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Browsing Office of the Dean: Health Sciences by Author "Bezuidenhout, J."
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Item Open Access An appreciative self-management coaching programme to facilitate the wellness of somatology therapists(University of the Free State, 2015-06) Henrico, Karien; Maritz, J.; Bezuidenhout, J.English: In this research project, an in-depth study was conducted by the researcher with a view to design and develop an Appreciative Self-Management Coaching (ASMC) programme to facilitate the wellness of somatology therapists. The work of many health disciplines, such as the somatology therapist, is mentally, physically and emotionally demanding. Working with clients on a daily basis has been found to cause distress to the professional within this emotionally labour-intensive context. In recent years, the prevalence of wellness and the need to look after the wellness needs of the health professional have become important. The significance and benefits of wellness initiatives to the individual and the employer has been well-documented in the academic literature. The literature, however, fails to provide the somatologist with a cost effective and time efficient wellness programme, tailor made for the somatology clinic context, which is as unique and flexible as the individual him/herself. In light of the above challenges, the following research question arose: What should an appreciative self-management coaching programme consist of to facilitate the wellness of somatology therapists? A qualitative, design-based research design was followed, including Appreciative Inquiry as the underpinning philosophy. The research took place in three phases. In Phase 1 – Preliminary phase – a needs-and-context analysis was done. This phase was informed by (1) a previous study on the self-management needs of somatology therapists (Richter 2010), conducted by the researcher in collaboration with practitioners in the field of somatology; (2) a literature review on wellness, self-management, self-coaching and appreciative coaching in order to probe the contemporary trends in modern somatology and elsewhere; and (3) Appreciative Inquiry based, in-depth, semi-structured interviews using the GROW model of coaching with practitioners in the field of somatology. Phase 2 – Prototyping phase – extended on the above research. An iterative design was used, consisting of two micro-cycles of research concerned with formative evaluation. Through collaboration with practitioners and experts in the somatology, education and coaching field, using focus group discussions, the researcher improved and refined the proposed ASMC programme. Phase 3 – Evaluation and Reflection phase. Through semi-formative and focused discussion, the perceived soundness and feasibility of the ASMC was tested, using a two-fold Alpha test. (1) The first part of the alpha test was conducted during the focus group discussion in Phase 2, and (2) a document analysis was conducted by expert appraisal (using an expert in the field of coaching, education and health). Finally the researcher conducted both organic and structured reflection to further both the theoretical and practical goals of this study. Bracketing was used to meet the methodological, ethical and emotional challenges that arose. This study presents an ASMC programme that is holistic, unique, flexible and effective. The researcher believes that the ASMC did more than just bridge the gap identified for the somatology therapist. Wellness is important to all professional groups, and the ASMC is believed to be a novel first step in addressing the maldistribution of wellness related practices for the somatologist and Higher Educational Institutions due to its flexible and adaptive nature.Item Open Access Assessment of current student selection criteria as performance predictors for academic success in entry level radiography education at the Central University of Technology(University of the Free State, 2014-06) Kridiotis, Carol-Anne; Bezuidenhout, J.The numbers of students enrolled in the Radiography programme at the Central University of Technology (CUT) are increasing each year, and selectors are therefore faced with critical admission decisions when selecting prospective students for a programme with limited spaces. This research study was undertaken to assess current student selection criteria in Radiography education, by retrospectively analysing the degree to which these criteria predicted actual academic performance over a three-year period amongst entry-level students enrolled in a three-year National Diploma in Radiography. The rationale behind the interest in student selection in Radiography education was the fact that the South African Qualification Authority (SAQA) has approved and registered a professional Bachelor’s degree in Radiography (480 credits), with a new curriculum and altered exit-level outcomes, including research skills. The transition from a diploma-level to a degree-level qualification in Radiography in South Africa indicated that a review and an assessment of current diploma-level student selection criteria could provide a benchmark for selecting students for degree-level education. An extensive literature study and document analysis provided background information and perspectives related to student admission criteria and selection tests in the health sciences, both nationally and internationally. The research design and methodology included a retrospective quantitative study and document analysis. In the research process, data were collected for each student, including biographical data, prior tertiary education, matriculation or National Senior Certificate (NSC) subject marks and a total Admission Points Score (APS) as calculated from each matriculation certificate. The CUT selection test results for each student were also documented, and included a General Scholastic Aptitude Test (GSAT) score, an English Proficiency Test score and a Self-Directed Search Questionnaire score. By using the above selection scores, a total CUT Rating Score was calculated, and a statistical correlation procedure compared all of the above variables with the marks of all entry-level Radiography modules, for each first-year student in the study group. A further correlation procedure compared selection criteria with whether the student had achieved the first year exit-level outcomes, or whether they had not achieved these exit-level outcomes. The main findings of the statistical analysis indicated that certain selection criteria are valid and can be used as academic performance predictors. This retrospective research study presents data which shows success rates for entry-level Radiography students in diploma-level Radiography education at the CUT over a three-year period were at a level of 71.53%. Recommendations for the future degree-level student selection process were made, which included increasing NSC achievement level admission requirements, using the current tests of merit and implementing methods to help students make valid and informed decisions about their career choice. The goal of optimising the student selection process would evolve over a number of years, and degree-level Radiography education has already been implemented at certain institutions since January 2014. The aim of this study was fulfilled by assessing current selection criteria as performance predictors for academic success.Item Open Access Best practices for quality assessment in the clinical phase of undergraduate medical training(University of the Free State, 2020-08) Brits, Hanneke; Bezuidenhout, J.; Van der Merwe, L. J.Medical universities