Research Articles (Centre for Health Professions Education)

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Browsing Research Articles (Centre for Health Professions Education) by Author "Archer, E."

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    The development, implementation and evaluation of a short course in objective structured clinical examination (OSCE) skills
    (Medical & Pharmaceutical Publications (Pty) Ltd -- MedPharm Publications, 2012-02) De Villiers, A.; Archer, E.
    Background: Objective structured clinical examination (OSCE) examiner training is widely employed to address some of the reliability and validity issues that accompany the use of this assessment tool. An OSCE skills course was developed and implemented at the Stellenbosch Faculty of Health Sciences and its influence on participants (clinicians) evaluated. Method: Participants attended the OSCE skills course, which included theoretical sessions concerning topics such as standard setting, examiner influence and assessment instruments, as well as two staged OSCEs, one at the beginning and the other at the end of the course. During the latter, each participant examined a student role-player performing a technical skill while being video recorded. Participants’ behaviour and assessment results from the two OSCEs were evaluated, as well as the feedback from participants regarding the course and group interviews with student role players. Results: There was a significant improvement in inter-rater reliability as well as a slight decrease in inappropriate examiner behaviour, such as teaching and prompting during assessment of students. Furthermore, overall feedback from participants and perceptions of student role players was positive. Conclusions: In this study, examiner conduct and inter-rater reliability was positively influenced by the following interventions: examiner briefing, involvement of examiners in constructing assessment instruments, as well as examiners viewing (on DVD) and reflecting on their assessment behaviour. This study proposes that the development and implementation of an OSCE skills course is a worthwhile endeavour in improving validity and reliability of the OSCE as an assessment tool.
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    Interventions aimed towards the development of patient-centredness in undergraduate medical curricula : a scoping review
    (Health and Medical Publishing Group, 2018) Archer, E.; Meyer, I.
    Background. Patient-centredness has been identified by most medical schools worldwide as a desired core graduate competence. Patient-centredness positions the patient at the centre of the consultation and, therefore, focuses on the patient instead of on the disease. The concept of patient-centredness is, however, multifaceted. The choice and development of approaches and interventions that can enhance or sustain the various dimensions of patient-centredness are challenges for undergraduate medical curriculum developers. Objectives. To determine what the extent and nature of published scientific literature on implemented interventions are and how these could assist in fostering the various constructs of patient-centredness in undergraduate medical curricula. Furthermore, to determine which of these interventions could potentially be applied and incorporated in the context of the undergraduate medical curriculum at the Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. Methods. The study followed the 6-step scoping review methodology framework. Four electronic databases were searched. Two independent reviewers screened citations for inclusion and performed the data abstraction. Results. Articles (N=581) were eligible for inclusion in this study. Information captured in the Excel spreadsheets resulted in 9 categories of teaching interventions, which could lead to the various constructs of patient-centredness. These included didactic sessions and workshops, simulated patients, reflection, small-group discussions, e-learning, peer role-play/drama/surrogate, narratives/storytelling/art, clinical experiences and mindfulness training. Conclusions. It is important to acknowledge that the development of patient-centredness in medical students is more than just a set of communication skills. Curricula need to provide learning opportunities for students to enhance knowledge, skills and attitudes related to patient-centredness to develop it as a strong competence. Furthermore, students need to be placed in clinical learning environments that foster a patient-centred approach, providing various opportunities where they can reflect on their learning, be more mindful of the needs of their patients and build caring relationships with them.
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    Making use of an existing questionnaire to measure patient-centred attitudes in undergraduate medical students : a case study
    (Health & Medical Publishing Group, 2014-09) Archer, E.; Bezuidenhout, J.; Kidd, M.; Van Heerden, B. B.
    Background. Patient-centred care is widely acknowledged as important to achieve improved patient outcomes in healthcare. Therefore, it is vital that medical schools should foster this attitude in their students. Studies report that students are becoming less patient-centred in the period between entry to medical school and graduation. Objective. To determine the shift in attitude towards patient-centredness in a group of South African undergraduate medical students. Simultaneously, the reliability and validity of the Patient-Practitioner Orientation Scale (PPOS) in our context were measured. Methods. A cross-sectional survey was undertaken by asking all the medical students from year 1 to year 6 to complete the PPOS. The mean PPOS score for each cohort was calculated using SPSS for Windows. Reliability and validity testing was conducted using Cronbach’s alpha and confirmatory and exploratory factor analysis. Results. The average return rate across the 6 years of study was 81%. The results indicated low initial scores on the PPOS and a decrease in scores over the years of study, with the most dramatic drop being from year 1 to year 2. The PPOS showed poor validity and reliability in our context. Conclusion. The study appears to indicate the same decrease in patient-centredness in our students as has been shown in other studies using this tool. However, the low reliability and validity of the PPOS in our environment means that the result should be interpreted with caution. Factors such as our medical students’ not having had first-hand experience of the doctor-patient relationship and second-language issues may play a role. It is recommended that the PPOS not be used in our context without further exploration of the factors contributing to this loss of reliability and validity.