A peer evaluation of the community-based education programme for medical students at the University of Zimbabwe College of Health Sciences: A southern African Medical Education Partnership Initiative (MEPI) collaboration

Background. The University of Zimbabwe College of Health Sciences (UZCHS), Harare, which has a long tradition of community-based education (CBE), has not been evaluated since 1991. An innovative approach was used to evaluate the programme during 2015.Objectives. To evaluate the CBE programme, using a peer-review model of evaluation and simultaneously introducing and orientating participating colleagues from other medical schools in southern Africa to this review process.Methods. An international team of medical educators, convened through the Medical Education Partnership Initiative, worked collaboratively to modify an existing peer-review assessment method. Data collection took the form of pre-visit surveys, on-site and field-visit interviews with key informants, a review of supporting documentation and a post-review visit.Results. All 5 years of the medical education curriculum at UZCHS included some form of CBE that ranged from community exposure in the 1st year to district hospital-based clinical rotations during the clinical years. Several strengths, including the diversity of community-based activities and the availability of a large teaching platform, were identified. However, despite the expression of satisfaction with the programme, the majority of students indicated that they do not plan to work in rural areas in Zimbabwe. Several key recommendations were offered, central to which was strengthening the academic co-ordination of the programme and curriculum renewal in the context of the overall MB ChB curriculum.Conclusion. This evaluation demonstrated the value of peer review to bring a multidimensional, objective assessment to a CBE programme

Essential professional duties for the sub-Saharan medical/dental graduate: An Association of Medical Schools of Africa initiative.

BACKGROUND - Globally, human resources for health are being optimized to address the increasing health burden and concomitant increased demands on health professionals. These demands are even more exacting in Sub-SaharanAfrica considering the shortage of health care workers, especially physicians. The noteworthy efforts at deploying task-shifting to address this situation not-withstanding, the situation also signals the need to re-define the objectives of medical instruction to ensure effective and contemporary medical practice in a mostly physician-led health workforce across the sub-continent. In this regard, medical and dental graduates must be educated to perform certain minimum essential professional duties competently. Essential Professional Duties are locally relevant professional activities of international standard that represent identifiable outcomes against which the effectiveness of physicians in a specific community can be measured to ensure social accountability. PROCEDURE AND PRODUCT - The Association of Medical Schools of Africa has developed the 'Essential Professional Duties for sub-Saharan medical and dental graduates' to ensure these physicians provide safe and effective contemporary medical/dental practice on the sub-continent. The duties have been grouped into those required for basic patient care, basic administrative skills, basic emergency care, communication, inter-professional relationships, self-directed learning and social responsibilities. Their relevance and suitability have been evaluated prior to their adoption by the Association. CONCLUSION; These Essential Physician Duties have been developed to serve as targets for health professionals training instruments and thus give direction to health system strategies. It is hoped that they will be adopted by medical and dental schools across sub-,. Saharan Africa.

Cultural and environmental influences on footedness: cross-sectional study in urban and semi-urban Malawi.

The present study was designed to assess cultural and environmental pressure against left-foot preference in urban and semi-urban Malawi. The findings demonstrated that, when compared to handedness, footedness appeared to be less biased behavioral laterality in culturally restrictive communities. The percentage of responders with negative views on left-foot preference was lower than that on left-hand preference (57% vs. 75%) and a smaller proportion of volunteers suggested that left-footers should be forced to change the foot (63.5% vs. 87.6%). In total, mobilizing and stabilizing tasks scored similar proportions of negative responses. Expectation of inferior performance of the left foot than the right one was the major reason for negative views on left-foot preference. Gender and driving experience had significant but weak effect on the view on left-foot preference. Most of the responders (74%) suggested that left-footers should change the foot in early family environment.

Cardiotonic and antidysrhythmic effects of oleanolic and ursolic acids, methyl maslinate and uvaol.

The cardiotonic and antidysrhythmic effects of four triterpenoid derivatives, namely oleanolic acid (OA), ursolic acid (UA), and uvaol (UV), isolated from the leaves of African wild olive (Olea europaea, subsp. africana) as well as methyl maslinate (MM) isolated from the leaves of Olea europaea (Cape cultivar) were examined. The derivatives showed low toxicity on brine shrimp test. They displayed significant, dose-response vasodepressor effect and sinus bradicardia, most prominent for OA and MM. The derivatives acted as beta-adrenergic antagonists, blocking the effect of adrenaline and isoprenaline. The established positive inotropic and dromotropic effects were most distinctive for OA and MM. The antidysrhythmic effects were evaluated on CaCl2- and adrenaline-induced chemical arrhythmias, and on ischemia-reperfusion arrhythmia. OA and UA displayed antidysrhythmic effects on both types of chemical arrhythmia; OA and UV in dose 40 mg/kg conferred significant antidysrhythmic activity on ischemia and reperfusion arrhythmias. The effect was comparable to that of propranolol and suggestive of beta-adrenergic antagonistic activity. On the basis of the vasodepressor, cardiotonic and antidysrhythmic effects of these compounds, it was concluded that OA and UV isolated from wild African olive leaves, or crude extract containing all components, can provide a cheap and accessible source of additive to conventional treatment of hypertension, complicated by stenocardia and cardiac failure.

Some physiological and psychophysiological signs of neuroticism level in healthy persons.

OBJECTIVE: To study cardiac reactivity on presentation of cardiotropic drug odour, perception of this odour and autonomic nervous system activity in high personality neuroticism healthy women. DESIGN: Cross sectional. SUBJECTS: 28 healthy female undergraduate university student volunteers in the age range 21 to 29 years. MAIN OUTCOME MEASURES: Eysenck Personality Questionnaire, threshold of nicethamidum odour detection, statistical parameters of electrocardiographic R-R intervals variance, Strain Index of cardiac regulatory systems (as a measure of the balance between sympathetic and parasympathetic system activities). RESULTS: Six subjects with low neuroticism level (LNL) and eight persons with high neuroticism level (HNL) were selected out of 28 young women volunteers using the Eysenck Personality Questionnaire. Baseline cardiac rhythm of the HNL group had a high level of stability and high values of the Strain Index which are characteristic of increased activity of the sympathetic nervous system. Increased variability of the cardiac rhythm and low values of Strain Index indicated elevated parasympathetic nervous system activity in LNL persons. HNL subjects also had low cardiac reactivity on presentation of nicethamidum solutions and high detection thresholds of odour stimuli. CONCLUSIONS: High neuroticism level in healthy females affects the balance between sympathetic and parasympathetic nervous system activities, cardiac reactivity on presentation of nicethamidum odour as well as perception of this odour. Low cardiac responsiveness to stimulatory effect of cardiotropic drug and increased sympathetic nervous system activity should be taken into consideration when planning treatment of neurotic subjects.