have a responsibility to ensure quality assessment of clinical competence when they certify that they produce competent medical practitioners who can integrate knowledge, skills and attitudes. The assessment of clinical competence is complex, and can be characterised by tension between validity, reliability and fairness, due to the assessment on the “does” level. The defined problem that was addressed is that assessment in the clinical phase of the undergraduate medical programme (MBChB) at the University of the Free State has not been reviewed critically or benchmarked against local and international standards. This thesis intended to benchmark clinical assessment practices against an assessment framework and then propose an action plan on how to bridge the gap between theory and practice when assessing clinical competence. A pragmatic approach was followed to address the practical problems of uncertainty regarding the quality of assessment. From a theoretical perspective, an abductive approach was used to achieve inference. An explanatory sequential mixed method research design was used. During triangulation, alignment of and gaps between theory and practice were identified and solutions recommended. A proposal with an action plan was drafted to enhance the quality of clinical assessment in the undergraduate medical programme. Firstly, an assessment framework to benchmark clinical assessment in undergraduate medical training was compiled. A rapid literature review of local, national and international official regulations and policies, supported by best evidence practices, were used to compile this assessment framework. In this framework, the three components of quality assessment, namely, accreditation, assessment and quality assurance, were addressed. In the second part of the study, current assessment practices were reviewed through data collected from three sources, namely, students, lecturers and student marks, to ensure that different aspects were included in the review. A questionnaire with open and closed-ended questions was completed by clinical students in the undergraduate medical programme, to get the students’ perspectives on assessment. More than half the students were of the opinion that current assessments were not fair, and >90% complained about the lack of formal feedback after assessments. Secondly, the teaching and learning coordinators and module leaders of all the clinical departments involved in undergraduate medical training completed questionnaires on the assessment methods used in their departments. They also made recommendations for ways to improve current assessment practices. Using multiple choice questions and objective structured clinical evaluations were standard practice in most disciplines. Workplace-based assessment (WBA) was not well established and was only used in 30.1% of disciplines. The overemphasis on summative assessment was identified as an area for improvement. Thirdly, current assessment practices were evaluated for reliability. The decision reliability between end-of-block assessment and summative assessment was excellent, with a G-index of agreement of between 0.86 and 0.98. Using unobserved long cases during summative assessment was shown to be unreliable and questionable. During a formal focus group interview, answers were sought on how to bridge the gap between theoretical principles of quality assessment and current assessment practices. Finally, the researcher compiled a proposal with an action plan on how to enhance quality assessment in the clinical phase of the undergraduate medical programme. Most of the practices that compromise the quality of assessment can be addressed on an operational level, and will not be costly to implement. This includes training of assessors, implementation of WBA, effective feedback to students and blueprinting and moderating all assessments. Assessor training will improve the quality of assessments, and will also contribute to the professional development of assessors. Continuous WBA will have the ultimate effect of improving validity and reliability, which will benefit all stakeholders.Item Open Access Community-based electrocardiography teaching and learning in semesters four and five of the UFS M.B.Ch.B. programme(University of the Free State, 2014-01-31) Larson, Carol Olivia; Bezuidenhout, J.; Van der Merwe, L. J.English: The current global emphasis on appropriate standards for medical education and greater civic engagement by higher educational institutions, and the value of electrocardiography as diagnostic aid stimulated the researcher to perform this study. Globally electrocardiography is an essential exit-level core competency of undergraduate medical programmes. Although an outcome-based curriculum was introduced by the UFS School of Medicine in 2000, certain aspects of competencybased education (such as the registration and interpretation of an electrocardiogram) can be adapted and included in outcome-based curricula. Prior to the commencement of this study, a preliminary literature review revealed that little research had been performed with regard to the use of electrocardiography as a learning task in community settings in the preclinical phase of medical curricula. The overall goal of the study was to facilitate the transition between electrocardiography teaching and learning in the preclinical and clinical phases of the UFS medical curriculum. The problem that initiated the research was that more information was required regarding the practicability of implementing electrocardiography teaching and learning in community settings during semesters four and five of the UFS undergraduate M.B.,Ch.B. curriculum. To address the problem, two research questions were formulated concerning the generic, context-specific and task-specific issues that inform decisions regarding community-based electrocardiography learning during semesters four and/or five of the UFS undergraduate medical curriculum and the attitudes and opinions of a purposive sample of Faculty members regarding community-based electrocardiography learning in semesters four and/or five. To answer the research questions, two research objectives were pursued regarding the identification of the principal issues and challenges that inform decisions regarding the feasibility of introducing community-based tasks in the preclinical phase of a South African undergraduate M.B.,Ch.B. curriculum and the collection of quantitative and qualitative information from a purposive sample of personnel employed at the UFS Faculty of Health Sciences. The first part of the study consisted of a comprehensive literature review, which assisted the researcher to identify applicable key aspects for inclusion in the interview schedule used for the empirical study. The survey was performed with a view to later formulating an effective strategy to facilitate the transition between the electrocardiography learning provided in the preclinical and clinical phases of the UFS M.B.,Ch.B. curriculum and possibly incorporate four additional hours of community-based learning in phase II of the curriculum. Ninety-two (92) per cent of the persons in the sample consented to participate in the study and a pilot study was conducted, to improve the reliability, validity and trustworthiness of the study. The data collected from the interviews was analysed and a description and discussion of the research findings were documented. Based on the literature review and the responses of the interviewees, several prominent conclusions were reached. Important faculty-related and communityrelated key issues and challenges were identified, and interviewees’ favourable responses regarding