The Delphi technique is a method of collecting opinion on a particular research question. It is based on the premise that pooled intelligence enhances individual judgement and captures the collective opinion of a group of experts without being physically assembled. The conventional Delphi uses a series of questionnaires to generate expert opinion in an anonymous fashion and takes place over a series of rounds. The technique is becoming a popular strategy that straddles both quantitative and qualitative realms. Issues that are critical to its validity are the development of the questionnaire; definition of consensus and how to interpret non-consensus; criteria for and selection of the expert panel; sample size; and data analysis. The authors used the Delphi technique to assist with making recommendations regarding education and training for medical practitioners working in district hospitals in South Africa. The objective of this Delphi was to obtain consensus opinion on content and methods relating to the maintenance of competence of these doctors. They believe the experience gained from their work may be useful for other health science education researchers wishing to use the Delphi method.

Rural clinical learning spaces influence the 'being and becoming' of a junior doctor. Understanding this process in the context of place (rural platform), participation (community of practice) and person can inform expanded agendas for students' clinical learning.

IntroductionHealth professions training institutions are challenged to produce greater numbers of graduates who are more relevantly trained to provide quality healthcare. Decentralised training offers opportunities to address these quantity, quality and relevance factors. We wanted to draw together existing expertise in decentralised training for the benefit of all health professionals to develop a model for decentralised training for health professions students.MethodAn expert panel workshop was held in October 2015 initiating a process to develop a model for decentralised training in South Africa. Presentations on the status quo in decentralised training at all nine medical schools in South Africa were made and 33 delegates engaged in discussing potential models for decentralised training.ResultsFive factors were found to be crucial for the success of decentralised training, namely the availability of information and communication technology, longitudinal continuous rotations, a focus on primary care, the alignment of medical schools’ mission with decentralised training and responsiveness to student needs.ConclusionThe workshop concluded that training institutions should continue to work together towards formulating decentralised training models and that the involvement of all health professions should be ensured. A tripartite approach between the universities, the Department of Health and the relevant local communities is important in decentralised training. Lastly, curricula should place more emphasis on how students learn rather than how they are taught.

Africa's health care challenges include a high burden of disease, low life expectancy, health workforce shortages, and varying degrees of commitment to primary health care on the part of policy makers and government officials. One overarching goal of the Medical Education Partnership Initiative (MEPI) is to develop models of medical education in Sub-Saharan Africa. To do this, MEPI has created a network of universities and other institutions that, among other things, recognizes the importance of supporting training programs in family medicine. This article provides a framework for assessing the stage of the development of family medicine training in Africa, including the challenges that were encountered and how educational organizations can help to address them. A modified "stages of change" model (precontemplation, contemplation, action, maintenance, and relapse) was used as a conceptual framework to understand the various phases that countries go through in developing family medicine in the public sector and to determine the type of assistance that is useful at each phase.

Background:The Ebola virus epidemic and civil war in Liberia left the country in need of strengthening the health workforce. E-learning in medical education provides relevant learning opportunities for students, develops faculty competencies, and assists with the retention of healthcare workers. The Stellenbosch University Rural Medical Education Partnership Initiative (SURMEPI), the College of Health and Life Sciences (COHLS) at the University of Liberia (UL), and the Health Resources and Services Administration (HRSA) formed a partnership to create an e-learning solution for the COHLS.Objective:This article outlines the implementation of an e-learning solution for the COHLS in Monrovia, and describes the challenges met, the key successes achieved, and the lessons learnt.Methods:An initial scoping visit to Liberia was followed by three further on-site visits. Problems identified were: very limited or no network and computer resources, no internet connection, intermittent power, and lack of IT skills. We followed an evolutionary approach to infrastructure implementation by trying various solutions before settling on an offsite-hosted solution using Software as a Service (SaaS). Local staff were upskilled to administer this while remote support from Stellenbosch IT was provided. A stable internet connection was established. Staff and students can access the Learning Management System (LMS) 24/7 using mobile devices and laptops. Workshops were held where staff were taught how to produce online teaching material. Each class has at least one teaching assistant to assist lecturers with uploading and indexing material on the LMS.A benchmarking visit by COHLS faculty to Stellenbosch University took place, during which an e-learning strategic plan was drawn up. Further online workshops were conducted, and teaching materials were placed on the new LMS.Outcomes:The intranet that was established consisted of internet connection and software as a service in the form of Office 365, providing access to several products and services. The e-learning model attended to technology and human resources simultaneously. The e-learning strategy aimed to improve teaching and learning at the COHLS, boost the number of qualified doctors, reduce the workload on lecturers, and be scalable in the future.Conclusion:It is challenging to implement e-learning in medical education. Inadequate infrastructure, limited bandwidth, lack of skilled IT staff, unreliable power supply, time commitment, and ongoing maintenance all need to be overcome. The creation of an e-learning solution for the COHLS over a period of 15 months was enabled by the common vision and close collaboration of the three partners. This model can potentially be replicated across other faculties in the University of Liberia and other educational institutions in Liberia.