Masters Degrees (Office of the Dean: Health Sciences)
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Browsing Masters Degrees (Office of the Dean: Health Sciences) by Advisor "Labuschagne, M. J."
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Item Open Access The experiences and attitudes of students and lectures regarding peer physical examination in the Faculty of Health Sciences at the University of the Free State(University of the Free State, 2017-01) Hattingh, Maryna Getruida Maria; Labuschagne, M. J.English: Health professions students use peer physical examinations (PPE) for the purpose of training globally, but in many institutions no formal policy or guidelines exists. There are many benefits of the use of PPE e.g. students are readily available to practise on, students need not to be financially compensated and it has proven to increase students’ clinical skills and confidence, but some students may not want to participate in PPE for various reasons like religion, culture etc. Peer physical examination is the physical examination of a student by a fellow student to enhance his/her clinical skills. This is done under the supervision of a professional person or lecturer. Currently no policy or guidelines regarding peer physical examination exists in the Faculty of Health Sciences (FoHS) at the University of the Free State (UFS) and it is required from the students to participate in peer physical examination during their studies. An in-depth study was conducted to establish the attitudes and experiences of students and lecturers regarding the use of PPE in the FoHS using focus group interviews with students and lecturers. The content of a PPE policy for the FoHS at the UFS was explored with the second question of the focus group interviews. The study was done in the field of Health Professions Educations in the domain of management and leadership and wanted to provide a guideline that may be used to direct students and lecturers when participating in PPE and to explore what is needed to be included in the content of a PPE policy. A qualitative research design was followed with three focus group interviews as data collection method and the compilation of an extensive literature review on the topic. One focus group was with lecturers of all three schools in the FoHS of the UFS who participate in teaching students’ clinical skills and surface anatomy and the other two with students from all three Schools in the FoHS, UFS. Data were transcribed verbatim by the researcher and themes, categories and subcategories identified. Five themes were identified from the collected data. The identified themes, categories and subcategories were compared and discussed with the findings and recommendations of an extensive literature review in mind. The literature review provided a contextual and conceptual understanding of PPE and the benefits and pitfalls associated with the use of it. Perspectives on the use of PPE in different professions were discussed as well as the advantages and disadvantages of the introduction of a policy on PPE at various universities globally. The identified themes were: • Value of PPE • Ethical considerations when using PPE • Student safety • Student concerns • Miscellaneous. The majority of participants agreed that the use of PPE is beneficial to students. The participants agreed participation in PPE increase competence levels in clinical skills, improve confidence and communication skills and assist them to act professionally. Some participants were concerned about educator supervision when practising on peers and some felt that flipping the classroom will benefit students and lecturers as less time will be spent on lecturing and more on the actual practising of the various clinical skills. This study provided recommendations on the content of a PPE policy for the use of PPE from the perspective of health profession students and lecturers from the FoHS at the UFS. The results may be used as guidelines to formulate a PPE policy for the FoHS at the UFS.Item Open Access Integrated clinical simulation assessment criteria for emergency care education programmes in South Africa(University of the Free State, 2015-07) Campbell, Roderick Grant; Labuschagne, M. J.; Bezuidenhout, J.English: An in-depth study was done into integrated clinical simulation with a view to identifying assessment criteria and case types in order to employ integrated clinical simulation as an instrument for summative assessment of learners by ALS emergency-care-education programmes in South Africa. Clinical simulation is mandated by the Health Professions Council of South Africa, Professional Board for Emergency Care (HPCSA: PBEC), for use by emergency-care-education programmes as a summative assessment instrument. The Higher Education Quality Committee (HEQC) calls for integrated assessment as a suitable test of applied competence reflecting the key purpose of a qualification. The South African Qualifications Authority (SAQA), using the outcomes-based education and training paradigm, provides a clear definition of “assessment criteria” and “integrated assessment” for employment when assessment of applied competence occurs (SAQA 2001:11, 21). These definitions were used to frame and focus the study. This study sought to bridge the gap created by the absence of guidelines by PBEC for assessment criteria and case types or scenarios for use with integrated clinical simulation summative assessment. In this study the elements of assessment criteria, as defined by SAQA, relevant to integrated clinical simulation were explored. In tandem with assessment criteria, case types or scenarios appropriate to integrated clinical simulation were extrapolated. This study is situated in the field of Health Professions Education and focused on the profession of Emergency Medical Care. The research methods comprised analysis of documents that contextualise the mandate and use of clinical simulation for assessment by emergency-care-education programmes in South Africa. A review of scholarship provided a conceptual framework for understanding healthcare simulation as an educational