BackgroundUganda is beset by a shortage of health workers and the few available are mal-distributed. Providing rural exposure through community-based education could positively influence students’ perspectives towards work in rural areas. We aimed to assess the impact of Community-Based Education and Research (COBERS) on health professions students’ attitudes towards working in rural areas. This was a before-and-after study among 525 students of 4 medical universities in Uganda. Data was collected using self-administered paper-based questionnaires. Logistic regression and Poisson regression respectively were used to assess intention and intended number of years of work in rural areas.ResultsBefore COBERS, 228/518 (44.0%) students indicated that they intended to work in rural areas as compared to 245/506 (48.4%) after the COBERS placement. Before the COBERS placement, the factors that were associated with students considering to work in a rural area were: extra allowance (OR = 0.2; 95% CI 0.1–0.6), and availability of social amenities (OR = 0.2; 95% CI 0.1–0.7). After their COBERS placement, the factors were: access to long distance courses (OR = 2.0; 95% CI 1.0–3.7) and being posted to a facility in a rural area (OR = 15.0; 95% CI 6.5–35.5). Before the COBERS placement the factors that influenced how long students thought they would be willing to work in a rural environment were: reliable electricity (IRR = 0.6; 95% CI 0.3–1.0) and Internet (IRR = 1.5; 95% CI 1.0–2.3), high salary (IRR = 0.4; 95% CI 0.3–0.7), and having skills to practice in rural settings (IRR = 2.0; 95% CI 1.3–3.1). Reliable electricity (IRR = 0.5; 95% CI 0.3–0.8) and long distance courses (IRR = 2.1; 95% CI 1.4–3.1) were significant motivators after having undergone the COBERS placement.ConclusionsThe majority of health professions students do not intend to work in rural areas after they graduate. Improving the welfare of health professionals working in rural areas could attract more health professionals to rural areas thus addressing the maldistribution of health workers in Uganda.

Several studies have established a relationship between morphological and behavioral asymmetry making investigations of bilateral bone asymmetry an attractive and important research area. The purpose of this study was to investigate bilateral asymmetry patterns of skeletal specimen from five geographical locations (Rwanda, Burundi, Congo, Kenya, and Uganda) at Galloway Osteological Collection, Department of Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences. The angle of torsion and retroversion, mid-shaft circumference, length, and weight of 232 pairs of humeri were determined. A Torsiometer was used to measure the angle of torsion in degrees according to Krahl and Evans 1945, a tape was used to measure the mid-shaft circumference at the level of the apex of the deltoid V, and the length in cm was determined. An osteometric board was used to measure the length of the humerus in centimeters. A weighing balance was used to measure the weight of the humerus in grams. The analysis of humeral asymmetry with respect to parameters of the human skeletal specimen at the Galloway Osteological Collection Mulago revealed bilateral asymmetrical status observed in the angle of torsion, length, weight, and mid-shaft circumference. Our result mostly showed lateralization to the right in all the parameters investigated except the torsion angle which is to the left. Our investigation revealed that humeral torsion is inversely proportional to weight, length, and mid-shaft circumference of the humerus. This study established the existence of bilateral asymmetries in the humeri of all the geographical regions investigated with more asymmetry observed in the male compared with the female.

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Skeleton models are important in facilitating a student’s easy retention and recollection of information in the future. These may assist students carry out hands-on practice in order to acquire and practice new skills that are relevant to first aid. The increasing number of medical institutions and medical students attracts the challenge of inadequate facilitation of the teaching and learning processes. This warrants a study and/or an exploration of an alternative solution such as wooden models in order to solve the problem of scarce and ethically restricted human teaching aids. Wooden pieces (50 cm length×20 cm diameter) from a Jacaranda mimosifolia tree were prepared for the carving process, and wooden replicas of human skulls were made. Two experimental groups of randomly selected medical students (60: active and 60: control) were separately taught using wooden and natural skull models, respectively. The two groups were assessed and evaluated using the natural skull models to compare their understanding of the anatomy of the skull. Additionally, opinion statements were collected from participants in the active group during the oral examination. Six (6) wooden skull models were produced and used for experimental study. Comparisons of academic scores (mean and median) between active (students using the wooden skull) and control (students using natural skull) groups showed no statistically significant difference (P≥0.05). Concerning the enhancement of learning skills, the wooden model was constructed in a way that would be able to enhance learning as it would be the natural skull. The wooden skull model, with more improvement in structural formation, can adequately facilitate the teaching and learning of anatomy of the human skull. This project and the experimental study about utilization of the wooden skull model provide a good potential of using the wooden models to supplement the use of the natural human skull.