Makerere University College Research Articles

Dissemination of medical research findings among medical researchers in a tertiary institution in Uganda

Background: Dissemination of research findings is a key obligation for researchers. It increases access to evidence and the ability to use and apply the evidence. Repackaging of research findings to inform policy and practice is not yet embraced in many low-and-middle income countries that have under-resourced health care systems. Objective: To determine the methods of communication of research findings by researchers at the Makerere University College of Health Sciences as well as the facilitators and barriers faced while disseminating the findings. Methods: This was a concurrent nested mixed-methods study among researchers. Key informant interviews and self-administered questionnaires were used. The collected Qualitative data was examined through thematic analysis. Quantitative data were analysed with STATA version 15.0, analysing categorical variables using frequencies and percentages. Results: Of 176 researchers involved in the quantitative survey, more than half (60%, n=106) were males and 40.9%(n=84/176) were lecturers. The most used dissemination method was journal publications (71.6%, n=126) followed by presentations in conferences/workshops (62.5%, n=110). Twelve researchers participated as key informant interviewees. Themes that emerged included: benefits, facilitators and challenges faced in research communication. Conclusions: Research findings are commonly disseminated through journals and conference presentations. However, researchers face challenges like financial constraints, time limitations, and misrepresentation of findings. Keywords: Dissemination of medical research; Journal Publication; Community engagement.

Barriers and facilitators of evidence-based practice among lecturers at Makerere University College of Health Sciences, Uganda: a qualitative study

Barriers and facilitators of evidence-based practice among lecturers at Makerere University College of Health Sciences, Uganda: a qualitative study

Ngũgĩ wa Thiong'o’s Writing Career: the Rise and the Development of a Dynamic African Literary Star

A myriad of Ngugi’s readers may presuppose that the literary career of this celebrated African writer began at the University. Albeit it was at Makerere that he triumphantly wrote and subsequently published his first and second novels, Weep Not Child and The River Between for which reason he reveals in his own words that “I started writing in 1960. I was then a student at Makerere University College” (Homecoming: 47), and for Lindfords, Ngugi’s literary career begun specifically “towards the end of 1960” (23), evidences corroborate that Ngugi has started his literary writing since at the secondary school: the Alliance High School. The motive behind this article is to unveil that Ngugi’s literary writing career history is marvellous and distinctive. Although famous African writers the likes of late Achebe have written earlier than him, he is such a rare prolific writer, who has written at different places, at different periods, for different motives, with varying degrees of inspirations, all of which demonstrate an unprecedented, literary dynamism in his entire literary writing career.

Attitudes and usage of visual-aids in graduate student learning of gross anatomy at Makerere University.

The increasing numbers of students studying human anatomy at Makerere University are beginning to overwhelm available resources, which presents challenges in learning and necessitates an evaluation of alternative ways to enhance anatomy learning.The increasing numbers of students overwhelm resources available and presents challenges in learning. This necessitates an evaluation of alternatives to enhance gross anatomy learning at Makerere University College of Health Sciences. The study aimed to assess the usage of visual aids and generate necessary information to enhance learning. A cross-sectional study employing a concurrent triangulation mixed method design was conducted among 44 graduate students actively participating in cadaveric dissection. Data was collected using self-administered questionnaires and two focus group discussions. Descriptive statistics and thematic analysis were used to summarize data. Most participants were male (77.3%) with a mean age of 31.5 years (SD 3.9, Range, 27-45 years). A majority of graduate students reported using non-traditional methods (online sources) to supplement learning. Students commonly used hard copies of Cunningham Manual of Practical Anatomy (88.6%) supplemented with well-illustrated textbooks (79.5%) and online dissection videos (72.7%). Students expressed most satisfaction with the use of videos and well-illustrated text books in supplementing learning. The availability of these electronic resources was limited by factors such as poor internet connectivity and the need to pay for online licenses and subscription fees. Graduate students in the Department of Anatomy at MakCHS are using non-traditional methods to supplement their learning. However, there are several challenges to accessing digital resources. There is a need to support students with accessing visual aids through integrating newer teaching modalities and modern technology to promote interest and retention of anatomical knowledge.

