Background: Multiple measures introduced early to restrict COVID-19 have dramatically impacted the teaching of medical and pharmacy students, exacerbated by the lack of infrastructure and experience with e-learning at the start of the pandemic. In addition, the costs and reliability of the Internet across Africa pose challenges alongside undertaking clinical teaching and practical programmes. Consequently, there is a need to understand the many challenges and how these were addressed, given increasingly complex patients, to provide future direction. Method: An exploratory study was conducted among senior-level medical and pharmacy educators across Africa, addressing four key questions, including the challenges resulting from the pandemic and how these were dealt with. Results: Staff and student members faced multiple challenges initially, including adapting to online learning. In addition, concerns with the lack of equipment (especially among disadvantaged students), the costs of Internet bundles, and how to conduct practicals and clinical teaching. Multiple activities were undertaken to address these challenges. These included training sessions, developing innovative approaches to teaching, and seeking ways to reduce Internet costs. Robust approaches to practicals, clinical teaching, and assessments have been developed. Conclusions: Appreciable difficulties to teaching arising from the pandemic are being addressed across Africa. Research is ongoing to improve education and assessments.

Background: Factors influencing how pharmacy students learn and experience pharmaceutical education have not been elucidated in Zambia. Aim: To elucidate contextual factors affecting academic self-efficacy and learning experiences among undergraduate pharmacy students at a public university in Zambia. Methods: A qualitative study utilising focus group discussions was conducted at the University of Zambia. Thirty-two undergraduate pharmacy students participated in four focus group discussions. Qualitative data were thematically analysed. Results: Four themes and eight sub-themes emerged from the data. Notional time management, learning style, and motivation; educational programme-related factors such as course load, the pace of teaching; the learning environment; and assessment practices affected undergraduate pharmacy students’ self-efficacy and learning experiences. Conclusion: Addressing the student-related, educational programme-related, and the learning environment factors identified in this study will contribute to the improvement of undergraduate pharmacy students’ learning experiences. This is premised to improve their educational outcomes and future practice of pharmaceutical care.

Background: The need for having reporting radiographers has been a part of the discussion in the last decade in Zambia. This is due to acritical shortage of radiologists, an increase in demand for imaging services, and the radiographers' desire for professional recognition in providing formal reportson radiographic images similar to those they undertake in ultrasonography. Objective: The study aimed at reviewing the evidence relating to image interpretation and reporting by radiographers in Africa and apply thefindings to Zambia. Methodology: A literature review was used to bring together studies on image interpretation and reporting by radiographers in Africa. Online databases, radiography journals, cited references, grey literature, and the internet were searched for relevant studies. Results: Thirteen studies were included in this review. The findings revealed that radiographers in Africa have a positive attitude towards image interpretation and reporting. In addition, their accuracy at image interpretation is comparable to radiologists. The main benefit identified by the establishment of reporting radiographers is improved access to imaging reports. The review also found that medical doctors are in support of the establishment of reporting radiographers. However, the main limitations are a lack of postgraduate courses in this speciality and the limitation of their scope of practice. Conclusion: Reporting radiographers contribute significantly to the delivery of quality imaging services by assisting radiologists in reporting on radiographic images. There is a need for policymakers in Africa, including Zambia, to extend the scope of practice of radiographers and establish postgraduate image interpretation courses.

Background: Breast cancer is the most common malignancy among women in Zambia. Ultrasound can be a useful tool for early diagnosis of breast cancer based on the breast lesions’ features. However, an overlap in the ultrasound features of malignant and benign breast tumours has been noticed together with a paucity of information on the ultrasound features that are more suggestive of breast cancer. Objective: The purpose of this study was to identify ultrasound features of suspected breast cancer lesions which may assist in ascertaining a high breast cancer or benign breast disease suspicion index, that may be used to prioritise patients requiring further and urgent management for breast cancer. Methods: Systematic random sampling was used for the selection of participants in this study. The selected patients first underwent an ultrasound scan in the Ultrasound department to obtain the breast lesion ultrasound features. The histology results for the same patients were then obtained from the University Teaching Hospital (UTH) histology laboratory or the histology report filed in the patient’s medical file. Results: Irregular shape of breast lesions, vertical orientation of breast lesions, hypoechogenicity of breast lesions, complex echo pattern of breast lesions, irregular or spiculated margin contours of breast lesions, compression of breast lesion surrounding tissue, absence of hyperechogenic spots in breast lesions and a breast lesion boundary with neither a hyperechoic halo nor thin capsule (None) were found to be associated with breast cancer. No breast lesion showed less than 3 ultrasound features suspicious for breast cancer. Hyperechoic spots in breast lesions were found to be associated with non-cancerous breast lesions. Conclusion: Low-resource countries, such as Zambia, where access to imaging diagnostic equipment such as Mammography and Magnetic Resonance Imaging machines (MRI), and histology examinations are scarce, the preceding ultrasound findings .......

Background: There is a critical shortage of radiologists in Zambia to report on all imaging examinations. Radiologists have concentrated on specialised imaging examinations, thereby leaving the interpretation of general radiography examinations to the referring medical practitioners, whose competence in image interpretation is not at the same level as radiologists. This can lead to misdiagnosis and mismanagement of patients.  Objective: This study aimed at determining the opinions of Zambian radiographers on extending their role in the interpretation and reporting of general radiographic images.  Methodology: This study was conducted using a cross-sectional survey approach. Data were collected using an online questionnaire. Radiographers with a minimum of two years’ work experience were invited to participate in the study. Both quantitative and qualitative data were collected. Descriptive statistics were used to analyse quantitative data, while thematic analysis was used for qualitative data.  Results: A total of 81 participants responded to the survey. A major finding showed that most radiographers (N=78, 95%) had a positive attitude towards image reporting because it improves the delivery of imaging services. Most of the radiographers were also willing to be trained at a postgraduate level (93%, N=76), and indicated the need to extend the scope of practice to include image reporting (N=78, 95%). The main challenges identified were inadequate advocacy and possible resistance from medical professions. Conclusion:  Radiographers are prepared to venture into image reporting. It is anticipated that this role extension can supplement radiologists in providing diagnostic reports and ensure that all patients have access to this service.