ABSTRACT
Background: Mentorship is useful in enhancing student learning experiences. The provision of feedback by faculty mentors is a central activity within a fruitful mentorship relationship. Therefore, effective feedback delivery by mentors is key to the development of successful mentorship relationships. Mentorship is a social interactive relationship between mentors and mentees. Therefore, activity theory, a sociocultural theory, has been applied in this study to develop a framework for feedback delivery within the mentorship educational alliance between mentors and mentees. Objective: The purpose of the study was to explore experiences of students and faculty mentors regarding feedback in a mentorship relationship, and to develop a feedback delivery framework in a mentorship relationship underpinned by activity theory. Methods: This was a mixed-method sequential study conducted at Makerere University College of Health Sciences using both quantitative and qualitative data collection methods. The study involved undergraduate medical students and faculty mentors. Data were collected through self-administered questionnaires, focus group discussions and interviews. Descriptive statistics were used for quantitative data, while thematic analysis was used for qualitative data. Results: Most students reported negative experiences with feedback received during the mentorship process. Of the total of 150, a significant number of students (n=60) reported receiving no feedback at all from their mentors. One hundred students reported that feedback received from mentors focused on only weaknesses, and 80 reported that the feedback was not timely. A total of 130 students reported that the feedback sessions were a one-way process, with limited involvement of mentees. The feedback also tended to focus on academics, with limited emphasis on psychosocial contextual aspects that may potentially influence student learning. The focus group discussions with students confirmed most of the quantitative findings. The interviews with faculty mentors led to the emergence of two key themes, namely: (i) limited understanding of feedback delivery during mentorship; and (ii) need for feedback guidelines for faculty mentors. Based on the findings of the mixed-method study as well as the theory guiding the study, a feedback framework for mentorship interactions has been suggested. Conclusion: While students generally reported low satisfaction with feedback received from mentors, faculty suggested the need to have feedback guidelines for mentors to frame their feedback during mentorship interactions. A feedback framework to guide mentorship interactions has therefore been suggested as a result of this study, guided by principles of activity theory.
ABSTRACT
Traditional birth attendants (TBAs) represent an important component of the healthcare system in resource-limited settings, and are present at 50% of deliveries in developing countries. While several studies have been carried out on the effectiveness of TBAs in reducing maternal morbidity and mortality, very little attention has been given to the needs assessment of TBAs within the environment they practice. We conducted a cross-sectional study among trained TBAs (TTBAs) in the Mukono District of Uganda with needs assessment as one of the aims of the survey. A total of 48 TTBAs within the age range of 19-80 years were interviewed. Knowledge of the TTBAs regarding obstetric cases requiring referral and years of experience gathered were satisfactory. Among the 38 referred mothers, one maternal and fetal death intra-partum were recorded, yielding a case fatality rate of 2.6%. The single most important need of TTBAs was transportation. On average, the distance between the residence and the workplace of a TTBA was 7 km, and lack of transportation hampered the actual transfer of cases to a higher level of care. To remedy this, we recommend the introduction of a practical, cheap and sustainable single-ambulance-multiple-cellular phone system to facilitate prompt referral of complicated obstetric cases within the entire Health District.
