Patient care, integration and collaboration of physician associates in multiprofessional teams: A mixed methods study.

AIMS: The aim of the study was to explore the physician associate role in patient care, integration and collaboration with team members, within the hospital setting. DESIGN: Convergent mixed methods case study design. METHODS: Questionnaires with some open-ended questions and semi-structured interviews were analysed with descriptive statistics and thematic analysis. RESULTS: Participants included 12 physician associates, 31 health professionals and 14 patients/relatives. Physician associates provide effective, safe and, importantly, continuity of care and patients received patient-centred care. Integration into teams was variable, and there was a lack of knowledge about the physician associate role amongst staff and patients. Views towards physician associates were mostly positive, but support for physician associates differed across the three hospitals. CONCLUSION: This study further consolidates the role of physician associates to multiprofessional teams and patient care and emphasises the importance of providing support to individuals and teams when integrating new professions. Interprofessional learning throughout healthcare careers can develop interprofessional working within multiprofessional teams. IMPACT: Leaders in healthcare will see that clarity about the role of physician associates must be given to staff members and patients. Employers and team members will see the need to properly integrate new professions and team members within the workplace and to enhance professional identities. The research will also impact on educational establishments to provide more interprofessional training. PATIENT AND PUBLIC INVOLVEMENT: There is no patient and public involvement.

Opinions of supervisors of clinical associates in South African district hospitals.

OBJECTIVE: To determine the opinions of supervising physicians about the introduction of clinical associates at South African district hospitals in 2012. METHODS: Twenty-four healthcare professionals in Gauteng and North West provinces were selected to participate in cross-sectional qualitative interviews exploring their opinions on the clinical practice of clinical associates, the effect of the new cadre, their achievements, and the concerns of the supervisors. The inductive content analysis process generated several themes. RESULTS: Three positive themes related to clinical associate practice were identified: professionalism, skill level, and efficiencies in patient management. Themes of concern included overtime and calls, writing prescriptions, and supervision. CONCLUSIONS: Interview results highlighted acceptance and appreciation for the introduction of clinical associates. Baseline opinions enhanced curriculum development and will inform further research on the effect of clinical associates on healthcare delivery in South Africa.

Clinical Associate students' perception of the educational environment at the University of the Witwatersrand, Johannesburg.

BACKGROUND: An important determinant of a student's behaviour and performance is the school's teaching and learning environment. Evaluation of such an environment can explore methods to improve educational curricula and academic atmosphere. AIM: To evaluate the educational environment of the Bachelor of Clinical Medicine Practice programme as perceived by students at the University of the Witwatersrand, South Africa. SETTING: This cross-sectional study was conducted with all final-year students (n = 25) enrolled in 2011, with a response rate of 88% (n = 22). Students were in two groups based in the Gauteng and North-West provinces. METHODS: Data were collected using the Dundee Ready Educational Environmental Measure questionnaire, which was administered to all students. Total and mean scores for all questions were calculated for both groups. RESULTS: The learning environment was given an average score of 130/196 by the students. Individual subscales show that 'Academic self-perception' was rated the highest (25/32), whilst 'Social self-perception' had the lowest score (13/24). Positive aspects of the academic climate included: student competence and confidence development; student participation in class; constructive criticism provided; empathy in medical profession; and friendships created. Areas for improvement included: feedback provision to students; course time-tables; ensure non-stressful course; provision of good support systems for students; and social life improvement. CONCLUSION: Students' perceptions of their learning environment were 'more positive' than negative. Results from this study will be used to draw lessons for improving the curriculum and learning environment, improve administrative processes and develop student support mechanisms in order to improve their academic experience.