Reviewing academic coordination on the rural distributed training platform in South Africa.

INTRODUCTION: Distributed training of students from a variety of health professions is increasing in South Africa because of the type of learning it offers and that it caters for the increasing number of students being accepted into health sciences programs. Challenges and facilitators to distributed training are well documented in the literature, and include increased distance from the academic home, human resources for health challenges, student access to support systems, and identifying learning environments to match learning outcomes. In the case of the Rural Clinical School in the Western Cape, South Africa, 'academic coordinators' were employed on site to fulfil the role of coordinating and supervising student learning and community engagement. This article explores their experiences. METHODS: A large-scale qualitative study was conducted in 2017 exploring the history and development of the Ukwanda Centre for Rural Health and the Rural Clinical School. Part of this study included semi-structured individual and focus group interviews with consenting academic coordinators exploring their experiences of developing and working on a rural distributed training platform in South Africa. Data were inductively analysed. Ethical approval and institutional permission were obtained for this study, and all participants provided consent. RESULTS: In addition to previously published challenges that clinical supervisors who are employed by the health system face, the academic coordinators reported facing challenges related to professional isolation, boundary blurring between providing student support versus acting as clinical educator, juggling multiple line managers and administrative responsibilities, navigating the new field of academia, and not having the potential for career progression. CONCLUSION: Reflecting on the needs of academic coordinators expressed in this article, we identified four conditions that may promote sustained and continuous academic coordination at rural or remote distributed training sites. These conditions are (1) living and working local; (2) having a dual role in academia and the health system; (3) having access to academic support; and (4) regular engagement with the academic home, the value of which is detailed in this article. These recommendations can be adopted to optimise and sustain academic engagement on the distributed training platform, especially in light of the current expansion of health professions training and subsequent need to attract and retain clinician-academics in remote locations.

Interprofessional service-learning: cutting teeth and learning to crawl.

An interprofessional community-based service-learning initiative, supporting early childhood development in an impoverished community, was launched on a South African university's rural training platform. The study aimed to determine how this learning experience influenced students' interprofessional person-centered practice. An interpretative qualitative approach was followed. In-depth focus group discussions with dietetic (n = 15), medical (n = 24) and occupational therapy (n = 6) students were conducted before they left for a rural training site, directly afterward and again six months later. The findings indicated that most students had a limited experience of interprofessional collaborative practice (IPCP) beforehand. Afterward, those demonstrating developmental learning reported increased knowledge about their own roles, a deeper understanding of the roles of other professions and a realization of the importance of IPCP. Different reactions were related to students' profession, attitude and insight, and other interprofessional experiences during the placement. Contact with service users in the community, additional interprofessional clinical activities and shared living spaces are likely to further enhance students' competencies in IPCP. A lack of interprofessional role modeling in the academic hospital, where most students returned to, hindered them to continue following an interprofessional, person-centered approach. Longer, synchronized rotations on a decentralized platform may be beneficial to inculcate competencies related to IPCP.