CBL, task-based CBL and CB ECG learning in the UFS undergraduate medical curriculum indicated that further related research is justified. Interviewees’ responses with regard to the practicability of implementing CB ECG learning in the preclinical phase were moderately favourable and useful recommendations were made. Of significance to the planning of future research studies was that twenty-six per cent more respondents supported the implementation of CB electrocardiography learning during the clinical phase of the curriculum than was the case for the preclinical phase. These research findings can assist with decisions as to whether future (more comprehensive and potentially more costly) research projects are justified. The appropriate implementation of electrocardiography, as community-based learning task during the preclinical and/or clinical phases, can contribute to a greater degree of community engagement and an improvement in the quality of electrocardiography learning in the UFS undergraduate curriculum. This should therefore benefit all the stakeholders involved.Item Open Access Description of the outcomes and essential content for a cardiovascular perfusion practice programme(University of the Free State, 2016-01) Musa, Zainul Aabideen Ali; Bezuidenhout, J.; Smit, F. E.English: Cardiovascular perfusion is a field of practice whereby the function of the heart and lungs is replaced or supported by equipment and machines in a hospital theatre setting so that a surgical procedure to correct or reverse a cardiac-related pathology can be carried out. In addition to possessing the above mentioned skill the perfusionist is also required to carry out various other clinically related tasks. Faced with the challenges of changes taking place in the disease profile of patients, changes in surgical indications, advancement in medical technology, therapeutic and surgical techniques and the widening of the scope of practice beyond the traditional practice norms, the cardiovascular perfusion programme needs to keep up pace in order to deal with these challenges. Furthermore the three universities of technology which offer the programme in South Africa (SA) do not have uniform outcomes and content thereby producing graduates who lack many skills required for current and future practice. In view of the abovementioned challenges the research is based on the hypothesis that the current outcomes and essential content of cardiovascular perfusion programmes are either not described at all or are inadequate for producing graduates who are able, immediately after qualifying, to provide the wide range of skills required by current and future cardiovascular perfusionists. The research question was thus formulated: What should the outcomes and essential contents of a perfusion practice programme in South Africa include? The overall goal of the study was to describe the outcomes and essential content of a cardiovascular perfusion programme specific to the South African context, with a view to developing a standardised, uniform and relevant curriculum for perfusion in SA, which will lay the foundation for producing highly skilled and knowledgeable cardiovascular perfusionists who are able to fulfil the requirements of a current and future cardiovascular perfusion practice. The aim of the study was to describe the outcomes and essential content of a cardiovascular perfusion practice programme that will address the requirements of a current and future cardiovascular perfusion practice in SA. To achieve the aim of the study four objectives were pursued with regards to determining the current content and outcomes of the programmes, the adequacy and validity of the currents programmes and to determine the required outcomes and essential content of the programme. These objectives were achieved by means of a literature study that included a document analysis of SA and international curricula, an electronic questionnaire survey to obtain statements for a Delphi technique survey that followed the questionnaire survey based on the online EvaSys survey-management system. After ethics committee approval and a successful pilot study, which required no amendments, an information document explaining the survey was distributed to 14 identified perfusionists which was followed by the actual online questionnaire. The questionnaire survey was conducted at the end of which 71% of participants originally identified had responded. The data collected from the questionnaire survey was analysed, interpreted, discussed and documented. After careful analysis of the results the researchers decided that all the questions posed in the survey would form part of the Delphi. The first round of the Delphi questionnaire was distributed to 18 experts identified by preselected criteria after a successful pilot study. Of these experts, 44.4% responded. Consensus was achieved on most statements in the first round. After the completion of the first round feedback was given to the respondents. For the second round of the Delphi 100% response was achieved. The results and the discussion of the findings of the Delphi survey were presented in the form of graphs, and analysed, interpreted and discussed accordingly. Statements on which consensus was achieved were included as part of the outcomes and essential content for a cardiovascular perfusion practice programme which has been presented in a tabular format in this dissertation. A uniform and standardised cardiovascular practice curriculum and training programme will enhance the field of cardiovascular perfusion and service delivery to the residents of SA. This research study was by no means an exhaustive one but has provided a basis upon which further perfusion and other healthcare related research can be done.Item Open Access Essential surgical skills in rural hospitals: a CPD programme(University of the Free State, 2016-12) Porter, D. C.; Bezuidenhout, J.; Du Toit, R. S.English: General practitioners have to deal with a variety of conditions, challenges and diseases. Currently there is little known about surgical practice and the surgical skills required to deal with it in rural South Africa. The aim of this study was to acquire an understanding of the current surgical practice of general practitioners in rural areas and identify the essential surgical skills needed for rural South Africa. The purpose of the study was to determine the contents of a Short Learning Programme in Essential Surgical Skills in Rural South Africa. The research consisted of a relevant literature search and document analysis to ascertain the current national and international scope of rural surgery, available programmes and the essential contents and outcomes thereof. Attention was also given to curriculum design, HPCSA guidelines for CPD points, learning tools and situations to acquire surgical skills and the development of short learning programmes. The current GP surgical practice for practitioners in rural areas was evaluated through the use of a Likert-type questionnaire, this was also employed to determine the essential content and outcomes for a short learning programme. The results of the research was applied to design a Short Learning Programme for Essential Surgical Skills in Rural South Africa. It is my recommendation that this programme is rolled out in the second part of 2017 at the University of the Free State. I trust it will contribute to surgical care not only in South Africa, but internationally as well.Item Open Access An evaluation of the assessment tool used for extensive mini-dissertations in the Master's degree in Family Medicine at the School of Medicine, University of the Free State(University of the Free State, 