'I felt colonised': emerging clinical teachers on a new rural teaching platform

Abstract

Studies that investigate the impact of long-term rural exposure for undergraduate medical students often focus largely on students' experiences and perspectives. Research focusing on the physician experience in clinical exposures appears to be limited. When the Ukwanda Rural Clinical School (RCS) at the Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa was implemented in 2011, the clinical specialists working at the rural hospitals were expected to take on the additional task of teaching the students in the year-long rotation. The specialists were prepared for the task through a series of workshops. The objective of this study was to explore what the implementation of the RCS meant for the practice of these physicians and to what extent the shift from full-time practising clinician to clinical teacher required them to adapt and change. This was a qualitative study. Semi-structured interviews were conducted with lead clinical specialists who were responsible for teaching medical students in the year-long RCS rotation. Following an interpretive approach, thematic content analysis was performed to obtain a clearer understanding of how these clinicians had experienced their first year as clinical teachers in the RCS. Four overarching themes were identified from the interviews with the clinicians: attitudes towards the implementation of the new medical education model, uncertainty and insecurity as a teacher, emergence of the clinician teacher, and a sense of responsibility for training a future colleague. These depict in part, the journey from clinician to clinician teacher travelled during the first year of implementation. Embracing the role of clinical teacher enabled the development of constructive relationships between clinicians and their students with a mutual sense of responsibility for learning, patient care and improvement in clinical practice. Understanding this journey ought to influence the thinking of those considering faculty development initiatives for novice clinical teachers.