Transformation of Medical Curriculum Highlighted at Colloquium
The 2014 NRF Medical Education Colloquium, hosted by UKZN’s Department of Rural Health, was held to launch a study focusing on transforming medical education so that it emphasizes quality, quantity and relevance in keeping with global developments in medical education.
The Department of Rural Health (DRH) HOD, Dr Mosa Moshabela, was recently awarded a R1 million NRF grant to support this study asking the question: How can we change the medical training curriculum to produce graduates able to meet the needs of the health care system in South Africa?
To ensure that the study has high levels of impact, UKZN is partnering with the Academy for Science of South Africa (ASSAf), the South African Committee of Medical Deans (SACOMD), the Health Professions Council of South Africa (HPCSA), and three independent national bodies with a vested interest in generating evidence for the transformation of health professions education.
Apart from these, UKZN is also collaborating with the Universities of Witwatersrand, Limpopo and Walter Sisulu.
Professor Miriam Adhikari, Emeritus Professor of Paediatrics at UKZN, said: ‘We started in the 1990s, initiating changes in medical education. Transformation moves so rapidly that if you do not progress, you become socially accountable to take responsibility. Each hospital deals with different issues and so we need to equip our students, who will become future doctors and nurses. The HPCSA has made changes and every faculty now has to make the core changes to be competent with the HPCSA’s regulations.’
Six themes were discussed at the Colloquium, with various panel members addressing each topic.
Professor Steve Reid of the University of Cape Town spoke on the Medical competencies of graduates, given the HPCSA recommendations, explaining what was happening with the Undergraduate Education and Training Committee at the HPCSA. ‘South Africa’s significant burden of diseases is largely carried by a public health system, and so the National Development Plan is creating an opportunity for a paradigm shift. Moving from a hospi-centric institution to one that is community based care,’ said Reid.
Dr Paula Diab from DRH explained that the medical education curriculum needed to be up to date with global advances and that by adopting innovations, ‘this can aid the health system to grow and meet the needs of the people, asking the fundamental question: Is your training adequately equipping you’?
Dr Honey Mabuza from the University of Limpopo spoke about: Exploring the perceptions of balance between Specialist and Generalist platforms in training a Medical Undergraduate in South Africa. ‘How well is the exiting doctor integrated into the medical field? Students should have integrated learning introduced in their first years of study to make them better aligned with primary health. South Africa requires a model devised between generalist and specialist training to build interdependence between these two levels of care,’ said Mabuza.
Adaptations in Medical training: Fostering Transformative agenda through decentralised training platforms and the need for decentralised learning sites were discussed by Ms Ntsiki Mapukata-Sondzaba of the Rural Health Division of Wits University. ‘Students are trained in tertiary hospitals, but aren’t equipped to handle unfamiliar environments when working in rural areas. Our present models may be academically competent, but culturally and socially, the students are incompetent.’
Moshabela discussed innovative models that promote primary health care through community involvement and what opportunities existed for mutual benefit between medical students and the communities in order to see the fit between training students and health systems/user needs and the opportunity for mutual benefits.
He said ‘in our thinking about competencies, we want to underline that there must be adequate knowledge and medical skills in education for students to benefit both themselves and the community. It is imperative that the role of the institution and its educational activities reflect and is responsive to the health care needs of society.’
The hidden curriculum and null curriculum and their impact, as unscripted and an informal form of education that take place among and between teachers and students, was discussed by Dr Tsholofelo Mhlaba of UKZN’s Department of Public Health. ‘Hidden curriculum encompasses what is learnt in medical school but doesn’t take place within formal course offerings. A null curriculum is the information that educators leave out due to limited time. It affects the competencies of medical graduates.’
Professor Relebohile Moletsane, Professor of Rural Education at Edgewood campus, discussed the Theories of Learning, explaining that each person conceives things differently. With the teaching environment being a power relation between the teacher and the learner, whose knowledge is of most worth? ‘Teaching is not an everyday activity. It is an intellectual activity, and what a teacher believes can inform their students. One needs to understand how a student learns, taking into consideration the context and society in which the student is learning. Teaching involves challenging concepts, and is varied every time.’
Moshabela said: ‘The Colloquium was intended to place the topic of medical transformation on the education agenda in the University. For me it was a good way of launching the three-year research project - networking with UKZN colleagues interested in medical and health professions education research within the University, linking with colleagues in other South African Universities actively involved in medical education and creating a platform to partner with major role players such as ASSAf and SACOMD.
‘My feeling is that we have laid a foundation for an inclusive research process going forward, but a lot of work still needs to be done to ensure that the research will generate locally-relevant evidence for the transformation of medical education.’
Moshabela acknowledged members of the Colloquium organising and scientific team, Dr Neeri Moodley, Ms Sbahle Mkhungo, Ms Roisin Drysdale and Ms Tivani Mashamba-Thompson. He also acknowledged the National Research Foundation, the University Teaching and Learning Office, and the Atlantic Philanthropies under the Centre for Rural Health for funding support; and the College of Health Sciences’ Deputy Vice-Chancellor, Deans and PR Manager for support provided for the Colloquium.
- Zakia Jeewa