scholarly journals Factors influencing choice of site for rural clinical placements by final year medical students in a South African university

Author(s):  
Nontsikelelo O. Mapukata ◽  
Rainy Dube ◽  
Ian Couper ◽  
Motlatso G. Mlambo

Background: Most of South Africa’s citizens who live in rural or underserved communities rely on the public health care sector to access quality health care. The value of rural exposure through clinical placements is well documented. Medical schools in South Africa have a responsibility to provide solutions that address the prevailing human resources challenges. Despite this commitment, medical students do not necessarily appreciate their role in resolving South Africa’s human resources challenges. This study aimed to assess the factors that influenced the choice of clinical learning sites in a self-selection process undertaken by Wits final year medical students for the compulsory 6-week integrated primary care block rotation.Methods: Qualitative data related to reasons for choice of service learning site were gathered from 524 pre-placement questionnaires completed by final year medical students entering the rotation over a 3-year period (2012–2014). Thematic analysis was performed using the MAXQDA software.Results: Eight themes emerged from the study indicating that the majority of participants were in favour of local urban underserved placement. Contextual factors, such as work commitments or family responsibilities, being compromised socially and losing academic standing were the main reasons for seeking urban placement. Good supervision, opportunistic learning, skills development and moral support were reasons for seeking rural placements. Previous voluntary exposure to rural practice or being of rural origin was a strong indicator for uptake of rural placement.Conclusion: This study has demonstrated the challenges faced by coordinators in balancing personal and institutional needs with country needs and the contextual factors that must be considered when implementing medical education programmes that respond to social challenges.

PRiMER ◽  
2020 ◽  
Vol 4 ◽  
Author(s):  
Lucy Bickerton ◽  
Nicolle Siegart ◽  
Crystal Marquez

Introduction: Medical schools are now required to address health disparities within their curriculum, with a recent emphasis on social determinants of health (SDOH). However, there is scant evidence that incorporating educational experiences around SDOH impacts health equity for patients. The COVID-19 pandemic provided a unique setting to engage students to address SDOH directly with patients. Methods: The authors designed a service-learning experience in which medical students conducted a patient needs assessment survey by phone to assess SDOH in the domains of health care access, economic stability, and social cohesion. We drew descriptive statistics from a deidentified Excel database of call outcomes to quantify health care interactions and community resource referrals generated by callers. Results: The call outcomes revealed unmet health and social needs among the patient population and generated a substantial number of actions to improve health care access and awareness of community resources. Conclusion: The results of this project show that employing medical students to engage with SDOH through action-oriented service learning positively impacts health care access and referrals to community resources. This initiative provides a flexible model to engage medical trainees in addressing health-related social needs that can be applied to a range of clinical settings and learner levels.


2014 ◽  
Vol 155 (21) ◽  
pp. 822-827
Author(s):  
Ágnes Váradi

The question of electronic solutions in public health care has become a contemporary issue at the European Union level since the action plan of the Commission on the e-health developments of the period between 2012 and 2020 has been published. In Hungary this issue has been placed into the centre of attention after a draft on modifications of regulations in health-care has been released for public discourse, which – if accepted – would lay down the basics of an electronic heath-service system. The aim of this paper is to review the basic features of e-health solutions in Hungary and the European Union with the help of the most important pieces of legislation, documents of the European Union institutions and sources from secondary literature. When examining the definition of the basic goals and instruments of the development, differences between the European Union and national approaches can be detected. Examination of recent developmental programs and existing models seem to reveal difficulties in creating interoperability and financing such projects. Finally, the review is completed by the aspects of jurisdiction and fundamental rights. It is concluded that these issues are mandatory to delineate the legislative, economic and technological framework for the development of the e-health systems. Orv. Hetil., 2014, 155(21), 822–827.


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