2013-08-23) Brits, Hanneke; Bezuidenhout, J.; Steinberg, W. J.English: Family Medicine became a speciality in South Africa in 2007. Postgraduate studies in Family Medicine changed from part-time MFamMed to a full-time MMed(Fam) degree with changes in curriculum and assessment criteria. The overall goal of this study was to evaluate the current assessment tool for extensive mini-dissertations in the postgraduate programme for Family Medicine, UFS and, if necessary to produce a valid and reliable assessment tool that is user-friendly. An Action Research approach was used in this study, using mixed methods. In the first phase, the current assessment tool was evaluated and the data analysed quantitatively. In phase two, the quantitative results of phase one was discussed during a focus group interview and data were analysed qualitatively. Phase three was the production of a new, improved assessment tool. The evaluation of the new assessment tool did not form part of this study. In phase one, 11 internal and four external assessors evaluated four extensive mini-dissertations with the current assessment tool. In phase two, the internal assessors took part in a focus group interview and evaluated the current tool for validity regarding regulations of the assessment bodies as well as reasons for the differences in marks allocated to specific assessment categories (reliability). The current assessment tool complied with all the regulations of the assessment bodies. In four out of the possible 12 assessment categories the median scores allocated to specific categories varied more than 15%. During the focus group interview, reasons for this were identified and the assessment tool was adapted accordingly. A lack of training and experience in the assessment of extensive mini-dissertations was also identified as a contributing factor. The existing assessment tool currently still in use is valid, but not reliable for all assessment categories. The new assessment tool addresses these areas and will be implemented after training of assessors in 2012.Item Open Access A framework for articulation between the emergency care technician certificate and the emergency medical care professional degree(University of the Free State, 2011-11-15) Vincent-Lambert, Craig; Bezuidenhout, J.; Jansen van Vuuren, M. V.English: The need to comply with the requirements of the SAQA Act necessitated a review of emergency care education and training in South Africa. The review and restructuring led to the creation of a formal two-year, 240-credit NQF level 5 Emergency Medical Care Technician (ECT) Qualification. The NDoH views the ECT programme as the “Mid-Level Worker” equivalent for the Emergency Care Profession. At the Higher Education level, the existing three-year National Diploma and one-year B Tech Programmes were collapsed to form a single four-year, 480-credit, NQF level 8 Professional Bachelor of Health Sciences Degree in Emergency Medical Care (B EMC). After the establishment of the two-year ECT and four-year B EMC programmes, the next challenge faced by the HPCSA, educators and educational providers within the emergency care field became that of facilitating articulation between the two qualifications. This study aimed to critically analyse and compare the two-year ECT qualification with the four-year professional B EMC degree in order to design a framework and bridging programme that may support and guide articulation between the two qualifications. An expository, retrospective analysis of existing documentation was followed by a focus group discussion with educators in the field in order to identify and explore potential obstacles and challenges with regard to articulation between the ECT and the B EMC qualifications. Finally, a detailed Delphi Questionnaire was sent to selected expert panel members. The study highlights a strong desire for articulation and academic progression within the emergency care profession. Similarities and substantial differences were identified in the scope, level and depth of knowledge of the ECT and B EMC qualifications. A framework was designed that includes a bridging programme to provide ECT graduates with the necessary knowledge, skills and insights required to enter directly into the third year of the Emergency Medical Care Degree.Item Open Access A framework for articulation between the emergency care technician certificate and the emergency medical care professional degree(University of the Free State, 2011-11) Vincent-Lambert, Craig; Bezuidenhout, J.; Jansen van Vuuren, M. V.English: The need to comply with the requirements of the SAQA Act necessitated a review of emergency care education and training in South Africa. The review and restructuring led to the creation of a formal two-year, 240-credit NQF level 5 Emergency Medical Care Technician (ECT) Qualification. The NDoH views the ECT programme as the "Mid-Level Worker" equivalent for the Emergency Care Profession. At the Higher Education level, the existing three-year National Diploma and one-year B Tech Programmes were collapsed to form a single four-year, 480-credit, NQF level 8 Professional Bachelor of Health Sciences Degree in Emergency Medical Care (B EMC). After the establishment of the two-year ECTand four-year B EMCprogrammes, the next challenge faced by the HPCSA,educators and educational providers within the emergency care field became that of facilitating articulation between the two qualifications. This study aimed to critically analyse and compare the two-year ECT qualification with the four-year professional B EMC degree in order to design a framework and bridging programme that may support and guide articulation between the two qualifications. An expository, retrospective analysis of existing documentation was followed by a focus group discussion with educators in the field in order to identify and explore potential obstacles and challenges with regard to articulation between the ECTand the B EMCqualifications. Finally, a detailed Delphi Questionnaire was sent to selected expert panel members. The study highlights a strong desire for articulation and academic progression within the emergency care profession. Similarities and substantial differences were identified in the scope, level and depth of knowledge of the ECT and B EMC qualifications. A framework was designed that includes a bridging programme to provide ECTgraduates with the necessary knowledge, skills and insights required to enter directly into the third year of the Emergency Medical Care Degree.Item Open Access A framework for service-learning in the undergraduate radiography programme in the Mangaung area(University of the Free State, 2016-03-02) Botha, René Walter; Bezuidenhout, J.In this research project, an in-depth study was done by the researcher with a view to compiling a framework for Service-Learning (SL) in the undergraduate Radiography programme in the Mangaung area. SL is “a credit-bearing educational experience in which students participate in an organised service activity that meets identified community needs and reflect on the service activity in such a way as to gain further understanding of course content” (Bringle & Hatcher 1995: 212). Currently no framework for SL in resource-based disciples such as Radiography exists in South Africa. The objectives of the study were: • To establish whether the community benefits from Radiography SL; • To establish whether SL cultivates social responsiveness in students; • To investigate the effectiveness of SL in enabling students to achieve the generic skills; • To establish specifically whether SL cultivates critical thinking in students; and • To analyse whether reciprocity is achievable when doing