Faculty of Health and Wellness Sciences, Department of Emergency Medical Science, Cape Peninsula University of Technology, Cape Town, South Africa.
Emergency Medical Rescue College, Mbabane, Kingdom of Eswatini.
BMC Health Serv Res. 2021 Aug 10;21(1):787. doi: 10.1186/s12913-021-06829-y.
Post-apartheid, South Africa adopted an inclusive education system that was intended to be free of unfair discrimination. This qualitative study examines the experiences and perceptions of racial discrimination between Emergency Medical Care (EMC) students, clinical mentors, and patients within an Emergency Medical Service (EMS) during clinical practice. Understanding the nature of such discrimination is critical for redress.
Within the conceptual framework of Critical Race Theory, critical ethnographic methodology explored how discriminatory social practice manifests during clinical practice. Semi-structured interviews enabled thematic analysis. We purposively sampled 13 undergraduate EMC students and 5 Emergency Care (EC) providers.
EMC student participants reported experiences of racial and gender discrimination during work-integrated learning (WIL) as they were treated differently on the basis of race and gender. Language was used as an intentional barrier to isolate students from the patients during WIL because EC providers would intentionally speak in a language not understood by the student and failed to translate vital medical information about the case. This conduct prevented some students from engaging in clinical decision-making.
Unfair discrimination within the pre-hospital setting have an impact on the learning opportunities of EMC students. Such practice violates basic human rights and has the potential to negatively affect the clinical management of patients, thus it has the potential to violate patient's rights. This study confirms the existence of discriminatory practices during WIL which is usually unreported. The lack of a structured approach to redress the discrimination causes a lack of inclusivity and unequal access to clinical education in a public clinical platform.
种族隔离后，南非采用了包容的教育系统，旨在消除不公平的歧视。本定性研究考察了在临床实践中，急诊医疗服务（EMS）中的急诊医疗护理（EMC）学生、临床导师和患者之间的种族歧视经历和看法。了解这种歧视的性质对于纠正歧视至关重要。
在批判种族理论的概念框架内，批判民族志方法探讨了在临床实践中歧视性社会实践是如何表现的。半结构化访谈使主题分析成为可能。我们有目的地抽取了 13 名本科 EMC 学生和 5 名急诊护理（EC）提供者。
EMC 学生参与者报告了在工作整合学习（WIL）期间经历的种族和性别歧视，因为他们基于种族和性别受到不同的待遇。语言被用作将学生与 WIL 期间的患者隔离的故意障碍，因为 EC 提供者会故意使用学生听不懂的语言，并且未能翻译有关病例的重要医疗信息。这种行为阻止了一些学生参与临床决策。
院前环境中的不公平歧视对 EMC 学生的学习机会产生影响。这种做法侵犯了基本人权，并有可能对患者的临床管理产生负面影响，从而侵犯了患者的权利。这项研究证实了 WIL 期间存在歧视性做法，而这些做法通常未被报告。缺乏解决歧视的结构化方法导致在公共临床平台上缺乏包容性和平等获得临床教育的机会。
