Abstract
BackgroundGood communication is integral to social accountability, and training is included in medical curricula internationally. In KwaZulu-Natal, training is conducted in English, in spite of most public sector patients being mother tongue isiZulu speakers. Communication challenges with patients are common, but good communication and African language teaching are not emphasised in teaching.AimThis study explored communication training and how it related to social accountability at a single institution in KwaZulu-Natal.SettingThis exploratory, qualitative case study design at the medical school explored participants’ perceptions about communication and social accountability and reviewed relevant educational documentation for evidence.MethodsPurposive sampling was used to select medical students, educators and stakeholders from the educational and service platforms. Focus group discussions and semi-structured interviews were conducted. The data were thematically analysed with reference to Boelen’s social obligation scale for medical schools.ResultsGood communication was valued, but often poorly role-modelled. Participants agreed that communication and isiZulu teaching were insufficiently supported to respond adequately to the needs of local communities. Social accountability was not well understood by students, while medical school educators and other stakeholders indicated that, despite aspirations, this goal had not yet been achieved.ConclusionsLearning isiZulu language and culture in an integrated manner in both pre-clinical and clinical phases would improve communication with patients, contribute to socially responsive health care, and better address health care needs. Incorporating a social accountability framework in curriculum review would highlight the importance of measuring health outcomes and community impacts, and so enhance the educational mission of the medical school.
Highlights
Good communication is integral to social accountability, and training is included in medical curricula internationally
To be able to communicate effectively, the curriculum needs to expose students to various aspects of communication so that they can understand that effective communication with and beyond the patient in health care is vital to good practice.[5]
Perceptions of benefits and challenges in communication teaching and learning In response to the question that explored the benefits of T&L communication, participants in all groups agreed on its value
Summary
Good communication is integral to social accountability, and training is included in medical curricula internationally. Africa has adopted medical curricula from the West, but, because of contextual challenges, education on the continent has failed to keep up with international advances, possibly contributing to a perpetuation of health disparities.[10] Research in African contexts has highlighted noteworthy deficiencies in how doctors are educated with regard to the social contract between medicine and society.[11] In general and in the South African (SA) context, there is a call to align competencies of medical practitioners with patient, population and health system needs in response to challenges of the 21st century.[12,13,14,15] South Africa has a diverse multicultural population, with 11 official languages and increasing inequality, including in access to and quality http://www.phcfm.org
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