Research Articles (Centre for Health Professions Education)

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

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    Applying empathic communication skills in clinical practice : medical students' experiences
    (AOSIS, 2021-02) Archer, Elize; Meyer, Ilse S.
    Background: Studies have demonstrated that empathic communication improves patient outcomes and helps doctors to deliver accurate symptom reports and diagnoses. These benefits emphasise the need for medical students to apply empathic communication skills during their interactions with patients. Focussed empathic communication skill workshops were introduced into the undergraduate medical students’ training at the Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa. This study aimed to explore students’ perceptions of applying these empathic communication skills during their clinical practice. We were interested in determining the factors that might influence the development of empathic communication skills. The findings could help curriculum developers to optimise these workshops for inclusion in a formal medical curriculum. Methods: This study followed a qualitative, descriptive enquiry, exploring the perceptions of medical students through focus-group discussions. The students (N = 18) were selected using convenience sampling techniques. Recordings were transcribed, and the data were thematically analysed. Results: The two main themes identified relate to the students and the clinical learning environment. The students valued the knowledge and skills they acquired. However, feelings of emotional vulnerability, a lack of language proficiency and inadequate role modelling were highlighted as challenges when applying empathic communication during clinical practice. Conclusion: The students reported positively on the workshops as these improved both their patient and personal interactions. However, for students to develop these skills further for clinical practice, they need more intentional and supervised opportunities to practise, reflect and receive constructive feedback. These learning opportunities could help medical schools deliver graduates who can competently communicate with their patients in an empathic manner.
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    Empathy : an essential tool in any doctor’s skillset
    (Health & Medical Publishing Group, 2019) Archer, Elize; Turner, Roseanne
    No abstract available
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    Fresh simulation options in critical care nursing education
    (Health and Medical Publishing Group (HMPG), 2010-12) Archer, Elize
    Many forms of simulation, as a teaching strategy, have been used successfully over the last few decades. Some of the advantages thereof in health sciences education are that it is a learner-centered training modality that presents with no risks to patients and allows for facilitated repetition of learning until all students have achieved the required level of proficiency. Simulation may reduce time spent by students in clinical areas to master the necessary skills and it is therefore perceived as an efficient use of limited resources. Utilising the Clinical Skills Centre (CSC) for teaching of procedures may therefore facilitate the reduction in time allocated to the clinical areas. Critical care (CC)-trained nurses are expected to have the expertise to perform a variety of practical procedures on patients, but even more importantly, they should be able to integrate information about a patient in order to provide holistic and effective care. The practical component of the CC nursing programme at the specific university consists of two parts: the completion of practical procedures and case presentations. Some of the challenges associated with the teaching and assessment of these two components are important and will be discussed in this article.
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    Improving undergraduate clinical supervision in a South African context
    (Health & Medical Publishing Group, 2011-12) Archer, Elize
    Objectives: The Faculty of Health Sciences, Stellenbosch University, has undergraduate programmes for several disciplines; these programmes need clinical supervisors to teach their students in the clinical settings. The faculty does not have the resources to present different clinical supervision courses for each discipline; therefore a short course with an interprofessional focus was designed. Design: A qualitative study was done to determine the strengths and weaknesses of the course in order to re-curriculate as deemed necessary. Semi-structured individual interviews were held with 10 (n=18) course participants as well as the tutors involved in the development of the course. Ethical approval was obtained. Participation was voluntary and anonymity was guaranteed. The recorded and transcribed data were analysed. Setting: The health professionals acting as supervisors may be the experts in their fields, but they do not always have the necessary teaching skills. The Centre for Health Sciences Education (CHSE) at the faculty has developed a generic short course in undergraduate clinical supervision to address the above issue. Results and conclusion: The data were used to inform restructuring of the short course for the following year. The impact of this short course on clinical supervisors was that their interaction with students in the clinical setting improved. There was unanimous support for extending the short course to all clinical supervisors. The lecturers involved in developing the course were positive about the interprofessional cooperation among colleagues and students. They emphasised that the Faculty of Health Sciences has an obligation to provide opportunities for clinical supervisors to improve their skills to supervise students.