SL in Radiography. A mixed method research approach was used to gather data consisting of both qualitative and quantitative data. Third-year Radiography students prepared and executed dramatised presentations, and Grade 12 learners, contact persons at the five schools involved and the Radiography facilitator evaluated the presentations using different rubrics. The Radiography students completed a structured reflection adapted from Zlotkowski et al. (2005) and the Watson-Glaser Critical Thinking Appraisal tool. Radiography academics participated in a semi-structured interview during the study. Data was also gathered from delegates at the 42th ISELT conference. The data sets were merged, connected and embedded to facilitate triangulated discussion and conclusions. Grade 12 learners, contact persons and academics who participated (42nd ISELT conference UJ, TUT and CPUT) indicated that communities benefitted from the SL intervention. From students‟ reflective comments it can be concluded that students became more socially responsive. This conclusion was confirmed by the academics who participated. From feedback by Grade 12 learners and contact persons and other academics involved, it can be concluded that SL enables students to attain generic attribute skills. The collective results of the Watson-Glaser Critical Thinking Appraisal tool of the third visit increased from the second visit. Facilitators from the ISELT conference, UJ, TUT and CPUT confirmed that SL assists in developing critical thinking skills in students. Academic reciprocity was made possible by incorporation of additional sources of information, through doing research and by having a practical approach to simplifying information. From the conclusions it is clear that SL activities benefit students and communities. The general approach to structuring the framework allows other academic fields to make use of this framework. The framework has an action-research format: activities and goals of the intervention are reflected on constantly.Item Open Access Guidelines for undergraduate nuclear medicine education in the MBCHB programmes in South Africa(University of the Free State, 2015-02) Nel, Maria Glaudina; Bezuidenhout, J.; Brüssow, S.English: Only six of the eight Schools of Medicine in South Africa are currently involved in presenting medical nuclear medicine education programmes. Nuclear medicine is traditionally taught at postgraduate level and no nationally accepted undergraduate medical nuclear medicine education guidelines exist. Due to the poor quality and inadequacy of referral letters to the local Nuclear Medicine Department, a need was identified to empower newly qualified doctors to utilise nuclear medicine imaging procedures more effectively. The researcher‟s intention was to investigate undergraduate medical nuclear medicine modules if they existed at the Schools of Medicine in South Africa. The aim was to use the research results to provide guidelines for a nationally accepted undergraduate medical nuclear medicine module. These guidelines could guide academic Nuclear Medicine Departments in ensuring that all medical students and future medical interns are exposed to the same level of undergraduate nuclear medicine education. The answers to specific, fixed questions regarding undergraduate medical nuclear medicine education, and the opinions of all academic and private nuclear medicine experts in South Africa were obtained. The value of the research for medical students will mainly be empowerment – they will be able to utilise nuclear medicine imaging studies effectively in their day-to-day patient care, though it will not turn them into “mini” nuclear medicine physicians. The research will also serve as a benchmark for the module during semester 6 of the MBChB programme of the School of Medicine, Faculty of Health Sciences at the University of the Free State. The research tool that accomplished the measurement and conceptual analysis of the required data best was a semi-structured survey questionnaire consisting of both closed and open-ended questions, combining a quantitative study with qualitative components. A Likert-type frequency scale was used to identify specific undergraduate level topics to be included in such an educational module. Key persons were identified in each academic Nuclear Medicine Department to complete the main questionnaire on the existing medical curriculum and each department‟s undergraduate educational module. A shortened questionnaire, excluding the sections on the curriculum and the existing undergraduate nuclear medicine module, was also distributed electronically via the EvaSys system of the UFS, to all other academic and privately practising nuclear medicine experts in South Africa. This study was conducted in the inter-disciplinary fields of Health Professions Education and Nuclear Medicine Imaging education in the undergraduate MBChB programmes in South Africa. The focus was on compiling and providing guidelines for a standardised and uniform undergraduate medical nuclear medicine educational module that could be included in MBChB programmes in South Africa. Results and findings, comprising of existing secondary data (Study Objective 1) and the opinions of key persons (Study Objective 2) and expert nuclear medicine practitioners (Study Objective 3), were applied to compile and provide guidelines (Study Objective 4) for the required educational modules as benchmark to Schools of Medicine in South Africa to bridge the gap identified. This research study makes a significant contribution to the body of knowledge in the field of undergraduate medical nuclear medicine education in South African.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 An investigation into the characteristics of the anatomy and embryology module (MEF 153) that affect first-year medical students' academic performance at the University of the Free State: a students' perspective(University of the Free State, 2014-01) Van Zyl, Gerhard Johannes; Bezuidenhout, J.English: The first two years of higher education is critical in creating a foundation for future academic success as this is the time with the highest gain in knowledge, namely the development of critical thinking and cognitive development (Reason, Terenzini & Domingo 2006:150). Experiences during this stage will influence future academic performance. In South Africa, as many as 33% of enrolled students do not proceed beyond the first year of study (CHE 2013:44). Factors that influence academic performance of first-year students include individual, organisational, environmental and academic programme factors. These factors are often interconnected (James 2007:2; Krumrei-Mancuso, Newton, Kim & Wilcocs 2013:248-253; Reason et al. 2006:149,167; Yates 2012:46-49). The extent to which a specific factor will influence an individual student is affected by the individual’s perspective and experience of such a factor. The strengths and weaknesses of a curriculum - as perceived by students - will affect academic performance, among other factors (Henzi, Davis, Jasinevicius & Hendricson 2007:642-645). Against this background, the problem that was addressed was the poor academic performance of students in module MEF153 (Structure and development of the body) in the first year of the Programme for Professional Medicine (MBChB), in the School of Medicine, Faculty of Health Sciences, University of the Free State. The question that had arisen was: “Which factors, within the curriculum of the first-year undergraduate medical programme module MEF153, influence the academic performance of students in this module?” An investigation was done by the researcher to identify factors