Videos are increasingly being used for teaching clinical skills in medical education. However, most reports on the effectiveness and benefits of videos in medical teaching have come from developed countries. Resource constraints in South African academic hospitals, together with increasing numbers, may apply pressure on the standard of clinical teaching. This study investigated the potential for using video demonstrations to replace the bedside teaching of introductory paediatric clinical examination skills to large groups of medical students. Sixty medical students were randomised to an experimental group that watched a video of a paediatric abdominal examination or to a control group that received a bedside tutorial on the same topic. Immediately afterwards, experienced assessors observed and scored the students in a clinical examination. Data were analysed for the non-inferiority of the video group scores within a 10% margin of the bedside group. Students’ and clinician educators’ perceptions of the two teaching methods and their views on how video instruction could be integrated into the clinical teaching programme were explored. Qualitative data were analysed thematically. The video teaching was non-inferior to the bedside teaching within the 10% margin and did not significantly affect the pass/fail or distinction rates. Students and clinician educators suggested that the videos be used for teaching basic concepts, allowing bedside tutorials to focus on applied learning. The findings have important implications for using video demonstrations to supplement the teaching of clinical skills to large groups of medical students across multiple variably-resourced settings.

the World Health Organization reported the emergence of an outbreak of pneumonia cases in Wuhan, China. The disease was later termed coronavirus disease 2019 and the causative agent was identified as a novel coronavirus, SARS-CoV-2. [1] The first case of COVID-19 in South Africa (SA) was announced on 5 March 2020, and a cumulative total of ~1.5 million confirmed cases and 50 000 deaths had been recorded by 7 March 2021. [2,3] The COVID-19 vaccination roll-out for healthcare workers (phase 1) was planned for February 2021 using the Oxford AstraZeneca vaccine. [4,5] However, concerns arose about the efficacy of COVID-19 vaccine candidates in the context of dominance of the B.1.351 variant, as it contained mutations at the receptor-binding domain of the virus, the target site of many vaccines. [6,7] Further data analysis revealed that a two-dose regimen of the AstraZeneca ChAdOx1 nCoV-19 vaccine had an efficacy of 10.4% against mild to moderate COVID-19 caused by the B.1.351 variant. [8] In contrast, interim analysis of the single-dose Johnson & Johnson/Janssen Ad26.COV2.S vaccine (J&J) demonstrated 57% protection against the B.1.351 lineage of SARS-CoV-2 and complete protection against COVID-19 hospitalisation and death. [9] These findings led to a public announcement on 7 February 2021 that healthcare workers would be vaccinated through an implementation study using the J&J vaccine, under the name Sisonke Early Access Vaccine Rollout for Healthcare Workers. [10,11] A core vaccine team was formed at Chris Hani Baragwanath Academic Hospital (CHBAH) on 13 January 2021. CHBAH is the largest hospital in the southern hemisphere and the third-largest in the world, with a bed capacity of 3 200 beds and a staff complement of ~7 400. [12] The facility is located in Soweto, a peri-urban town 27 km south-west of Johannesburg in the most populous province of the country, Gauteng. [12] The hospital serves a population of >1.3 million people, and offers a full range of generalised specialist and subspecialist services. [12] The vaccine team planned for a 'mass vaccination' roll-out of staff on the launch date, 17 February 2021. Mass vaccination strategies are considered to be most useful in pandemic situations, as they allow for the fast and efficient vaccination of a large number of susceptible people, using a central vaccination site. [13] The benefits of mass vaccination of healthcare worker programmes over ward-toward-based vaccination programmes are: (i) a streamlined process for pharmacy vaccine delivery, preparation and secure storage, while also ensuring that the cold chain is maintained; (ii) easy access to an emergency care team that remains in the vaccination site in the event of adverse events following immunisation (AEFIs); and (iii) a centrally controlled data capture system. Disadvantages include the need for a large number of staff to support the mass vaccination process itself, requiring precision and careful planning. [14,15] There is a paucity of peer-reviewed literature on the implementation of mass vaccinat...

No abstract

No abstract

Neonatal AKI (NAKI) remains a challenge in low- and middle-income countries (LMICs). In this perspective, we address issues of diagnosis and risk factors particular to less well-resourced regions. The conservative management pre-kidney replacement therapy (pre-KRT) is prioritized and challenges of KRT are described with improvised dialysis techniques also included. Special emphasis is placed on ethical and palliation principles.