on guidelines for a PPE policy for the FoHS at the UFS were also obtained from the participants.Methods. This research was designed as a qualitative study that used focus group interviews involving 26 participants (19 students and 7 educators) to obtain verbal statements that described their experience and perceptions of the use of PPE in undergraduate health professions education. Results. Participants reported that PPE was useful to create a safe learning environment and to prepare students for the clinical aspects of their training. Enhancing students' empathy, competency and clinical confidence were among the advantages attributed to using PPE; it also encouraged peer-assisted learning. Some of the disadvantages ascribed to PPE were that it made it difficult to maintain classroom discipline, and that it could promote memorisation over understanding. Finally, participants suggested that a guideline for PPE policy should address matters of consent, confidentiality, participation and gender, cultural, religious and racial considerations.Conclusions. The findings of this study reveal that PPE is an acceptable and useful learning strategy for the majority of students and educators. Issues relating to consent, confidentiality and cultural, religious and racial considerations are some of the potential problems associated with the use of PPE at the UFS. We believe that the suggestions given by the participants of this study will inform the establishment of a PPE policy for the FoHS of the UFS

Perceptions of undergraduate allied health students of the clinical learning environment and clinical educators' attributes at the University of Ghana

Background. Clinical education is a vital aspect of the education of health sciences students and consists of two components, i.e. the clinical learning environment and supervision.Objectives. To determine the undergraduate allied health sciences students' perceptions regarding clinical educators' attributes and the clinical learning environment.Methods. This cross-sectional study included 169 undergraduate students, randomly recruited from various allied health professions programmes of the University of Ghana. The McGill clinical teacher evaluation tool and the clinical learning environment inventory were used to determine students' perceptions of clinical educators' attributes and the clinical learning environment, respectively. The Kruskal-Wallis test and independent t-tests were used to test for relationships between students' level and programme of study and their perceptions. The level of significance was set at 95%.Results. Of the 169 participants, there were 99 (58.6%) male students, 79 (46.7%) third-year students and 82 (48.5%) medical laboratory science students. Only 16 (9.5%) participants indicated visits by lecturers during clinical rotations. The third-year students had a statistically significant perception of their clinical learning environment (p=0.000), while the differences between perceptions of clinical learning environment among the various programmes were also statistically significant (p=0.028), but not for clinical educators' attributes (p=0.261).Conclusion. Allied health sciences students have positive perceptions of their clinical learning environment and clinical educators' attributes. More frequent visits by lecturers to students during clinical rotations may ensure that student innovation is achieved in accordance with their classroom tuition

Factors associated with risky sexual behaviour among sexually experienced undergraduates in Osun state, Nigeria

Background: Risky sexual behavior (RSB) is common among youths which predispose them to sexually transmitted infections. This study sets out to identify the factors associated with RSB among undergraduates in Osun state. Methods: The study design was descriptive cross sectional and a total of 550 respondents from two universities in Osun state were sampled using a multistage sampling technique, out of which data from 266 sexually experienced respondents was further analyzed. Data collected via a semi­structured self-administered questionnaire and analyzed using univariate, bivariate and multivariate analyses. Results: The 266 respondents consisted of 54.5% males and 45.5% females and larger percentage of them were in the age group 15-24years. Seven out of ten respondents (69.9%) were sexually active while 65.8% were involved in at least one RSB. Of the 266 respondents, 28.6% ever had concurrent multiple sexual partners, 15.8% used alcohol/drugs at last sex while 48.1% did not use condom at last sex. More males (71.7%), alcohol users (76.8%), drug users (78.0%), pornography watchers (82.7%), internet users (71.2%) respondents "not in good terms with mum" (86.7%) and "those whose mum doesn't instruct them morally" (84.2%) were involved in RSB compared to their respective counterparts (p<0.05). However, there were no identifiable predictors of RSB on regression analysis. Conclusion: Risky Sexual Behavior is prevalent among undergraduates with males being more involved, among other associated factors. Concerned stakeholders should engage youths via behavioral change communication strategies so as to significantly reduce their involvement in RSB

Prevalence and risk factors of depression among undergraduate medical students in a Nigerian university