contributing to the poor academic performance of students in the module MEF153. Therefore the aim of the study that was pursued was to investigate students’ perspectives regarding the importance of the various factors affecting their academic performance in their first year of study in the module MEF153. Research was conducted with the goal of making recommendations for changes to the curriculum of module MEF153. This was deemed necessary to improve the academic performance of first-year medical students in the module, without the lowering of academic standards. To answer the research question and in order to achieve the aim, the objectives pursued included conceptualising and contextualizing factors affecting students’ academic performance through conducting a literature survey. The presence and relevance of these factors within module MEF153 were determined through the analysis of module MEF153. Emphasis was placed on the curriculum, module structure and layout, educational strategies and methods, study content, assessment methods and finally, the time available for this module. A questionnaire was composed from these factors. The students’ perception of the importance of factors affecting academic performance in module MEF153 was then evaluated by means of the questionnaire and statistical analysis of data. The research approach used was a descriptive survey with quantitative and qualitative methodologies. All students registered for the module MEF153, and present on the day of data collection were included. The prevalence and perceived importance of factors affecting academic performance was determined by means of voluntary participation in an anonymous and confidential self-administered questionnaire completed by numerous research participants. The questionnaire contained questions with reference to demographic- and personal information, curriculum and programme characteristics and educational information such as teaching and learning methods used in this module. Quantitative data on the perceived importance and effect of factors on academic performance were recorded with the aid of questions and a Likert scale. Qualitative data were gathered through open-ended questions in the questionnaire. The results of the quantitative data were reported as frequencies and percentages or medians for each factor evaluated and discussed. The major findings from this study were that all factors, except “personal interracial relations”, investigated for their possible effect on academic performance, are perceived to have an effect of median = 5 or more on academic performance on a scale from 0 to 10 where 10 = most important. Except for nine factors, the majority of participants reported a positive effect on academic performance for factors investigated. The factors that reported a majority negative effect on academic performance included financial cost of studies; workload of the undergraduate medical programme; workload of module MEF153; load of independent study in module MEF153; difficulty of content in module MEF153; difficulty of language in resources used in module MEF153; number of assessment opportunities in module MEF153; volume of content assessed per assessment opportunity; and stress associated with assessment in module MEF153. The qualitative data presented and discussed here were classified in themes and categories for each question. It provided further insight and understanding of the quantitative results. These results show that the undergraduate medical programme and module MEF153 manage most factors in such a way that it contributes positively to academic performance for the majority of participants in this study. It also identifies areas that negatively influence the academic performance of the majority of participants. Furthermore, it emphasises the diverse effect of each factor on academic performance among participants. This knowledge can be used to address problematic areas of the curriculum to improve academic performance. It can also be used to improve academic development and support activities to address shortcoming in skills among students.Item Open Access A model for the teaching of imaging informatics, a platform in biomedical informatics, in a future integrated National Health Insurance system in South Africa(University of the Free State, 2020-12) Grobler, A. D.; Bezuidenhout, J.; Botha, R.In this research project, the researcher conducted an in-depth investigation into imaging informatics, to develop a teaching model in imaging informatics, applicable to the South African context. Imaging informatics in the digital radiology department is a division of medical imaging informatics and a study level in biomedical informatics, and function on a cellular or organ system level (Huang 2014a:631). It involves Picture Archiving Communication Systems (PACS), Radiology Information Systems (RIS), radiographic digital imaging modalities and a secure network for storing, retrieving and communicating of medical information and DICOM (digital imaging and communication in medicine) images. In digital radiology departments, in private and public healthcare institutions, it is usually the IT specialists (or manager) and the PACS administrator that is responsible for ensuring a smooth exchange of health information. Currently, no registered, accredited training programme in imaging informatics is available in South Africa. The objectives of the study were: • To gather data regarding imaging informatics nationally and internationally; and • To develop a teaching model for imaging informatics, a platform in BMI, in a future integrated NHI system in South Africa. The researcher used a mainly quantitative research approach to collect quantitative and qualitative data through three structured questionnaires and a three-round Delphi technique. The target population involved radiographers, IT specialist, PACS administrators and system managers. Purposive sampling was used to select the samples from each of the different research populations. The research design was appropriate, as it assisted in answering the research questions within a pragmatist paradigm. Six summated themes regarding imaging informatics principles were derived from the first two questionnaires and incorporated into the development of the first Delphi questionnaire. The categories of the professional practices of imaging informatics professional in the third structured questionnaire were also included in the first-round Delphi questionnaire. The three-round Delphi survey resulted in consensus achieved for 142 of the 184 statements (categories). Stability was proclaimed on an additional 37 statements. Only five categories were excluded after round three. The information retrieved from the literature review during Phase 1 of the study regarding BMI platforms and training; imaging informatics principles and teaching courses; learning theories, teaching strategies and models; and the categories where consensus was reached, and stability proclaimed, were used to develop the teaching model for imaging informatics in a future integrated National Health Insurance system. From the conclusions, it is clear that the teaching model developed through this study will be useful for developing and implementing a curriculum for imaging informatics teaching and learning in South Africa.Item Open Access The needs and preferences of general practitioners regarding their continuous professional development: a Free State perspective(University of the Free State, 2015-02-28) Botes, Petrus Johannes; Bezuidenhout, J.; Steinberg, W. J.The Health Professions Council of South Africa requires all Health Practitioners to complete accredited learning opportunities, and