Scoring Clinical Competencies of Learners: A Quantitative Descriptive Study

This article reports the correlation between different clinical assessors' scoring of learners' clinical competencies in order to exclude any possible extraneous variables with regard to reasons for poor clinical competencies of learners. A university in Gauteng; South Africa provides a learning programme that equips learners with clinical knowledge; skills and values in the assessment; diagnosis; treatment and care of patients presenting at primary health care (PHC) facilities. The researcher observed that; despite additional clinical teaching and guidance; learners still obtained low scores in clinical assessments at completion of the programme. This study sought to determine possible reason(s) for this observation. The objectives were to explore and describe the demographic profile of learners and the correlation between different clinical assessors' scoring of learners. A purposive convenience sample consisted of learners (n = 34) and clinical assessors (n = 6). Data were collected from learners using a self-administered questionnaire and analysed using a nominal and ordinal scale measurement. Data from clinical assessors were collected using a checklist; which was statistically analysed using a software package. The variables were correlated to determine the nature of the relationship between the different clinical assessors' scores on the checklist to ensure inter-rater reliability. Findings showed that there was no significant difference in the mean of the scoring of marks between clinical assessors after correlation (p 0.05). Thus; scoring of marks did not contribute to poor clinical competencies exhibited by learners

Value-Sensitive Clinical Accompaniment in Community Nursing Science

Clinical community health facilities where undergraduate students are placed for their practical work in community nursing science are dynamic and have undergone major transformation over the past few years. In the clinical field; community nurses and undergraduate students are representative of the different races and language and ethnic groups in the South African population; with each group espousing different value systems. Both parties - students and community nurses - report that; due to these differences; value conflicts are experienced during clinical accompaniment and that this has negative effects on clinical learning in community nursing science. The goal of this study was to explore and describe the experiences of students with regard to value-sensitive clinical accompaniment in the community nursing environment. An exploratory; descriptive and contextual design was used. Interactions between community nurses and students during clinical accompaniment were explored for value sensitivity by means of video recordings; participant observation and focus group interviews. Data were collected by means of video recordings; participant observation and focus group interviews. The data were analysed and coded by the researcher and the external coder; using an inductive descriptive method to identify important segments of the regularity of behaviour. The focus group interviews were transcribed; analysed and coded by the researcher and the external coder; using Tesch's steps of analysis (Creswell 1994:155-156). Lincoln and Guba's criteria (1985:290) for trustworthiness were applied to the study. The general findings indicate that clinical accompaniment in community nursing is not value sensitive and; as a result; guidelines for value-sensitive clinical accompaniment need to be developed for undergraduate students in the community nursing environment. The following values (values for which guidelines need to be developed) were identified: respect during clinical accompaniment; value-sensitive communication and sensitivity to the quality of clinical accompaniment. People's thoughts often focus on the suicide victim immediately after a completed suicide. Yet; the real victims of such an event are those individuals who are left behind to cope with the aftermath of the suicide. This phenomenological psychological study explored the lived experiences of lateadolescent suicide survivors; particularly those negative experiences that seemed to worsen in the weeks and months after a significant other's completed suicide. The research participants were five female late-adolescents (aged 17-22 years) who were recruited by means of purposive sampling at a South African tertiary institution and at youth camps. Data collection consisted of collagefacilitated; face-to-face phenomenological interviews. In addition; some participants provided documentary material in the form of personal diaries; letters and poems. The data analysis was conducted according to Giorgi's phenomenological method. The following salient experiences emerged during the data analysis: guilt; self-blame; blaming others or God; anger; loss or restriction of 'self'; depression; suboptimal behavioural coping patterns; changes in relationship dynamics; and suicidality. The results of this study can be used by mental health professionals and caregivers to support adolescent suicide survivors effectively; in the midst of their mourning

Facial profile perceptions in a group of South African blacks.