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    Influence of confidence and experience on the competency of junior medical students in performing basic procedural skills
    (African Journal of Health Professions Education, 2011-06) De Villiers, Adele; Archer, Elize; Southern African FAIMER Regional Institute (SAFRI) Poster Day, Cape Town, March 2011; SA Association of Health Educationalists (SAAHE) Conference, Johannesburg, July 2010
    ENGLISH ABSTRACT: Studies, mostly done with final-year medical students and doctors, show that the confidence level with which a clinical skill is performed is not a reliable benchmark of actual clinical competence. This inaccurate selfevaluation of proficiency has far-reaching implications, e.g. the inability to identify learning deficiencies and consequently to manage learning – both essential components of self-directed learning programmes.
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    Measuring empathy in a group of South African undergraduate medical students using the student version of the Jefferson Scale of Empathy
    (AOSIS, 2019) Archer, Elize; Turner, Roseanne
    Background: Patient-centred care is a model of care that demands healthcare providers change their focus from the disease to the patient and his or her perceived physical and psycho-social needs. This model requires healthcare workers to listen actively and to have effective communication skills and well-developed levels of empathy. Aim: The aim of this study was to determine the suitability of the Jefferson Scale for Empathy (JSE-S) as a valid test for empathy in third-year medical students at a South African university and also to determine the baseline level of empathy in this same group of students. Setting: The study took place at a medical school in the Western Cape, South Africa. This medical degree (MB ChB) is a 6-year programme. Students are first exposed to patients within their second year of training, but it is during their third-year that they start their clinical rotations. We wanted to test whether our empathy training would give students the necessary skills and enable them to establish good empathic communication habits in order to prevent a fall in empathy during this vulnerable period. Methods: This article explores the suitability of the student version of the JSE-S as a valid test for empathy, within the South African medical school context. We briefly discuss the psychometrics and the scores against what is already known in countries like ours, specifically, developing nations where cultural and language differences exist in the student populations. Furthermore, we explore whether the JSE-S is a valid scale for pre- and post-intervention measurement of medical student empathy within our context and discuss the limitations of self-assessment. We also report on baseline levels of empathy in third-year medical students. Results: Two hundred and six third-year medical students (69% females) completed the JSE-S prior to the intervention. Females and students aged 25 years and older had significantly higher scores than males and those 22 years old or less. The mean JSE was 109.98 (SD = 12.54), which is lower than most internationally reported scores. The Cronbach’s alpha coefficient was 0.81, indicating scale reliability and consistency, but graded item response testing highlighted variance in three reverse-scored questions. Conclusion: The JSE-S is an appropriate and valid scale for measuring levels of empathy in undergraduate medical students in South Africa. However, language may need to be clarified in the negatively phrased items.
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    Patient-centred care: The patients’ perspective – A mixed-methods pilot study
    (2020-10-09) Turner, Roseanne E; Archer, Elize
    Background: Patient centredness is a broad concept, a moral philosophy. Patient-centred care can be viewed as the actions of patient-centredness. One of the most pertinent actions that a healthcare practitioner can utilise to deliver patient-centred care is empathic communication. Whilst many medical programmes include empathetic communication skills as part of their curricula, the recipients of this care are not asked about the relevance of this teaching. Aim: We attempted to determine whether the Western constructs of empathy were relevant in our context and also establish whether there were any parts of the medical interview which participants felt were especially important to be communicated to in their home language. Setting: Two urban communities within the City of Cape Town, Western Cape Province, South Africa. Methods: This was a mixed-methods pilot study using an explanatory sequential design. Participants who would typically make use of public health care facilities and whose first language was Afrikaans or isiXhosa were conveniently sampled. A subgroup of participants was invited to take part in a follow-up focus group discussion to add clarity to the survey responses. Results and conclusion: Western constructs for empathy appeared to be relevant within our multicultural context. Patients wanted to communicate with their doctors and understand the cause of their problems as well as the management plan. Finally, whilst the numbers in this pilot study were too small to be generalisable, it was evident that patient-centred care was not perceived to be implemented in some public healthcare facilities attended by the participants, which resulted in them feeling unseen and disrespected.