SWITCH: Flattening the Hierarchy

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UKZN’s College of Health Sciences, as a previous Medical Education Partnership Initiative (MEPI) recipient, was awarded a nine-month grant (1 August 2019 – 31 March 2020) by the Human Resources and Services (HRSA) through the University of California in San Francisco (UCSF), to Strengthen Interprofessional Education for HIV (STRIPE).

This is supportive of the President’s Emergency Plan for AIDS Relief (PEPFAR’s) commitment to strengthening the calibre of HIV training for health professional students, with the goal of improving the quality of HIV service provision delivered by graduating doctors, nurses and pharmacists.

Dean and Head of School of Nursing and Public Health, Professor Mosa Moshabela is the principal investigator on the grant, while Professor Fatima Suleman, Professor Fikile Mtshali and Dr Serela Ramklass are key personnel.

The UKZN project, titled: Strengthening the Workforce to Improve Treatment and Care for HIV (SWITCH), will provide training for final-year students in Medicine, Nursing, and Pharmacy by a small cohort of interns and community service health professionals at decentralised sites. The goal is to prepare trainees to have capacity to improve the quality of care in practice by working in teams and using the pedagogy of interprofessional education and collaborative practice focusing on using continuous quality improvement skills.

Project partners are the Prince Mshiyeni Memorial Hospital Nursing College, the KwaZulu-Natal Nursing College, and the Sefako Makgato Health Sciences University (SMU). UKZN will also be providing assistance to the Mpumalanga Nursing College (MNC).

The SWITCH project launched at UKZN in September this year with a few train-the-trainer workshops to train the facilitators, which included UKZN academics and KwaZulu-Natal Department of Health programme managers, who introduced students to concepts of interprofessional education, and continuous quality improvement to improve HIV education and the care of patients.

A series of workshops was held for final-year Medical, Nursing and Pharmacy students, which introduced the students to interprofessional education and quality improvement concepts. These workshops were offered to UKZN Medical, Nursing and Pharmacy students; Nursing students from the RK Khan and Addington Campuses. Once the introductory sessions were completed, students who were interested signed up to attend a two-day workshop to take them through the STRIPE modules which dealt with varying real-life medical situations the students would experience in their year of internship. The purpose of SWITCH is to train future health care providers to deliver high quality team-based and patient-centered care.

During the workshop, health professionals were divided into groups in which each profession was represented. The mainstay of SWITCH is to illustrate to the future health care providers that every member of the health care team is important to provide quality care to patients; therefore flattening the hierarchy of care.

Final-year Medical student Mr Nhlakanipho Mkhize, had the following to say about the training: ‘It was great, especially for us Medical students because our campus is secluded so we do not get to interact with other disciplines. Being isolated we start thinking we are the only ones who are informed, we are generally arrogant and ignorant about what other people are doing and this is why this was most beneficial for me,’ he said.

‘It was interesting to hear how the Nursing students explain to patients how to use medication, I realised how much we doctors have difficulty in simplifying things and tend to use medical jargon. Pharmacy students were very informative about drug interactions, side effects and being able to explain all of that to patients. It would be nice if social workers, psychologists, occupational therapists and physiotherapists were included in the training, as you really don’t know between them where you are going to send a patient. For example, between a social worker and a psychologist, where should a patient go?’

The mixing of the different healthcare professionals opened their minds to the possibility of working together in practice and showing the students that each health practitioner played an integral part in taking care of patients and making sure that the patients came first.

Many students hoped the SWITCH training could be incorporated into their curriculum as the sessions covered vital information that some of them had not encountered during their years as health professional students. For the students the most valuable aspect of the training workshops was that they had been exposed to problems they may encounter in practice. Having attended the training they gained confidence for the next phase of their careers.

Words and Photograph: Lungelo Khanyile