Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Gauteng Department of Health, Ekurhuleni Health District Services, Germiston.
Afr J Prim Health Care Fam Med. 2022 Mar 14;14(1):e1-e13. doi: 10.4102/phcfm.v14i1.3111.
Specialist training in family medicine (FM) is growing rapidly in sub-Saharan Africa. The strong emphasis on workplace-based learning for speciality training makes it vital to gain in-depth insights into registrar supervision. Previous studies have explored aspects of supervision at decentralised sites in high-income countries, however, little is known about the benefits and constraints of decentralised postgraduate supervision in low- to middle-income countries, especially in Africa.
This study aimed to explore family physicians' and registrars' perceptions of the strengths and challenges of clinical and educational supervision across decentralised training sites.
The study was conducted across two provinces at five decentralised training sites affiliated with the University of the Witwatersrand, Johannesburg.
This qualitative study involved semi-structured interviews with a purposive sample of 11 FPs and 11 registrars. The data were thematically analysed.
Two of the four themes identified, 'supervision is context-specific and supervisor-dependent', and 'the nature of engagement matters', involved strengths and challenges. The other two, 'supervision is not ideal' and 'the training environment is challenging', focussed on challenges.
Supervisors and registrars described the postgraduate FM supervision as context-specific and supervisor-dependent. Supervisors displayed good clinical-teacher characteristics and supervisory relationships. However, several challenges, including registrars' workload, resource shortages and a lack of standardisation across training sites, need to be addressed. Regular faculty development is essential for supervisors to be aware of relevant aspects of, and current trends in, postgraduate training.
在撒哈拉以南非洲，家庭医学（FM）的专科培训正在迅速发展。专科培训非常强调基于工作场所的学习，因此深入了解住院医师的监督至关重要。先前的研究已经探讨了高收入国家分散地点监督的各个方面，但是，对于中低收入国家，尤其是非洲，分散式研究生监督的优势和限制知之甚少。
本研究旨在探讨家庭医生和住院医师对跨分散培训地点的临床和教育监督的优势和挑战的看法。
这项研究是在约翰内斯堡威特沃特斯兰德大学附属的两个省的五个分散培训地点进行的。
这项定性研究采用了半结构化访谈，对来自 11 名家庭医生和 11 名住院医师的目的样本进行了访谈。对数据进行了主题分析。
确定的四个主题中的两个，“监督具有特定的背景和取决于监督者”和“参与的性质很重要”，涉及到优势和挑战。另外两个主题，“监督并不理想”和“培训环境具有挑战性”，则侧重于挑战。
住院医师和导师描述了研究生 FM 监督具有特定背景和取决于监督者的特点。监督者表现出良好的临床教学特征和监督关系。但是，仍需要解决一些挑战，包括住院医师的工作量，资源短缺以及培训地点之间缺乏标准化等问题。定期的教师发展对于监督者了解研究生培训的相关方面和当前趋势至关重要。
