Ramklass Serela S
Department of Geriatrics, Nelson R Mandela School of Medicine, University of Kwazulu-Natal, Durban, South Africa.
Health Soc Care Community. 2009 Sep;17(5):522-9. doi: 10.1111/j.1365-2524.2009.00869.x. Epub 2009 May 27.
Increasing access to health services and the introduction of primary health care are the cornerstones of transforming healthcare initiatives in South Africa. Sustainability of healthcare provision in rural and under-resourced areas is secured by legislation of a year-long community service (CS) contract with graduating healthcare practitioners. This study explored how the first cohort of physiotherapists experienced their year-long CS and how they felt their undergraduate training prepared them for practice. A survey was conducted at the end of 2003 amongst the first cohort of CS physiotherapists who emerged from the physiotherapy programme of a South African university. All 23 of the graduates from the 2002 final year class were invited to participate in the study. A self-administered open-ended questionnaire was faxed to the participants. Twenty of the 23 questionnaires were completed and returned within a month. The questionnaires were coded and the data were analysed using content analysis methodology. The results were categorised into emerging patterns. CS physiotherapists assessed their preparation for practice largely in relation to the technical skills that were acquired through the curriculum. Community-based physiotherapy practice in under-resourced areas was under-emphasised in the curriculum in relation to practice opportunities within hospital and institution-based settings. The curriculum was found not to advance the role of physiotherapists as socially responsive agents and appeared to pay little attention to knowledge underpinning socio-cultural and inter-professional relations. Physiotherapy academic knowledge alone was inadequate to support novice physiotherapists within under-resourced communities in their multiple roles as clinician, manager of physiotherapy department, as member of a multidisciplinary team, health educator and advocate for social justice.
增加医疗服务的可及性以及引入初级卫生保健是南非医疗改革举措的基石。通过与即将毕业的医疗从业者签订为期一年的社区服务（CS）合同的立法，确保了农村和资源匮乏地区医疗服务的可持续性。本研究探讨了首批物理治疗师在为期一年的社区服务中的经历，以及他们认为本科培训对其执业的准备情况。2003年底，对一所南非大学物理治疗专业毕业的首批参与社区服务的物理治疗师进行了一项调查。邀请了2002届最后一年班级的所有23名毕业生参与研究。一份自行填写的开放式问卷被传真给参与者。23份问卷中有20份在一个月内完成并返回。对问卷进行编码，并使用内容分析方法对数据进行分析。结果被归类为新出现的模式。参与社区服务的物理治疗师主要根据通过课程获得的技术技能来评估他们的执业准备情况。与医院和机构环境中的实践机会相比，资源匮乏地区基于社区的物理治疗实践在课程中未得到充分重视。研究发现，该课程未能提升物理治疗师作为社会响应者的角色，似乎很少关注支撑社会文化和跨专业关系的知识。仅物理治疗学术知识不足以支持资源匮乏社区中的新手物理治疗师承担临床医生、物理治疗部门经理、多学科团队成员、健康教育者和社会正义倡导者等多重角色。