methodology and valid assessment instrument for assessing applied competence in an authentic situation. A conceptual understanding of the prerequisites for using healthcare simulation that ensures an authentic situation for meaningful student engagement was discoursed. Perspectives from literature that address assessment criteria and case types relevant to ALS paramedic practice were discovered. An embedded, single-case study design was employed and focus-group interviews were used as the method of data collection for the empirical phase of the study. Data from focus-group interviews with experienced ALS paramedics was analysed and interpreted in conjunction with scholarly viewpoints and experience of the researcher to examine integrated clinical simulation as a summative assessment instrument, which was the main unit of analysis, and the subunits, namely, assessment criteria and case types. From the analysis of focus-group discussions, seven themes informing the research questions were deliberated. The first theme addressed the integrated clinical simulation as an assessment instrument. The second theme spoke to the context and conditions of ALS paramedic practice that are relevant to the integrated clinical simulation. Theme three through to theme six tackled the knowledge framework together with the physical, cognitive, affective and the social-professional dimensions of ALS paramedic practice that are relevant to the integrated clinical simulation. Finally, theme seven engaged case types and scenarios for integrated clinical simulation as a summative assessment instrument. The lack of fidelity of the integrated clinical simulation perceived by focus-group participants, together with its historical use as a summative assessment instrument challenges the application of integrated clinical simulation as an authentic assessment. Using a single, once-off integrated clinical simulation to assess competence in ALS paramedic practice is contested by the range of life-threatening emergencies possible across medical disciplines. In order for the integrated clinical simulation to assess competence it must cover the range of medical disciplines, incorporate the dimensions of ALS paramedic practice, reflect the conditions, complexity and range of life-threatening emergencies presented to ALS paramedics in South Africa and elicit the appropriate response modes required in practice. Although no specific case types were identified for use in the integrated clinical simulation, characteristics of case types were identified and they provide a matrix for case-type selection. These characteristics refer to the categories of medical and trauma conditions, with a focus on life-threatening emergencies across the range of medical disciplines. The action-response mode of the ALS paramedic and life-support interventions required are determined by the nature of the presenting life-threatening emergency within the scope of practice prescribed by the PBEC. The context and conditions of ALS paramedic practice must also be represented if true competence is to be assessed. This study informs a conceptual framework of healthcare simulation for use by emergency-care-education programmes in South Africa. The study serves to frame the breadth, depth and scope of assessment criteria applicable to integrated clinical simulation for use as a summative assessment instrument. Finally, this study provides a conceptual matrix for case type and case design for clinical simulation in emergency care.Item Open Access The opinions on and use of simulation in undergraduate pharmacy education at South African universities(University of the Free State, 2016-01) Naudé, Adele; Labuschagne, M. J.English: An in-depth study was done to obtain greater insight into the current use of simulation, and the opinions of lecturers regarding simulation, in undergraduate pharmacy education at South African Universities registered with the South African Pharmacy Council as training institutions. The South African Pharmacy Council recently published Good Education Practice Standards (GPES) guidelines to ensure quality pharmacy education across South Africa. Simulation experiences are specifically addressed in these guidelines including facilities for practice simulations, “in order to provide students with practical and simulated pharmaceutical care experiences”. The delivery of competent, eight-star, practice-ready pharmacists to fulfil the needs of the community are paramount. The research methods consisted of a literature review and an online questionnaire survey sent to lecturers involved in undergraduate pharmacy education. The literature review provided the background for a conceptual framework, as well as information to develop the questionnaire survey. The study originated from the lack of information regarding the use of simulation in undergraduate pharmacy education in South Africa. To bridge the information gap, the researcher used the results from the questionnaire survey as the foundation for the compilation of recommendations for possible incorporation of simulation to enrich undergraduate pharmacy education at pharmacy schools. Through the assessment of the current use of simulation, including the opinions of lecturers regarding simulation as well as possible advantage and disadvantages thereof, the results of the study provided a valuable contribution to knowledge. The reliability and validity of the study were ensured through sound research approach and methodology. The research can form the foundation for further research projects.Item Open Access Preparation of nursing students for operating room exposure(University of the Free State, 2017-01) Breedt, Shimone Chantel; Labuschagne, M. J.English: The South African Nursing Council (SANC) requires that all nursing students rotate and work in the operating room. Most of these students have never been inside an operating room and feel unsure of what is expected of them due to the fact that they are not proficient in most of the skills that will assist them in their participation within this set-up. These students are unable to participate and