Browsing by Author "Matthews, Margaret Glynnis."

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Application of communication skills in an authentic clinical setting: assessing the communication competency of sixth year medical students during history taking.
(2017) Ntando, Ekanda Alfred.; Van Wyk, Jacqueline Marina.; Matthews, Margaret Glynnis.
The Nelson R. Mandela School of Medicine (NRMSM) launched a new 6 year MBChB programme in 2010. This curriculum includes a clinical communication course which emphasises the patient centred approach in line with the Health Professions Council of South Africa Core Competency Framework for undergraduate students. The Calgary-Cambridge Guide to the Medical Interview was adopted as a method for teaching communication. The 2015 final year medical students constituted the first cohort to have been taught clinical communication skills in this manner in the pre-clinical phase. Aim of the study The study was conducted to investigate the transfer of communication skills taught using the Calgary-Cambridge Method (CCM) in the pre-clinical phase to the clinical setting. This study focused mainly on the process skills of history taking and had the following objectives: 1. to determine whether students used the CCM as taught at medical school. 2. To measure and compare process skills of students in two different phases of MBChB programme. 3. To explore role modelling of the CCM by clinical teachers. 4. To describe challenges encountered by students for or in the application of the CCM. Methods The study was observational, analytical and cross-sectional. The population was the 2015 final year class of medical students (n=198) with exception of 13 students who were trained in a different method in Cuba. The study was conducted in the Internal Medicine wards of four teaching hospitals affiliated to the medical school in the Durban functional region. Results The population of the study comprised 185 eligible students; 107 participants were enrolled, and the final number of participants was 105 (57%). In response to the four objectives of the study, the findings revealed that most students used the CCM in a modified manner. There was a marked decline in some of the process skills of history taking, specifically in subcategories such as providing structure and eliciting the patients’ perspective. Educators in Internal Medicine wards did not model the use of the CCM and discouraged its application due to workload and time constraints. Challenges encountered by students included negative attitudes of clinical trainers towards the CCM and language barriers, as most patients spoke in isiZulu. Discussion Results demonstrated that the clinical communication teaching and learning of the pre-clinical phase had some positive impact on application, even if students only used the Calgary Cambridge Method in a modified manner in the clinical phase. The environment of clinical training influenced the transfer, development and the progress of the communication skills learnt in the pre-clinical phase. The decline of process skills in providing structure and eliciting the patient’s perspective was associated with negative attitudes and the poor role modelling of educators. This observation is contradictory to the increase shown in the process skills of building relationship and initiating the session, which probably reflects students’ accumulated experience in the wards. Students encountered challenges associated with language barriers and with different approaches used for personal and organizational reasons. Conclusion With regard to students’ attainment of the HPCSA core competency of communication, and despite communication teaching in the pre-clinical phase and its application in the disciplines of Family Medicine and Rural Health, communication was not equally valued or reinforced in all disciplines involved in undergraduate teaching on the MBChB programme. Key words: communication skills, transfer, application, clinical setting
Vocation-specific isiZulu language teaching and learning for medical students at the University of KwaZulu-Natal.
(2013) Matthews, Margaret Glynnis.; Van Wyk, Jacqueline Marina.
Being an effective communicator is a core competency required of all health care practitioners. Some undergraduate medical students at the Nelson R. Mandela School of Medicine (NRMSM), University of KwaZulu-Natal, Durban, are unable to communicate in isiZulu, the mother tongue of nearly 80% of the 10.2 million people in the province, and the most common home language spoken in South Africa. A one-year isiZulu course to teach communicative competence in the language, and assessed in the first three years of the 6-year MBChB programme, is currently offered at the first year level to medical students. This study was conducted in 2012 to assess how isiZulu clinical communication was perceived by a third year cohort of medical students, and whether current teaching in the period 2010-2012 had prepared them to communicate with their patients. An observational, cross-sectional study design was used to assess the knowledge, attitude and practice of the study group through a self-completed questionnaire. Their knowledge of isiZulu was assessed in a written test, and the students’ marks were compared with their marks in 2010. Oral competence was assessed in an isiZulu history-taking station in the objective structured clinical examination. Students’ comments on their experiences and their recommendations were recorded. Ethics approval was obtained to conduct the study, and informed consent was obtained from participants. Medical students’ competence in isiZulu had improved. They were largely positive about learning the language of their patients but seldom used the language in the clinical setting. Many students indicated that the current teaching of isiZulu in the programme was inadequate for their needs. Although isiZulu is taught to non-isiZulu students, this does not convert into an ability to use the language in the clinical setting. In order for medical students to acquire a satisfactory and safe level of communicative competence in isiZulu, and in line with the UKZN Language Plan to emphasize language training specific to various vocational groups, it is recommended that the teaching, learning and assessment of isiZulu language and culture be integrated into all levels of the undergraduate medical programme in the form of vocation-specific isiZulu for medical students.