Faculty of Medicine and Health Sciences, Stellenbosch University, ZA.
Ann Glob Health. 2018 Apr 30;84(1):58-65. doi: 10.29024/aogh.17.
Medical schools in Africa are responding to the call to increase numbers of medical graduates by up-scaling decentralized clinical training. One approach to decentralized clinical training is the longitudinal integrated clerkship (LIC), where students benefit from continuity of setting and supervision. The ability of family physician supervisors to take responsibility for the clinical training of medical students over a longer period than the usual, in addition to managing their extensive role on the district health platform, is central to the success of such training.
This study investigated the teaching experiences of family physicians as clinical supervisors in a newly introduced LIC model in a rural sub-district in the Western Cape, South Africa.
Nine semi-structured interviews were conducted with six family physicians as part of the Stellenbosch University Rural Medical Education Partnership Initiative (SURMEPI) five-year longitudinal study. Code lists were developed inductively using Atlas.ti v7, they were compared, integrated, and categories were identified. Emerging common themes were developed. Findings: Three overarching themes emerged from the data, each containing subthemes. The rural platform was seen to be an enabling learning space for the LIC students. The family physicians' experienced their new teaching role in the LIC as empowering, but also challenging. Lack of time for teaching and the unstructured nature of the work emerged as constraints. Despite being uncertain about the new LIC model, the family physicians felt that it was easier to manage than anticipated. Conclusion: The centrality of the rural context framed the teaching experiences of the family physicians in the new LIC, forming the pivot around which constraints and opportunities for teaching arose. The African family physician is well positioned to make an important contribution to the upscaling of decentralized medical training, but would need to be supported by academic institutions and health service managers in their teaching role.
非洲的医学院校正在响应号召，通过扩大分散式临床培训来增加医学毕业生的数量。分散式临床培训的一种方法是纵向综合实习（LIC），学生可以从连续性的环境和监督中受益。家庭医生导师能够在比通常更长的时间内承担医学生的临床培训责任，除了在地区卫生平台上管理他们广泛的角色外，这对于这种培训的成功至关重要。
本研究调查了南非西开普省农村分区新引入的 LIC 模式中家庭医生作为临床导师的教学经验。
作为斯坦陵布什大学农村医学教育伙伴关系倡议（SURMEPI）五年纵向研究的一部分，对六名家庭医生进行了九次半结构化访谈。使用 Atlas.ti v7 归纳性地开发了代码列表，对其进行了比较、整合，并确定了类别。发展了新兴的共同主题。
从数据中得出了三个总体主题，每个主题都包含子主题。农村平台被视为 LIC 学生的有利学习空间。家庭医生在 LIC 中的新教学角色被认为是赋权的，但也具有挑战性。缺乏教学时间和工作的非结构化性质成为限制因素。尽管对新的 LIC 模式感到不确定，但家庭医生认为它比预期更容易管理。
农村背景的核心地位框定了家庭医生在新 LIC 中的教学经验，形成了教学机会和限制出现的支点。非洲家庭医生完全有能力为扩大分散式医学培训做出重要贡献，但需要得到学术机构和卫生服务管理者在教学角色方面的支持。
