Ukwanda Centre for Rural Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Western Cape, South Africa
Division of Human Nutrition, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Western Cape, South Africa
Rural Remote Health. 2023 Jul;23(3):7671. doi: 10.22605/RRH7671. Epub 2023 Jul 28.
Distributed training of students from a variety of health professions is increasing in South Africa because of the type of learning it offers and that it caters for the increasing number of students being accepted into health sciences programs. Challenges and facilitators to distributed training are well documented in the literature, and include increased distance from the academic home, human resources for health challenges, student access to support systems, and identifying learning environments to match learning outcomes. In the case of the Rural Clinical School in the Western Cape, South Africa, 'academic coordinators' were employed on site to fulfil the role of coordinating and supervising student learning and community engagement. This article explores their experiences.
A large-scale qualitative study was conducted in 2017 exploring the history and development of the Ukwanda Centre for Rural Health and the Rural Clinical School. Part of this study included semi-structured individual and focus group interviews with consenting academic coordinators exploring their experiences of developing and working on a rural distributed training platform in South Africa. Data were inductively analysed. Ethical approval and institutional permission were obtained for this study, and all participants provided consent.
In addition to previously published challenges that clinical supervisors who are employed by the health system face, the academic coordinators reported facing challenges related to professional isolation, boundary blurring between providing student support versus acting as clinical educator, juggling multiple line managers and administrative responsibilities, navigating the new field of academia, and not having the potential for career progression.
Reflecting on the needs of academic coordinators expressed in this article, we identified four conditions that may promote sustained and continuous academic coordination at rural or remote distributed training sites. These conditions are (1) living and working local; (2) having a dual role in academia and the health system; (3) having access to academic support; and (4) regular engagement with the academic home, the value of which is detailed in this article. These recommendations can be adopted to optimise and sustain academic engagement on the distributed training platform, especially in light of the current expansion of health professions training and subsequent need to attract and retain clinician-academics in remote locations.
由于分布式培训提供的学习方式以及越来越多的学生被健康科学项目录取,南非越来越多的来自各种健康职业的学生进行分布式培训。文献中详细记录了分布式培训的挑战和促进因素,包括远离学术基地的距离增加、卫生人力资源挑战、学生获得支持系统的机会以及确定与学习成果相匹配的学习环境。在南非西开普省的农村临床学校,“学术协调员”被雇用在现场履行协调和监督学生学习和社区参与的角色。本文探讨了他们的经验。
2017 年进行了一项大规模的定性研究,探索了 Ukwanda 农村卫生中心和农村临床学校的历史和发展。这项研究的一部分包括对同意参与的学术协调员进行半结构式个人和焦点小组访谈,探讨他们在南非开发和从事农村分布式培训平台的经验。数据进行了归纳分析。本研究获得了伦理批准和机构许可,所有参与者均提供了同意。
除了之前发表的卫生系统雇用的临床主管面临的挑战外,学术协调员还报告了与职业孤立、在提供学生支持与作为临床教育者之间的界限模糊、兼顾多个直线经理和行政职责、在新的学术界领域导航以及没有职业发展潜力相关的挑战。
根据本文中表达的学术协调员的需求,我们确定了可能促进农村或偏远分布式培训点持续和持续学术协调的四个条件。这些条件是:(1)在当地生活和工作;(2)在学术界和卫生系统中具有双重角色;(3)获得学术支持;(4)定期与学术基地接触,本文详细说明了其价值。这些建议可以被采纳,以优化和维持分布式培训平台上的学术参与,特别是考虑到当前健康职业培训的扩张以及随后在偏远地区吸引和留住临床学者的需求。