Objectives: This study assessed the prevalence and risk factors of depression among undergraduate medical students at the University of Benin, Benin City, Nigeria. Design: This was a cross-sectional study. Setting: This study was carried out at the University of Benin. Participants: Three hundred medical students were recruited for this study. Methods: The Patient Health Questionnaire 9 (PHQ-9) and a structured pre-tested self-administered questionnaire were used to assess the prevalence and risk factors of depression, respectively. Results: The students' age ranged from 15 ­ 34 years, with a mean age of 21.8 ± 3.3 years. Many risk factors which could predispose students to depression were identified. Overall, 96 (32.0%) students were found to have depression. Of these, 59 (19.0%) had mild depression, 4 (1.3%) had severe depression, 53 (39.3%) were pre-clinical students, and 43 (26.1%) were clinical students. Emotional problems (OR 2.205, 95% CI 1.122 ­ 3.749, p = 0.020), financial challenges (OR 3.971, 95% CI 2.170 ­ 7.269, p < 0.001) and smoking (OR 6.877, 95% CI 1.731 ­ 27.327, p = 0.006) were the significant independent predictors of depression. Conclusion: The prevalence of depression was high among medical students. There is a need to include screening for risk factors of depression in the routine medical examinations for new students admitted into medical schools

Assessment practices in undergraduate clinical medicine training: what do we do and how we can improve?

Background: Assessment should form an integral part of curriculum design in higher education and should be robust enough to ensure clinical competence. Aim: This article reports on current assessment practices and makes recommendations to improve clinical assessment in the undergraduate medical programme at the University of the Free State. Methods: A descriptive cross-sectional study design was used. Qualitative and quantitative data were gathered by means of open- and closed-ended questions in a self-administered questionnaire, which was completed by teaching and learning coordinators in 13 disciplines. Results: All disciplines in the undergraduate medical programme are represented. They used different assessment methods to assess the competencies required of entry-level healthcare professionals. Workplace-based assessment was performed by 30.1% of disciplines, while multiple-choice questions (MCQs) (76.9%) and objective structured clinical examinations (OSCEs) (53.6%) were the main methods used during formative assessment. Not all assessors were well prepared for assessment, with 38.5% never having received any formal training on assessment. Few disciplines (15.4%) made use of post-assessment moderation as a standard practice, and few disciplines always gave feedback after assessments. Conclusion: The current assessment practices for clinical students in the undergraduate medical programme at the University of the Free State cover the spectrum that is necessary to assess all the different competencies required. Multiple-choice questions and OSCEs, which are valid and reliable assessment methods, are used frequently. Poor feedback and moderation practices should be addressed. More formative assessments, and less emphasis on summative assessment, should be considered. Workplace-based and continuous assessments may be good ways to assess clinical competence

Knowledge and awareness of undergraduate university students towards eye donation in North-west, Nigeria: a cross-sectional study

Background: Corneal blindness still remains a large contributor of childhood blindness in Africa. Corneal transplant is a sight saving procedure that is still lacking in most of African countries despite the first successful corneal transplant in 1905 by Dr. Eduard Zirm. The cornea eye bank and transplant procedure in Nigeria is still in the infancy stage despite Federal Government of Nigeria acknowledged the need for an eye bank and promulgated the decree No. 23 titled Corneal Grafting Decree 1973. Objectives: To assess the level of knowledge and awareness on eye donation among the undergraduate students of Kebbi State University of Science and Technology. Methods: A cross-sectional study was undertaken among undergraduate university students, using a pre-tested, self-administered questionnaires. Information on the socio-demographics, the participants' knowledge and willingness to donate eye was obtained. The questionnaires were analyzed using SPSS version 20. Results: Of 281 participants, 157 (55.9%) were males and Muslim 204 (72.6%). Few students 59 (21%) were willing to donate their eyes after death, while131 (46.6%) were not willing to donate their eye because of their religious belief. Ninety-three (33.8%) of the students support eye donation. Television was the main 94 (33.5%) source of information about eye donation. Conclusion: The knowledge and awareness of eye donation among the students was low. Furthermore, majority were not willing to donate their eye mostly because of their religious belief. Health education on eye donation is needed to increase the uptake of eye donation among population

'Pain and stress are part of my profession': Using dental practitioners' views of occupation-related factors to inform dental training

