Perceptions of resources available for postgraduate family medicine training at a South African university

Abstract

Background: Clinical training is one of the roles of family physicians (FPs) in decentralised postgraduate training. Effective training requires skilled trainers and sufficient resources. Little is known about the resources available for decentralised clinical training in district health systems in low- to middle-income countries, especially in sub-Saharan Africa.Aim: To explore FPs’ and registrars’ perceptions of the available resources in a decentralised postgraduate family medicine (FM) training programme.Setting: Five decentralised training sites affiliated with the University of the Witwatersrand across two provinces in South Africa.Methods: This qualitative study forms part of a broader project evaluating a FM registrar training programme using the logic model. Semistructured interviews were conducted with a purposive sample of 11 FPs and 11 registrars. The interviews were transcribed verbatim and analysed thematically.Results: Three themes were identified: ‘Impact of resource constraints’, ‘Family physicians’ skills and knowledge could be further improved’ and ‘Family physicians need additional support to optimise their training role’. The additional resources needed include more FPs, equipment, infrastructure and funding. Knowledge and skills of FPs were reported variable and needed further improvement. Additional support was required from peers, the district management and the university.Conclusion: Well-resourced decentralised training environments with sufficient skilled trainers and adequate resources are needed to positively influence FP training and supervision, especially in middle-income countries like South Africa.Contribution: Clinical trainers need adequate resources and support from peers, district management and the university for effective decentralised clinical training.

Postgraduate medical trainees at a Ugandan university perceive their clinical learning environment positively but differentially despite challenging circumstances: a cross-sectional study

“…Perceptions regarding availability of resources for training were similar to that in a recent study from South Africa in which family medicine registrars (residents) reported shortages of resources such as training tools (e.g. ECG), Internet availability, and training space [34]. In both studies, residents observed that essential equipment were unavailable and hindered their training because they perceived that they could not develop mastery of skills needed in working with the lacking equipment.…”

“We just don't have the resources”: Supervisor perspectives on introducing workplace-based assessments into medical specialist training in South Africa, a qualitative study

“…WBA needs engaged stakeholders, and its implementation is deeply in uenced by the context in which it is practised, being grounded in the social realities of the workplace context (18,19). A core premise that informs this practice is the quality of the feedback provided by supervisors to registrars in the clinical spaces, which implicates the institutional culture and relationship between supervisors and registrars as key factors that in uence the assessment outcomes (20,21). Student engagement in the process of WBA is also integral to its success, and attention should be paid to the social nature of learning (22).…”