INTRODUCTION: Each society has its own general perceptions of facial aesthetics and one study show that there is significant agreement among populations regarding facial preferences. People of African decent generally have a bimaxillary protrusive profile which in some orthodontic circles is regarded as a malocclusion that should be treated. OBJECTIVES: The purpose of the study was to evaluate Black South African student perceptions on the facial profile of Black South African subjects with bimaxillary protrusion. METHODS: Silhouetted lateral facial profiles of 30 Black South Africans with bimaxillary dento-alveolar protrusion were subjected to an initial evaluation process by 128 students extracted from secondary schools, junior tertiary and senior tertiary university institutions. These evaluators were asked to select the 5 most attractive and 5 most unattractive profiles. Due to a tied ranking 13 instead of 10 of the 30 profiles were selected. The 13 selected profiles were subjected to further evaluation by a group of 605 evaluators from the same educational institutions that had to select five profiles in the categories of the most attractive, attractive, average, unattractive and most unattractive profile. The results were subjected to pairwise comparisons with a Fisher extact test and Z-test for normal approximation of the binomial distribution. RESULTS: From the first evaluation process the average age and gender distribution for the evaluators were 21.8 yrs (75 females and 51 males). The most attractive profiles chosen were nos. 27 (12.19%), 11 (6.88%), 13 (6.88%) and 8 (6.56%). Profiles nos. 2, 12 and 14 (6.25%) were chosen in equal frequency as the fifth most attractive profile. The most unattractive profiles were nos. 18 (9.38%), 29 (8.91%), 22 (7.81%), 30 (7.34%), 6 (6.56%) and 7 (6.56%). The second evaluation process had an age and gender distribution of 21.6 yrs (307 females and 275 males). Profiles no. 1 was chosen as the most attractive, no. 11 as attractive, no. 5 as average and no.6 as unattractive and most unattractive. There was no statistical significant difference between male and female profile preferences. There was a highly statistical significant difference for the most attractive and most unattractive profile. A statistical significant difference was also found between the scholars and the senior tertiary university students in the category of the most unattractive profiles. CONCLUSION: Profile no. 1 was chosen as the most attractive profile. Results indicate that Black South Africans from this sample prefer exaggerated bimaxillary protrusive profiles with lip competence and normal overjet/overbite relationships.

Soft tissue profile analysis in a sample of South African Blacks with bimaxillary protrusion.

INTRODUCTION: Evaluation of facial proportions and shape is one of the most important steps in determining treatment options and outcomes for the orthodontist and maxillo-facial surgeon. Balancing the position of the lips in relation to the nose and chin has a direct relationship with the patient's aesthetic preference. OBJECTIVES: The purpose of this study was to analyse the soft tissue profile preferences in a sample of South African Blacks and to establish a Profile Index for bimaxillary protrusion. METHODS: An earlier study by Beukes, Dawjee and Hlongwa was undertaken to determine facial profile perceptions by a group of South African Black evaluators. Adjudicators were drawn from Black students from Medunsa campus, University of Limpopo, the Holy Trinity secondary school and the Mphwe secondary school, and had to evaluate silhouetted facial profiles of 30 bimaxillary dento-alveolar protrusive patients. After an initial group of 128 Black evaluator chose 13 profiles as the most attractive and most unattractive, a second group of 605 Black evaluators (also drawn from the same academic institutions) chose three profiles as acceptable and four profiles as unacceptable. From this final selection, a soft tissue analysis was undertaken to evaluate the nasolabial angle, nasofacial angle, the facial contour angle, the lower lip-chin-throat angle and the lower and upper lip prominence in relation to the Burstone "B"- line. A Fisher exact test was done to determine the statistical difference between the mean values for the acceptable and unacceptable profiles. RESULTS: The three acceptable profiles, which were chosen by more than 69% of the evaluators, had a lip prominence of 5 to 6mm more than their African American counterparts. The angular measurements of the nose, lip and chin were in close proximity to the values given by Naidoo and Miles and Flynn et al. The three acceptable profiles had normal overjet, overbite, minimal incisor visibility and efficient lip function. CONCLUSION: A "Profile index for bimaxillary protrusion" has been concluded from this study and proposes acceptable soft tissue values for bimaxillary protrusive Black South Africans.