Prevalence and effects of menstrual disorders on quality of life of female undergraduate students in Makerere University College of health sciences, a cross sectional survey

BackgroundMenstrual problems affect as high as 90% of adolescent females and are the main reason for gynecology visits. Dysmenorrhea was the most frequent menstrual disorder for which adolescents and their parents were referred to a physician. Many undergraduate students are adolescents who undergo several hormonal changes that affect menstrual patterns. This study aimed to determine the prevalence of menstrual disorders and to determine the effect of menstrual disorders on quality of life (QOL) of female undergraduate students at Makerere University college of health sciences.MethodsA cross sectional study design using a self-administered questionnaire. WHO (World Health Organization) QOL-BREF (QOL-Best Available Reference document) questionnaire was used to assess QOL of participants. Collected data was double entered into EPIDATA, and transferred to STATA for analysis. Data was presented using tables, and analyzed using percentages, frequencies, medians, interquartile range, means and standard deviations, t-test and ANOVA were used to establish statistical significance. P < 0.05 was considered statistically significant.ResultsOf the participants, 275 were included in the data analysis. The median age of the participants was 21 years with range of 18–39 years and interquartile range of 20–24 years. All the participants had attained menarche. Of the participants, 97.8% (95%CI: 95.2–99.0) (269/275) reported some form of menstrual disorder. Premenstrual symptoms were the commonest disorder (93.8% (95%CI: 90.2–96.1), N = 258) followed by dysmenorrhea (63.6% (95% CI: 57.7–69.1), N = 175), irregular menstruation (20.7% (95%CI: 16.3–25.9), N = 57), frequent menstruation (7.3% 95% CI:4.7–11.0, N = 20) and infrequent menstruation (3.3% (95% CI:1.7–6.2), N = 9). Dysmenorrhea and premenstrual symptoms significantly reduced the QOL scores of participants.ConclusionMenstrual disorders were highly prevalent with negative effects on QOL and class attendance. Efforts should be made to screen and possibly treat menstrual disorders among university students as well as to conduct further studies to elucidate more on the effects of menstrual disorders on quality of life.

Evaluation of a competency based medical curriculum in a Sub-Saharan African medical school

BackgroundMedical schools in Sub-Saharan Africa have adopted competency based medical education (CBME) to improve the quality of graduates trained. In 2015, Makerere University College of Health Sciences (MaKCHS) implemented CBME for the Bachelor of Medicine and Bachelor of Surgery (MBChB) programme in order to produce doctors with the required attributes to address community health needs. However, no formal evaluation of the curriculum has been conducted to determine whether all established competencies are being assessed.ObjectiveTo evaluate whether assessment methods within the MBChB curriculum address the stated competencies.MethodsThe evaluation adopted a cross-sectional study design in which the MBChB curriculum was evaluated using an Essential Course Evidence Form (ECEF) that was developed to collect information about each assessment used for each course. Information was collected on: (1) Assessment title, (2) Description, (3) Competency domain (4) Sub-competency addressed, (5) Student instructions, and (6) Grading method/details. Data were entered into a structured Access data base. In addition, face-to-face interviews were conducted with faculty course coordinators.ResultsThe MBChB curriculum consisted of 62 courses over 5 years, focusing on preclinical skills in years 1–2 and clinical skills in years 3–5. Fifty-nine competencies were identified and aggregated into 9 domains. Fifty-eight competencies were assessed at least one time in the curriculum. Faculty cited limited training in assessment as well as large student numbers as hindrances to designing robust assessments for the competencies.ConclusionCBME was successfully implemented evidenced by all but one of the 59 competencies within the nine domains established being assessed within the MBChB curriculum at MaKCHS. Faculty interviewed were largely aware of it, however indicated the need for more training in competency-based assessment to improve the implementation of CBME.

Biobanking in East and Central Africa: A case of the Integrated Biorepository of H3Africa Uganda.

