Abstract
Background: The short timeframe of medical students’ rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach.Aim: To describe the process of inducting students into a longitudinal quality-improvement project, using the topic of the Mother- and Baby-Friendly Initiative as a case study; and to explore the possible contribution of a quality-improvement project to the development of student competencies.Setting: Mpumalanga clinical learning centres, where University of Pretoria medical students did their district health rotations.Method: Consecutive student groups had to engage with a hospital's compliance with specific steps of the Ten Steps to Successful Breastfeeding that form the standards for the Mother- and Baby-Friendly Initiative. Primary data sources included an on-site PowerPoint group presentation (n = 42), a written group report (n = 42) and notes of individual interviews in an end-of-rotation objectively structured clinical examination station (n = 139).Results: Activities in each rotation varied according to the needs identified through the application of the quality-improvement cycle in consultation with the local health team. The development of student competencies is described according to the roles of a medical expert in the CanMEDS framework: collaborator, health advocate, scholar, communicator, manager and professional. The exposure to the real-life situation in South African public hospitals had a great influence on many students, who also acted as catalysts for transforming practice.Conclusion: Service learning and quality-improvement projects can be successfully integrated in one rotation and can contribute to the development of the different roles of a medical expert. More studies could provide insight into the potential of this approach in transforming institutions and student learning.
Highlights
The report of the Global Independent Commission on the Education of Health Professionals for the 21st Century recommends health education reforms that make provision for transformative learning in academic systems of hospitals and primary care networks rather than in academic centres.[1]
The quality improvement (QI) project contributed to the development of students as medical experts
Professional In the Mother- and Baby-Friendly Initiative (MBFI) QI project, students expanded their role as professionals by discovering that the art of medicine is much more than the care for individual patients: ‘While assessing what the focus of our QI project would be, we reviewed the quality improvement cycle and the principles of quality improvement in district hospitals
Summary
The report of the Global Independent Commission on the Education of Health Professionals for the 21st Century recommends health education reforms that make provision for transformative learning in academic systems of hospitals and primary care networks rather than in academic centres.[1]. [t]he education of health professionals in the 21st century must focus less on memorising and transmitting facts and more on promotion of the reasoning and communication skills that will enable the professional to be an effective partner, facilitator, adviser, and advocate. The Royal College of Physicians and Surgeons of Canada proposes the CanMEDS framework to develop leadership attributes and competencies.[2] This model describes the different roles performed by a competent medical expert: collaborator, health advocate, scholar, communicator, manager and professional.[2] The Accreditation Council for Graduate Medical Education (ACGME) divides the core competencies for residents into six areas: patient care and procedural skills; medical knowledge; interpersonal and communication skills; professionalism; practice-based learning and improvement (PBLI); and systems-based practice (SBP).[3]. The short timeframe of medical students’ rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach
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