Student perceptions of an online surgical teaching programme during the COVID-19 pandemic at the University of KwaZulu-Natal: A short report

Background. The COVID-19 pandemic has led to an unprecedented global health crisis, with impacts on many facets of the health system, including lack of access to regular training wards and the need for social distancing, which posed particular challenges to undergraduate teaching. Objectives. To explore the perceptions of students of the online surgical programme at the University of KwaZulu-Natal (UKZN). Methods. An online survey was administered to 258 final-year students. Data were collected on student demographics, the impact of COVID-19 restrictions on the teaching programme, engagement and learning from live Zoom sessions, overall perceptions about the module and general feedback on students' experience of the programme. Results. Most students (84%, 77/91) supported the need to change to the virtual programme. The module was perceived as well-structured (89%, 81/91). Most students (87%, 79/91) regarded the online resource materials as beneficial. Analysis of open-ended responses showed that asynchronous delivery allowed students to review and revisit resources in their own time. Student challenges included poor internet connectivity, difficulty in concentrating where live sessions exceeded an hour, and lack of clinical exposure. Conclusion. Online teaching in medical education is a feasible option for remote learning. However, it cannot replace the benefits gained during clinical exposure. Findings from this study will help to set a benchmark for online surgical training at UKZN and develop best practices for blended teaching models. As we adapt to a new normal in the era of COVID-19, the disruptions and results of innovative teaching methods have the potential to change the future of medical education

Fieldwork practice for learning: lessons from occupational therapy students and their supervisors

Background. Fieldwork practice forms a vital part of occupational therapy (OT) education and contributes significantly to competent practice and students' clinical reasoning. Students' learning is positively or negatively influenced by their fieldwork experience. Objective. To explore the views and experiences of final-year OT students, site-based clinicians and university-based academic supervisors to identify strategies that influenced students' learning during fieldwork practice. Methods. This descriptive qualitative study used a purposeful sampling technique. Data collection strategies included focus group discussions with clinical and academic supervisors and semistructured interviews with final-year students. Each set of data was analysed according to the research questions. The researcher analysed the data into themes, which were corroborated by a supervisor. Data source and analyst triangulation ensured trustworthiness of the study. Results. Two themes, i.e. difficulties experienced by students during fieldwork and supervision strategies that they found beneficial for learning, are described. Guidance and mentoring from experienced therapists helped students to link observations from assessments and intervention plans. Observations of treatment sessions, peer learning and practice in the skills laboratories were beneficial for learning, competence and confidence. Guided questions from supervisors to enhance reflexive practice and peer learning strengthened the students' confidence and ability to give feedback to their peers. The students also benefited from sessions that allowed them the freedom and space to work autonomously. Conclusion. This study provides insight into the difficulties that students experienced when engaging with fieldwork and offers some strategies that have been found to advance their learning

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

Learning anatomy through dissection: perceptions of a diverse medical student cohort / Aprendizaje de la anatomía a través de disección: percepción de una amplia cohorte de estudiantes de medicina

The debate on how best to teach anatomy and the central role of cadaveric dissections in medical training remains topical even today. Despite the use of a variety of teaching methodologies e.g. prosected specimens, plastinated specimens, cadaveric dissection and computer-assisted learning, the amount of time dedicated to a full body human dissection programme, its clinical relevance and whether it promotes deeper learning has become a bone of contention in problem- based learning context. The implementation of student centred, PBL curricula means that students' learning is autonomous, and studies suggest the link between students' approaches to learning with their perceptions of their learning environment. Therefore, this study explored the perceptions of an educationally diverse medical student cohort in a 5 year problem-based learning programme who learned anatomy through the dissection method, elaborating on the value of this subject to their medical studies. Quantitative and qualitative data was collected and thematically analysed. One hundred students of the MBChB2 cohort (44%) completed the questionnaire. The majority of the respondents (70%) reported a positive experience during anatomical dissection in terms of visual and clinical application whilst gaining anatomy understanding and skill. Students with prior educational qualifications (mature) and first time school leavers voiced similar complaints. Student responses differed qualitatively on how they benefitted from the dissection. This study confirms that dissection remains an effective method for basic anatomy teaching even in PBL contexts. It concludes with strategies to enhance the learning experiences of educationally diverse students.

