Mash Robert, Blitz Julia, Edwards Jill, Mowle Steve
Division of Family Medicine and Primary Care, Stellenbosch University.
Afr J Prim Health Care Fam Med. 2018 May 31;10(1):e1-e6. doi: 10.4102/phcfm.v10i1.1589.
The training of family physicians is a relatively new phenomenon in the district health services of South Africa. There are concerns about the quality of clinical training and the low pass rate in the national examination.
To assess the effect of a five-day course to train clinical trainers in family medicine on the participants' subsequent capability in the workplace.
Family physician clinical trainers from training programmes mainly in South Africa, but also from Ghana, Uganda, Kenya, Malawi and Botswana.
A before-and-after study using self-reported change at 6 weeks (N = 18) and a 360-degree evaluation of clinical trainers by trainees after 3 months (N = 33). Quantitative data were analysed using the Statistical Package for Social Sciences, and qualitative data wereanalysed thematically.
Significant change (p < 0.05) was found at 6 weeks in terms of ensuring safe and effective patient care through training, establishing and maintaining an environment for learning, teaching and facilitating learning, enhancing learning through assessment, and supporting and monitoring educational progress. Family physicians reported that they were better at giving feedback, more aware of different learning styles, more facilitative and less authoritarian in their educational approach, more reflective and critical of their educational capabilities and more aware of principles in assessment. Despite this, the trainees did notreport any noticeable change in the trainers' capability after 3 months.
The results support a short-term improvement in the capability of clinical trainers following the course. This change needs to be supported by ongoing formative assessment and supportive visits, which are reported on elsewhere.
在南非地区卫生服务中，家庭医生培训是一个相对较新的现象。人们对临床培训质量以及全国考试的低通过率存在担忧。
评估为期五天的家庭医学临床培训师培训课程对参与者随后在工作场所能力的影响。
主要来自南非，但也有来自加纳、乌干达、肯尼亚、马拉维和博茨瓦纳培训项目的家庭医生临床培训师。
采用前后对照研究，在6周时进行自我报告的变化评估（N = 18），并在3个月后由学员对临床培训师进行360度评估（N = 33）。定量数据使用社会科学统计软件包进行分析，定性数据进行主题分析。
在6周时发现有显著变化（p < 0.05），涉及通过培训确保安全有效的患者护理、建立和维护学习环境、教学和促进学习、通过评估加强学习以及支持和监测教育进展。家庭医生报告称，他们在提供反馈方面做得更好，更了解不同的学习风格，在教育方法上更具促进性且更少专制，对自己的教育能力更具反思性和批判性，并且更了解评估原则。尽管如此，学员在3个月后并未报告培训师的能力有任何明显变化。
结果支持该课程后临床培训师能力的短期提升。这种变化需要通过持续的形成性评估和支持性访问来维持，这在其他地方有相关报道。
