Blitz J, Bezuidenhout J, Conradie H, de Villiers M, van Schalkwyk S
Division of Family Medicine and Primary Care, Stellenbosch University, Tygerberg, South Africa.
Division of Anatomical Pathology and Deputy-Director (Education Research) Centre for Health Professions Education, Stellenbosch University, Tygerberg, South Africa.
Rural Remote Health. 2014;14:2511. Epub 2014 May 6.
Studies that investigate the impact of long-term rural exposure for undergraduate medical students often focus largely on students' experiences and perspectives. Research focusing on the physician experience in clinical exposures appears to be limited. When the Ukwanda Rural Clinical School (RCS) at the Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa was implemented in 2011, the clinical specialists working at the rural hospitals were expected to take on the additional task of teaching the students in the year-long rotation. The specialists were prepared for the task through a series of workshops. The objective of this study was to explore what the implementation of the RCS meant for the practice of these physicians and to what extent the shift from full-time practising clinician to clinical teacher required them to adapt and change.
This was a qualitative study. Semi-structured interviews were conducted with lead clinical specialists who were responsible for teaching medical students in the year-long RCS rotation. Following an interpretive approach, thematic content analysis was performed to obtain a clearer understanding of how these clinicians had experienced their first year as clinical teachers in the RCS.
Four overarching themes were identified from the interviews with the clinicians: attitudes towards the implementation of the new medical education model, uncertainty and insecurity as a teacher, emergence of the clinician teacher, and a sense of responsibility for training a future colleague. These depict in part, the journey from clinician to clinician teacher travelled during the first year of implementation.
Embracing the role of clinical teacher enabled the development of constructive relationships between clinicians and their students with a mutual sense of responsibility for learning, patient care and improvement in clinical practice. Understanding this journey ought to influence the thinking of those considering faculty development initiatives for novice clinical teachers.
调查本科医学生长期农村实习影响的研究通常主要关注学生的经历和观点。关注临床实习中医师经历的研究似乎有限。2011年南非斯泰伦博斯大学医学与健康科学学院的乌夸万达农村临床学院（RCS）实施时，农村医院工作的临床专家被期望承担在为期一年的轮转中教授学生的额外任务。专家们通过一系列研讨会为这项任务做好了准备。本研究的目的是探讨RCS的实施对这些医师的实践意味着什么，以及从全职执业临床医生转变为临床教师在多大程度上要求他们进行适应和改变。
这是一项定性研究。对负责在为期一年的RCS轮转中教授医学生的首席临床专家进行了半结构化访谈。采用解释性方法，进行了主题内容分析，以更清楚地了解这些临床医生作为RCS临床教师的第一年经历。
从对临床医生的访谈中确定了四个总体主题：对新医学教育模式实施的态度、作为教师的不确定性和不安全感、临床教师的出现以及培训未来同事的责任感。这些部分描绘了实施第一年从临床医生到临床教师的历程。
接受临床教师的角色有助于临床医生与学生之间建立建设性的关系，在学习、患者护理和临床实践改进方面具有共同的责任感。了解这一历程应该会影响那些考虑为新手临床教师开展教师发展计划的人的想法。
