Training of workplace-based clinical trainers in family medicine, South Africa: Before-and-after evaluation

Abstract

BackgroundThe training of family physicians is a relatively new phenomenon in the district health services of South Africa. There are concerns about the quality of clinical training and the low pass rate in the national examination.AimTo assess the effect of a five-day course to train clinical trainers in family medicine on the participants’ subsequent capability in the workplace.SettingFamily physician clinical trainers from training programmes mainly in South Africa, but also from Ghana, Uganda, Kenya, Malawi and Botswana.MethodsA before-and-after study using self-reported change at 6 weeks (N = 18) and a 360-degree evaluation of clinical trainers by trainees after 3 months (N = 33). Quantitative data were analysed using the Statistical Package for Social Sciences, and qualitative data were analysed thematically.ResultsSignificant change (p < 0.05) was found at 6 weeks in terms of ensuring safe and effective patient care through training, establishing and maintaining an environment for learning, teaching and facilitating learning, enhancing learning through assessment, and supporting and monitoring educational progress. Family physicians reported that they were better at giving feedback, more aware of different learning styles, more facilitative and less authoritarian in their educational approach, more reflective and critical of their educational capabilities and more aware of principles in assessment. Despite this, the trainees did not report any noticeable change in the trainers’ capability after 3 months.ConclusionThe results support a short-term improvement in the capability of clinical trainers following the course. This change needs to be supported by ongoing formative assessment and supportive visits, which are reported on elsewhere.

The International Literature on Teaching Faculty Development in English-Language Journals: A Scoping Review and Recommendations for Core Topics

“…Five articles (1 intervention 148 and 4 other publications 152,158,162,166 ) described the efforts of the European Academy of Teachers in General Practice (EURACT) to advance education in family medicine and general practice, and 2 described the outreach work by the Canadian Besrour Centre for Global Family Medicine. 151,163 Three articles (2 interventions 43,48 and 1 program description 54 ) resulted from the work of the US-funded Medical Education Partnership Initiative to enhance medical education capacity in Sub-Saharan African nations. 169 TABLE 1 shows the distribution of intervention studies by type and sample size over the entire study period.…”

“…Within the PGME FD literature, the EURACT family medicine courses have been taught for 2 decades 151 and have grown to focus at 3 levels (novice teacher, intermediate, and advanced course for proficient teachers). 148 Other interventions focused on general, 23 psychiatry consult, 27 and change management skills 29 for UK general practice physicians; training general practice teachers in Germany; 65 the experience of Japanese 129 and South American family physicians 150 attending FD in the United States; ''train the trainer'' courses for family medicine faculty from Sub-Saharan African nations; 43,44 and communication skills training for PGME teachers in Qatar. 141 Several publications explored the utility of transporting established US FD courses like the Stanford Faculty Development Program to international settings.…”

Optimising the learning environment for undergraduate students in the Department of Family Medicine at Sefako Makgatho Health Sciences University

“…It is worth noting that durable knowledge is one of the primary goals of medical education. 35 The highest individual scores in this section indicate that teaching helps to develop the students' competence (3.38) and confidence (3.26), which are important traits needed for their future professional career. Students also believed that they were encouraged to participate in class (3.36), which is an indication of an open and interactive learning atmosphere.…”

The state of family medicine training programmes within the Primary Care and Family Medicine Education network

“…Another strength is the Training of Clinical Trainers faculty development initiative offered in partnership with the RCGP. 18 , 19 Specialists from other disciplines also attended the training, which gave them better insight into family medicine training. There is a need to train more clinical trainers and to support ongoing formative assessment visits to improve the learning environments.…”