Background. Stress is prevalent among dental workers and students. A possible means to address this would be to include stress management programmes in undergraduate dental programmes. The purpose of this study was to establish how the current cohort of dental practitioners incorporate occupational health and self-care principles into professional practice, and their potential relevance to future curriculum design.Objectives. To gain input from participants regarding stress and burnout ­ their causes, implications and prevention ­ as linked to their practice in dentistry.Methods. A qualitative research design was used, with a purposive sampling technique. The study population consisted of dentists, dental therapists, hygienists and specialists. A total of 36 participants participated in four focus-group discussions to explore dental education, occupational health, stress and self-care. The data were thematically analysed.Results. Dental training in the South African context, occupational health experiences, self-care, coping strategies and education were the main themes that emerged. Dental services in the public sector were reported to be overwhelmed by high patient volumes and shortages of staff and resources, which added to these stressors. The coping strategies adopted were exercise, stretching, reducing workload and encouraging teamwork. The participants believed that the causes of musculoskeletal disorders, and their impact, should be taught in dental training, as students do not perceive this as a potential problem. A multidisciplinary approach and teamwork training are the recommendations for curricula.Conclusion. Stress management techniques and workplace posture assessment should be taught in preclinical training to make students aware of managing stress and correct working postures. A multidisciplinary approach should be used. Dental curricula should include occupational health safety principles

Socio-demographic variables as predictors of accessibility, utilization, and preference for reproductive health information sources among undergraduate students in Nigerian universities

This study examined socio-demographic variables as predictors of accessibility, utilization and preference for reproductive health information sources among undergraduate students in Nigerian universities. The study adopted a survey research design. A sample of 2615 undergraduate students was drawn from six conventional federal universities in the six geopolitical zones in Nigeria. Data were collected using the questionnaire. Of the 2615 copies of questionnaire distributed, 1615 usable copies of the questionnaire were returned, giving 62% return rate. Result of Regression analysis revealed that the seven independent variables jointly predicted accessibility to reproductive health information sources, utilization of reproductive health information sources, preference for reproductive health information sources and knowledge of reproductive health among undergraduate students. The study concluded that strategies aimed at the provision of access to reproductive health information to young people may be more effective if their socio-demographic characteristics are factored into such interventions.

The forensic autopsy as a teaching tool: attitudes and perceptions of undergraduate medical students at the University of Pretoria, South Africa

Background. Numerous articles have been published on the use of autopsies in training medical students in anatomy and different branches of pathology. Some authors have described the emotional response of students who attend such postmortem sessions. Forensic pathology is an important subdivision of pathology. In some countries undergraduate medical students are expected to attend postmortem examinations on persons who died from traumatic causes. Objective. To determine the attitudes and perceptions of 5th-year medical students with regard to forensic postmortem examinations at the University of Pretoria; South Africa. Methods. A questionnaire was voluntarily completed by medical students on the last day of the practical rotation.Results. The overall rating of the practical rotation was 82%. The strengths; weaknesses; opportunities and threats (SWOT) analysis indicated the following as strengths: record keeping; legislation review and traumatology description; as weaknesses: emotional trauma and nightmares; as opportunities: the attendance of autopsies; and as threats: physical dangers. Conclusion. The current study was similar to international studies with regard to students' emotional response to attending autopsies. The autopsy remains a valuable teaching tool for undergraduate students. Emotional support is currently available for all students to assist them in overcoming their fear of attending forensic autopsy sessions

Multidisciplinary leadership training for undergraduate health science students may improve Ugandan healthcare

Background. Community-based education research and service (COBERS) is a platform for embedding progressive transformative leadership and research-related medical education in Uganda. The leadership development programme (LDP) developed at Mbarara University of Science and Technology (MUST); Uganda is a key component of COBERS. Health science students at MUST are equipped by means of the LDP with leadership knowledge and skills; and a positive attitude towards leadership and rural communities. The programme involves employing interactive learner-centred education techniques; with the opportunity to implement these skills in a community setting immediately after the training.Objective. To assess the students' self-reported perception and effectiveness of the precommunity placement LDP at MUST and its impact during the community clinical placement; and to measure the self-reported improvement of students' knowledge and their application of leadership skills in the community. The results of the evaluation will improve and build on this educational programme. The study also evaluated the effectiveness of the preplacement leadership training course for undergraduates at MUST; as reported by students.Methods. The programme evaluation of the LDP used quantitative pretest and post-test measures and qualitative data from focus group discussionsto enrich the evaluation. Data were collected from students before and after the 1-week leadership training course using the same self-administered questionnaire. Variables were then compared to evaluate the impact of the LDP.Results. Prior to the intervention; only 14% of the participants had ever attended a leadership training session. There was significant self-reported change in the task accomplishment skills; interpersonal relationship skills and quality of leadership.Conclusion. The results suggest that the LDP may increase leadership skills among health science students to improve healthcare in Uganda. Our study recommends that this leadership programme be considered for use by Ugandan medical training faculties and similar environments elsewhere