provide proof thereof, for the purpose of updating their knowledge and acquire new skills. Continuing Professional Development is the chosen model, which has a goal of holistic development of practitioners. The Department of Family Medicine, University of the Free State, provides such opportunities through Refresher Courses, which covers common fields of interest over a period of three years. The goal of this study was to find reasons and possible solutions for the perceived lack of interest in these Refresher Course learning opportunities and to determine how the Department of Family Medicine could adapt their education strategy to meet the needs of General Practitioners. A cross-sectional study design was chosen, by which a questionnaire was posted to randomly chosen participant in the Free State Province. The needs and preferences of General Practitioners regarding their continuous development were queried and factors influencing their usage of learning opportunities were assessed. The study revealed that General Practitioners still prefer a lecture form of presentation in large or small groups. They prefer the current format to continue, but find it difficult to leave their practices unattended. There is a slight movement towards training opportunities on computer. Thus, although the current format should not change, the Department of Family Medicine should consider strategies to accommodate those who find it difficult to attend.Item Open Access A stratified competency based learning programme for practitioners of medical aesthetics in South Africa(University of the Free State, 2016) Khumalo, Ntombi Valencia; Bezuidenhout, J.; Vincent-Lambert, C.; Sinclair, W.𝑬𝒏𝒈𝒍𝒊𝒔𝒉 In this study, a comprehensive study was carried out by the researcher with the intention of developing a stratified, competency-based learning programme for practitioners of medical aesthetics (MA) in South Africa (SA). MA in the current South African context is characterised by a shortage of literature and a lack of evidence-based guidelines for the knowledge, skills and competencies required by the persons practicing MA in SA. This is in contrast to countries such as Brazil and the United States of America, where MA is far more advanced and where guidelines for the regulation of the MA industry are in place. To the contrary, in SA there is a lack of practice guidelines and regulations applicable to the wide variety of professions involved in the practice of MA. Furthermore, there is an absence of a stratified, competency learning programme for the various professions involved in the practice of MA in SA. Therefore, this research study was carried out in order to develop a stratified, competency-based learning programme for practitioners of MA in SA. In addressing the above challenges, the central research question was: What would a stratified, competency-based learning programme consist of in order to provide learners with the required knowledge, skills and competencies to function as professional medical aestheticians in the South African healthcare environment? For this study, an exploratory mixed-method design that was sequential in nature was followed. This design consisted of a two-phased approach, whereby the qualitative phase (desktop study) was followed by a quantitative phase (questionnaire). A desktop study was first applied as a method for collecting qualitative data to highlight the knowledge, skills and competencies involved in the practice of MA in SA. This assisted in providing the relevant literature and components of programme for MA practitioners. The desktop study also assisted to place MA in context and understand its complexities in a South African context. The desktop study was then followed by the questionnaire (quantitative) which was used as another method of gathering data relating to the building of theory on stratified knowledge, skills and competencies of MA practitioners in SA. The questionnaires were distributed to stakeholders involved within the MA fraternity, in order to gain a clear view of the topic under study. The study resulted in a stratified, competency-based learning programme for medical aesthetics in South Africa. It became clear that to facilitate MA a short-learning programme would be suitable. The study meets the need for educational competence and regulation regarding the practice and implementation of MA in SA. The researcher believes the learning programme that was developed could serve as a source of inspiration to the education system as far as MA is concerned in the South African context; by doing so, the study may serve to provide encouragement for the regulation and professionalisation of MA in SA. This can be achieved through the expansion of education and training for MA, which has the potential to translate into an improvement of the quality of services rendered to patients. The results of this study indicate that there are very few mechanisms for regulating the practice of MA in SA, which cements the need for and importance of SA having both a stratified, competency-based learning programme for MA, and more robust regulatory mechanisms. Having completed the study, the researcher made a number of recommendations, the major one being that a pre-test/pilot of the proposed stratified competency-based learning programme be done, as it may identify issues related to the implementation process – this was not the main focus of this study. ___________________________________________________________________Item Open Access Student's experiences of simulation based education vs. problem based learning in emergency medical care training(University of the Free State, 2017) Rowland, Mugsien; Bezuidenhout, J.English: An in-depth study was done into Simulation Based Education (SBE) and Problem Based Learning (PBL) with a view to understanding which method of education is best suited to paramedic education. The researcher performed a survey of students who were studying towards becoming a paramedic at the Free State College of Emergency Care in Bloemfontein. Paramedic education requires the educator to understand a variety of teaching skills and an understanding to support the needs of the students. As such, the educator’s role is critical for learning to occur in the classroom and it requires the educator to have sound knowledge about different teaching strategies, as well as an understanding of which strategies work best with the specific discipline content information. This study sought to bridge the gap created by the absence of guidelines by the Health Professions Council of South Africa (HPCSA) for curriculum deployment in emergency medical care (EMC) training. With the recent shift from vocationally-based training to higher education in paramedic education a dire need exists to explore student paramedics’ perception of the curriculum that is being used in EMC training. Simulation is currently being used as a summative assessment instrument to measure students’ competency, but it does not integrate educational methods which are being used in emergency medicine and in other allied health care education. Universities and other institutions use outcomes-based education and training as set out by the requirements of the South African Qualifications Authority (SAQA). Countries such as the United States and Australia make use of integration of PBL and SBE or Case-based learning (CBL) and SBE. SBE and PBL studies were used to frame and focus the study. This study is situated in the field of Health Professions Education and focused on the profession of EMC. The research methods comprised analysis of documents that contextualise the use of clinical simulation by emergency care education