Factors influencing the decision-making process of clinician family physicians during workplace-based assessments in the Western Cape, South Africa

Simple item page
dc.contributor.advisorDe Villiers, Marietjie Renéen_ZA
dc.contributor.authorEksteen, Lawson Barryen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Health Systems and Public Health.en_ZA
dc.date.accessioned2024-01-23T12:07:45Z
dc.date.accessioned2024-04-26T23:17:45Z
dc.date.available2024-01-23T12:07:45Z
dc.date.available2024-04-26T23:17:45Z
dc.date.issued2024-03
dc.descriptionThesis (MPhil)--Stellenbosch University, 2024.en_ZA
dc.description.abstractENGLISH SUMMARY: The integration of Workplace-Based Assessment (WBA) methods into medical education has become more frequently used, bringing assessments into clinical settings. The decision-making process in WBA, crucial for shaping trainee performance and clinician Family Physicians judgments, is intricately influenced by several factors. Understanding these factors is pivotal for advancing assessment outcomes in Health Professions Education. This exploratory, descriptive qualitative research delves into the decision-making process of Family Physicians during mini Clinical Evaluation Exercise (mini-CEX) assessments on postgraduate trainee registrars in Family Medicine. Semi-structured interviews were conducted with six clinician family physicians based in district hospitals who regularly conduct WBA as part of clinical training. Registrars are trained in either small (one supervisor), medium (two supervisors) or large (three or more supervisors) training complexes, and some registrars would be assessed by the same supervisor for the whole training period. This study was conducted to gather in-depth insights into the perceptions that guide their decision-making. The results highlighted a diverse array of factors influencing the decision-making process of Family Physicians conducting mini-CEX evaluations on postgraduate registrars. Each clinician Family Physician has a unique perception of WBA, as well as a specific approach and framework when conducting WBA in the primary setting. Three overarching themes emerged from the data, namely context, relationships, and the educational environment. From these themes, the contextual background was most prominent, and especially the opportunity to use interruptions as learning opportunities. The unique relationship between the supervisor and trainee were also described as a significant factor, and although this can be multifaceted and challenging, it also gives opportunity for richer feedback and more extensive professional growth. The specific educational environment is also a major factor, where previous training, clinical complexity and the available academic time were most valid. These themes underscore the complexity of decision-making in WBA, and although intricate and diverse, hold a pivotal role in the decision-making dynamics, challenging the conventional view of variability as mere human error. These factors should not be viewed as a flawed human error of assessment, but rather different professional elements of clinical characteristics that takes assessment practices in the workplace to a deeper and richer degree of clinical competence.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Die integrasie van werkplekgebaseerde assesseringsmetodes (WBA) in mediese onderwys word al hoe meer gereeld gebruik in Gesondheidsonderrig. Die besluitnemingsproses in WBA, wat sentraal is tot die vorming van leerlingprestasie, word deur 'n aantal faktore beinvloed. Om hierdie faktore te verstaan is deurslaggewend vir die bevordering van assesseringsuitkomste in Gesondheidsberoepe Onderwys. Hierdie verkennende, beskrywende en kwalitatiewe navorsing delf in die besluitnemingsproses van Huisartse tydens mini-kliniese evaluasie-oefeninge (mini-CEX)-assesserings op nagraadse leerling Kliniese Assistente in Huisartskunde. Semi-gestruktureerde onderhoude is gevoer met ses kliniese Huisartskundiges gebaseer in distrikshospitale wat gereeld WBA as deel van kliniese opleiding voer. Kliniese Assistente word opgelei in of klein (een studieleier), medium (twee studieleiers) of groot (drie of meer studieleiers) opleidingskomplekse, en sommige sal deur dieselfde studieleier vir die hele opleidingstydperk geassesseer word. Hierdie studie is uitgevoer om in-diepte insigte te verkry oor die persepsies wat hul besluitneming raak en beinvloed. Die resultate het 'n uiteenlopende reeks faktore uitgelig wat die besluitnemingsproses beinvloed. Dit blyk dat al die Huisartskundiges 'n unieke persepsie van WBA het, sowel as 'n spesifieke benadering en raamwerk wanneer WBA uitgevoer word. Drie oorkoepelende temas het uit die data na vore gekom, naamlik konteks, verhoudings en die opvoedkundige omgewing. Vanuit hierdie temas was die kontekstuele agtergrond die prominentste, en veral die geleentheid om onderbrekings as leergeleenthede te gebruik. Die unieke verhouding tussen die studieleier en leerling is ook beskryf as 'n beduidende faktor, en al kan dit veelvlakkig en uitdagend wees, gee dit ook geleentheid vir ’n ryker terugvoer en tot meer uitgebreide professionele groei. Die spesifieke opvoedkundige omgewing is ook 'n belangrike faktor, waar vorige opleiding, kliniese kompleksiteit en die beskikbare akademiese tyd die mees geldige was. Hierdie temas onderstreep die kompleksiteit van besluitneming in WBA, en hoewel ingewikkeld en divers, speel hulle 'n deurslaggewende rol in die besluitnemingsdinamika, wat die konvensionele siening van veranderlikheid as blote menslike fout uitdaag. Hierdie faktore moet nie gesien word as 'n gebrekkige menslike fout van assessering nie, maar eerder verskillende professionele elemente van kliniese kenmerke wat assesseringspraktyke in die werkplek na 'n dieper en ryker mate van kliniese bevoegdheid neem.af_ZA
dc.description.versionMasters
dc.format.extent49 pages : illustrations, maps, includes annexures
dc.identifier.urihttps://scholar.sun.ac.za/handle/10019.1/130594
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch University
dc.subject.lcshPhysicians -- Decision making -- Western Cape (South Africa)en_ZA
dc.subject.lcshclinical competence -- Evaluation -- Western Cape (South Africa)en_ZA
dc.subject.lcshClinical medicine -- Decision making -- Western Cape (South Africa)en_ZA
dc.subject.lcshMedicine -- Ability testing -- Western Cape (South Africa)en_ZA
dc.subject.nameUCTD
dc.titleFactors influencing the decision-making process of clinician family physicians during workplace-based assessments in the Western Cape, South Africaen_ZA
dc.typeThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
eksteen_factors_2024.pdf
Size:
2.3 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters Degrees (Centre for Health Professions Education)