Effect of bedside teaching activities on patients' experiences at an Ethiopian hospital

Background. Clinical bedside teaching is more effective when done at the bedside. The number of medical schools in Ethiopia has increased tenfold in 8 years to meet the Millennium Development Goals. The increased number of students at the patient's bedside has been met with mixed feelings by patients. Objective. To determine patients' perceptions of bedside teaching during their admission to the medical and surgical wards at Mekelle University Hospital; Ethiopia. Methods. A 32-item questionnaire was used for data collection. Patients used a Likert scale to rate their perceptions of the quality of their hospital stay with regard to teaching; clerkships and physical examinations. Items where respondents scored less than the median of 67 (interquartile range 21) were categorised as displaying a negative attitude. Results. Patients (60%) did not favour the bedside teaching activities. No significant association was found with age; sex; occupation; literacy level; duration of hospital stay; and ward. Patients (80%) also did not understand the discussions following teaching sessions; and claimed to be unaware of the teaching status of the hospital. Patients (80%) did not understand the role of the students and were anxious when left alone to be examined and clerked by them. Conclusion. The rights of patients in medical education should be emphasised. Patients should be informed about the role of students at teaching ospitals and about their rights and responsibilities as patients. Institutional protocols and country-wide guidelines can help to regulate the number of times that a patient should be clerked and physically examined by students. Instructors should ensure that patients understand the purpose of the discussion that follows the examination

Knowledge Attitudes and Practices of evidence based medicine among residence doctors in Sudan

Objectives: The aim of this cross-sectional study was to determine the awareness and attitude of hospital resident doctors towards evidence-based medicine (EBM) and their related educational needs. Methods: A cross-sectional descriptive study was performed on a randomly selected sample of 141 hospital resident doctors from teaching hospitals. Awareness and Attitude towards EBM; accessing to internet and Midlines and perceived barriers to practice EBM among participants were the main outcome measures. Results: 92.1strongly welcomed introduction and promotion of EBM in daily management of patients. About one-third of respondents (32.7) thought that the most appropriate way to move towards EBM was by seeking and applying EBM summaries. Most of the participants had access to internet (82) and those who were never heard or had a course on EBM were (85). Only 10who used EBM in 50to 100of their clinical practice. The major barriers to practicing EBM were no time due to patient overload (85); lack of libraries (65) limited resource (62) and lack of training (60). Most of the participants (79) agreed to be one of the requirements of full registration in Sudan Medical Council. Conclusions: Although there is a high support among doctors for the promotion of EBM; there is a deficit in knowledge and lack of skills of EBM. Hence; the time is suitable for planning and implementing an effective EBM educational programme for both undergraduate and postgraduate doctors. Evidence-based medicine has limitations; and more efforts need to be directed toward improving doctors' skills and access to evidence at the point of care

The Undergraduate Training in Ophthalmology: The University of Nigeria Nsukka Medical Students

Objective: The study was embarked upon to determine the view of University of Nigeria final year medical students on the adequacy of their undergraduate training in ophthal- mology; vis-a-vis rendering basic eye care as general duty doctors. Methods: One hundred final year medical students; who had finished their ophthalmology clinical postings; completed a self-administered; structured and semi structured questionnaires in August 2004. Data analysis was done manually using an electronic calculator. Result: Majority of the students (60) were of the view that the training was inadequate. This was largely attributed to the low level of clinical exposure and community experience in the programme. Conclusion: The undergraduate training in ophthalmology undergone by these final year medical students may not have equipped them with adequate knowledge and skills to render basic eye care as general duty doctors. There is a need to improve the relevance and quality of the training.) were of the view that the training was inadequate. This was largely attributed to the low level of clinical exposure and community experience in the programme. Conclusion: The undergraduate training in ophthalmology undergone by these final year medical students may not have equipped them with adequate knowledge and skills to render basic eye care as general duty doctors. There is a need to improve the relevance and quality of the training

Lost investment returns from the migration of medical doctors from Malawi

Migration of medical doctors from African countries to developed nations compromises the delivery of health care on the continent. The full cost of producing a medical doctor was estimated in Malawi by adding the costs of education from primary school through undergraduate medical education. The cost in fees for one medical doctor produced was US$ 56;946.79. The amount of lost investment returns for a doctor who migrated out and served for 30 years in the receiving country ranged from about US$ 433;493 to US$46 million at interest rates 7and 25; respectively. Quantitative assessments of the estimated loss in investment allows for informed policy discussions and decisions