programmes in South Africa. A review of scholarship provided a conceptual framework for understanding health care simulation as an educational methodology and its use as an instrument of assessment in EMC. Literature on PBL was also sought in EMC and since no articles could be found locally, articles from Australia, the United States and medicine were used to draw conclusions. Limited articles could be found internationally and even less information was found when the researcher looked within the South African EMC system with regard to different curriculums in use for paramedic education. A quantitative descriptive design was employed and a questionnaire survey was used as the method of data collection for the empirical phase of the study. All participants was first introduced to SBE and PBL prior the completion of the questionnaire survey. This ensured that each participant knew exactly how each method of education works. Data from questionnaire survey was analysed and interpreted in conjunction with the ICT Department University Free State, and the experience of the researcher, to examine which method of education is preferred by paramedic students’ which was the main unit of analysis, and the subunits, namely, how students experienced SBE and PBL. The data collected from the questionnaire survey was analysed and a description and discussion of the research findings were documented. Based on the literature review and the responses to the questionnaire, several prominent conclusions were reached. One of the key issues identified is that simulation is employed as a tool of assessment only, and not as an integration of an educational method. PBL also received favourable feedback from students who had never encountered PBL before this session. These research findings can assist with decisions as to whether future (more comprehensive and potentially more costly) research projects are justified. Both SBE and PBL prepare the paramedic with knowledge, skills and competence to treat a patient safely and with quality care. SBE should be seen as a method of education that can be integrated with other methods of education such as lectures, PBL and bedside teaching. Understanding the competence of paramedics is an important resource. They transport millions of people to hospitals each year and consequently, the need to measure how they learn is an important task. The study serves to frame the breadth, depth and scope of SBE and PBL in paramedic education in South Africa.Item Open Access Training for interpersonal communication skills relevant to neurological practice in South Africa(University of the Free State, 2020-09) Moodley, Anandan A.; Bezuidenhout, J.; Van Aswegen, A.Training in proper communication between doctor and patient is not a requirement for the training of neurologists in South Africa. This is not the case in neurology training in countries such as Canada, the United Kingdom and Australia, where communication is taught and tested in the final neurology examination. The aim of this study was to assess how qualified neurologists and neurology doctors in training (registrars) view their ability to communicate with patients, and how they view such communication as an item in the neurology-training syllabus. The researcher conducted a survey to investigate the opinions of neurology doctors by using a questionnaire completed either via the internet or on printed forms. The target groups were neurology registrars and qualified neurologists working in private practice, public and academic hospitals. The results of this study will be made available to the seven neurology-training units in South Africa, as well as the College of Neurology, which is the neurology examining body of the College of Medicine of South Africa. The study found that neurology registrars and qualified neurologists are not adequately skilled in communication and, therefore, the study will motivate for the introduction of proper training and testing of communication in the objectively structured clinical examination of the final neurology exam. After all, if students are not tested in doctor-patient communication, it is unlikely that they will possess the required skills in doctor-patient communication.Item Open Access A work-integrated learning education and training programme for radiography in South Africa(University of the Free State, 2015-06) Du plessis, Jeanetta Gesina Elizabeth; Bezuidenhout, J.English: An in-depth study was conducted to investigate current practices in the delivery of work-integrated learning (WIL) in Radiography training at selected universities in South Africa (SA) with the ultimate goal of developing an education and training programme for WIL in Radiography training. The study was prompted by a growing awareness that a gap existed in the delivery of WIL in Radiography programmes in SA. WIL is a relatively new jargon term that focuses attention on the integration of theoretical learning and learning in the workplace. Until recently the focus in many professional programmes has been on workplace learning (WPL) as a component of the training of students. Although the concept of placing students in the workplace to acquire work experience is not new, the rationale behind WIL goes beyond merely providing a physical workplace environment as a site for students to experience work or to learn from professional practice. However, to achieve success in the delivery of any WIL programme, it is important to structure the WIL component of any learning programme with regards to the diligent and constructive alignment of learning outcomes/objectives, the delivery of learning (i.e., facilitation methods), and assessment. For quality delivery of WIL, the coordination and monitoring of the learning processes, and hence of student progression, are also important. The research methods comprised a two-fold approach. First, a literature review was conducted in order to provide an appropriate background for the formulation of a conceptual framework and to contextualise the problem against related theory and research. Second, data were collected using questionnaires that generated both quantitative and qualitative data. The latter data were obtained by means of open-ended questions that allowed for comments that facilitated the gathering of information about the current status of the delivery of WIL in Radiography training. The compilation of an education and training programme for WIL for the Bachelor of Radiography in Diagnostics degree to enhance undergraduate radiography training in SA was achieved by merging the information from the literature review and the collected data. The findings on the current status of WIL, which emanated from the questionnaire survey, were compared with suggestions garnered from the literature for best practice in WIL in order to make recommendations to bridge the identified shortcomings in the delivery of WIL in Radiography training. By developing an education and training programme for WIL in Radiography and by providing recommendations towards improvements in the delivery of WIL, the study contributed significantly to the creation of new knowledge in the Radiology field and was thus successful in bridging the identified gap in the delivery of WIL. The implementation of the proposed programme for WIL can aid in the development of a curriculum for WIL that includes appropriate modules, learning units, assessment and monitoring strategies, and guidelines for the development of generic skills. The sound research approach and methodology that were employed ensured the quality, reliability and validity of the study. The completed research can form the basis for a further research undertaking.