learn on their first rotation in the operating room, leaving the students often feeling in the way and with a negativity regarding operation room nursing. Implemented preparation programmes in the United States of America and the United Kingdom, has proven that improved preparation programmes are successful. A study was conducted to establish what should be in such a preparation programme, as well as what teaching strategies would be most beneficial. The study was done in the field of Health Professions Education and lies in the domain of academic programme development, as the view was to improve the student nurse’s preparation for OR rotation. The study was interdisciplinary, as it reaches across Health Professions Education and Nursing. For this study, a descriptive qualitative inquiry was used by means of two nominal group sessions for data collection and the assimilation of a literature review on the topic. One nominal group was undertaken with third-year nursing students that had just completed their placement in the operating room and the other group comprised of personnel working in the operating room where the students were placed. The data were written verbatim on a flip board and categories were identified by the researcher. These categories were compared and discussed with regard to the findings and the recommendations of the literature review in mind. The categories identified were: Documentation Swab and instrument control Maintaining of sterility Equipment Orientation Theatre preparation. Preferred teaching strategies that were identified: Formal lecture with written test Practical group sessions Pre-placements preparation Simulation and demonstration Visual learning. All of the participants agreed that the current preparation/orientation programme do not adequately prepare the students for optimal participation or learning during their placement and that a programme that ensured that the students are able to perform certain tasks from the first day of placement would be equally beneficial for personnel and students. This could improve learning of the students while improving their overall experience of the operating room. This study provides recommendations on the content for a preparation programme and the results may be used to develop an improved preparation programme.Item Open Access Simulation as educational strategy: an interprofessional approach at the Faculty of Health Sciences, University of the Free State(University of the Free State, 2016-01) Van Wyk, Riaan; Labuschagne, M. J.; Joubert, G.English: With an ever-evolving and complex patient population, healthcare professionals need to adapt to these changes. A response to this challenge is to deliver patient care and management as an interprofessional healthcare team or collaborative practice. In order to deliver professionals that are ready for collaborative practice, education institutions need to enhance interprofessional education (IPE) amongst its students. Various strategies can be followed for effective IPE. These are didactic lessons, simulated experiences and community based education. The question arises as to the extent and techniques currently used by the Faculty of Health Sciences, UFS, to achieve IPE amongst its undergraduate students. Specific focus was given to addressing IPE utilising simulation. A quantitative descriptive study was performed and data was collected using structured interviews with 47 of 57 (82.5%) undergraduate module leaders of the Faculty of Health Sciences, UFS, covering 66 of 80 (82.5%) undergraduate modules. The research topics covered by the interview were interprofessional education, the use of and opinions on simulation and the possibility of utilising simulation to address IPE. The results were analysed and reported quantitatively. It was found that 36 out of 66 modules (56.1%) had no form of interprofessional education. In cases where interprofessional education was present, it was mostly addressed coincidentally (58.7%) and was not part of the formal outcomes of the module. The main platform utilised for interprofessional education is ward rounds in hospital and clinic visits during community based education. Simulation is used by 36 out of 66 (54.5%) modules and the most common type utilised is low-fidelity skills training. The module leaders’ opinions on simulation are positive, highlighting the advantages it holds for improved student learning. Some concerns were raised on the logistical challenges simulation could pose. The majority of module leaders (66.7%) indicated that simulation would not be a viable training tool to address interprofessional education in their module. The most common (84.1%) reason given was that there were no interprofessional activities in the relevant module to address. However, 21.7% did not see any disadvantages of its potential use to address interprofessional education where needed. Some challenges were highlighted and the biggest potential advantage mentioned (41.3%) was improved role clarification amongst the students. The conclusion was that although IPE does take place, it is mostly coincidental and not formalised in the modules. The majority of module leaders were positive about the possible use of simulation to address IPE, but various challenges and concerns were also reported and discussed. When using simulation to address interprofessional education, it is important to engage the students from all professions. In most cases the scenarios would be role-play using standardised (simulated) patients. These actors must be properly trained to ensure the authenticity of the scenario. The principles of interprofessional education (aspects such as collaboration, communication and professionalism) should be addressed in the outcomes and must be the focus during the debriefing phase of the simulation experience. Facilitators must be trained and competent in debriefing and reflection techniques.Item Open Access A student review of doctor-patient communication skills training in the UFS undergraduate medical programme(University of the Free State, 2020-01) Swinfen, Dirkie; Labuschagne, M. J.; Joubert, G.