El debate sobre la mejor manera de enseñar la anatomía y la relevancia de las disecciones de cadáveres en la formación médica sigue siendo un tema de actualidad. A pesar del uso de una variedad de metodologías de enseñanza, por ejemplo especímenes plastinados, la disección de cadáveres y el aprendizaje asistido por computador, el tiempo dedicado a un programa de disección de cuerpo completo, su relevancia clínica y el promover un aprendizaje más profundo se ha convertido en un tema de discordia en el contexto del aprendizaje de los estudiantes y sus percepciones del ambiente de aprendizaje. Este estudio investigó las percepciones desde un punto de vista educativo en un grupo de estudiantes de medicina en un programa de aprendizaje basado un estudio observacional, en un programa de 5 años basado en problemas a través del método de disección, evaluando el valor de este tema para sus estudios de medicina. Los datos cuantitativos y cualitativos fueron recolectados y analizados temáticamente. Un centenar de estudiantes de la cohorte MBChB2 (44%) completaron el cuestionario. La mayoría de los encuestados (70%) reportó una experiencia positiva durante la disección anatómica en términos de aplicación visual y clínica, mientras van adquiriendo comprensión de la anatomía y habilidad. Los estudiantes con títulos de estudios previos (maduros) y los recién egresados de la escuela secundaria expresaron quejas similares. Las respuestas de los estudiantes difieren cualitativamente en la forma en que se beneficiaron de la disección. Este estudio confirma que la disección sigue siendo un método eficaz para la enseñanza de anatomía básica incluso en contextos de ABP. El estudio concluye con estrategias para mejorar las experiencias de aprendizaje de los estudiantes basado en diversos problemas.

Alternativas para o controle de nematoides gastrintestinais de pequenos ruminantes / Alternative techniques for the control of gastrointestinal nematodes in small ruminants

Sheep and goat farming requires an efficient management program, due to losses caused by parasites in susceptible animals. Many factors may collaborate to improve infection tolerance in the herd, such as: genetics, nutrition, physiological status, and age. The problem caused by resistance to antihelmintic agents has led to the spread of alternative techniques for parasite controls. The latest strategies include selective treatment with the FAMACHA method, phytotherapy, biological control with predatory fungi, and strategies that still await scientific confirmation, such as homeopathy, the dilution of resistance with the introduction of susceptible parasites, and the combination of drugs without antihelmintic effect. The main objective of these methods is to reduce the usage of antiparasitic agents, thus slowing the development of resistance and promoting the better use of effective products and newly released products. The objective of this article is to describe techniques for controlling nematodes in small ruminants, and it is aimed at technicians interested in increasing their knowledge about the mechanisms of resistance to antihelmintic agents as well as alternatives to the use of these products.

A criação de ovinos e caprinos depende de um manejo eficiente, devido, principalmente, ao prejuízo causado por parasitos em animais susceptíveis. Vários fatores colaboram para que os animais tolerem as infecções parasitárias, como: genética, nutrição, estado fisiológico e idade. O grave problema causado pela resistência anti-helmíntica promoveu a difusão de técnicas alternativas de controle parasitário. Dentre essas novas estratégias incluem-se a adoção do tratamento parcial seletivo com o método FAMACHA, fitoterapia, controle biológico com o uso de fungos nematófagos e estratégias que ainda necessitam de mais dados como a homeopatia, a diluição da resistência com a introdução de parasitos sensíveis e a combinação de produtos químicos sem efeito antiparasitário. O objetivo central destes métodos é reduzir o uso de antiparasitários, retardando o desenvolvimento da resistência, e promover melhor utilização de produtos ainda eficazes na propriedade e de novos produtos que venham a ser lançados. Este artigo abordará as técnicas descritas acima para o controle de nematoides de pequenos ruminantes e é direcionado aos técnicos interessados em ampliar seu conhecimento sobre os mecanismos de resistência dos parasitos aos anti-helmínticos e de alternativas ao uso desses produtos.