Biorepositories are essential because they guarantee the proper storage and distribution of biospecimens and their associated data for current and future research. In Eastern and Central Africa, the Integrated Biorepository of H3Africa Uganda (IBRH3AU) at Makerere University in Uganda was the first of its kind. It is strategically located at Makerere University College of Health Sciences, which is home to some of Uganda's most relevant and impactful infectious and non-infectious disease research. Since its inception as a pilot project in 2012, the IBRH3AU biorepository has grown into a state-of-the-art facility serving the H3Africa consortium and the rest of the scientific community. IBRH3AU has built a solid infrastructure over the past ten years with cutting-edge methods and technologies for the collection, processing, quality control, handling, management, storage and shipment of biospecimens. H3Africa researchers, local researchers, postgraduate and postdoctoral students, and the greater scientific community in Eastern and Central Africa and beyond have benefited from IBRH3AU's exceptional biobanking services.

Infectious Diseases Institute at Makerere University College of Health Sciences: a case study of a sustainable capacity building model for health care, research and training.

Twenty years of sustained investment in infrastructure, human capital, leadership, and collaborations present Makerere University and the sub-Saharan Africa region with an agile center of excellence with preparedness to meet the current and future challenges to global health.

Makerere University-Uganda Heart Institute collaborative cardiovascular disease training and research since 1988.

Makerere University College of Health Sciences has been collaborating with the Uganda Heart Institute to build capacity for research, training and clinical care in cardiovascular medicine for the last 34 years to appropriately respond to rising societal needs for advanced cardiovascular care which was lacking before this period. To describe the major milestones in the MakCHS-UHI cardiovascular training collaboration and chart way for future collaborations. This short communication highlights some of the salient features and important milestones in the collaboration journey of the two institutions. Clinical centres of excellence in specialised fields of health care, such as the Uganda Heart Institute for Cardiology, provide a conducive academic environment for MakCHS clinical scientists to provide high quality evidence-based care to meet societal needs.

Use of individual development plans: experiences from junior faculty in the "NURTURE" mentored research program at Makerere University College of Health Sciences.

Individual Development Plan (IDP) is a multi-component career planning worksheet that guides trainees through an iterative self-assessment. This paper provides the first investigation of IDP use and experiences among junior faculty at academic institutions in low- and middle-income countries (LMICs) where IDP is seldomly used by trainees. An online survey determined the utilization and impact of IDP among junior faculty trainees enrolled on "NURTURE" mentored research program to support career development for faculty at Makerere University College of Health Sciences (MakCHS) between 2016-2020. Responses were received between March and June 2021, a period of intense COVID-19 pandemic in the country. Of 64 trainees 64(39%) were female and 60/64(98%) developed an IDP during the fellowship period; of whom 45/60(75%) had never been exposed to IDP. Trainees' benefits included intentional thinking about own career goals and support to execute the goals as well as self-management skills of time management and communication, among others. IDP was well-received by junior faculty trainees, with several self-management and motivation benefits to the scholars. We recommend that academic programs and faculty at academic institutions in LMIC should consider taking on the IDP approach to promote focused career development for all trainees including junior faculty.

Health Service delivery and training at Makerere University College of Health Sciences: The role of the academic health centers' network.

Academic Health Centers provide a network of clinical training facilities for high quality service delivery, within clinical training and research settings. At an academic health/medical center, education, research, and clinical care are combined to provide the best possible clinical care, which uses cutting-edge technologies, resources and therapies other community hospitals may not have available. This paper summarizes the network of teaching hospitals for health care training in the last century of Makerere University College of Health Sciences, its local and regional impact, lessons learned and future of actively engaging the network of academic health centers to expand clinical training and research opportunities to meet the needs of the 21st Century populations. Medical schools and training hospitals need to integrate of their roles in research, education, and patient care to provide evidence-based interventions and innovations to both treat illness and improve health.

A quality improvement project assessing a new mode of lecture delivery to improve postgraduate clinical exposure time in the Department of Internal Medicine, Makerere University, Uganda.

BackgroundThe Masters in Internal Medicine at the Makerere University College of Health Sciences is based on a semester system with a blend of lectures and clinical work. The programme runs for 3 years with didactic lectures set mostly for mornings and clinical care thereafter. Anecdotal reports from attending physicians in the department highlighted clinical work time interruption by didactic lectures which was thought to limit postgraduate (PG) students’ clinical work time. We set out to evaluate the clinical learning environment and explore avenues to optimise clinical exposure time.MethodsBaseline data in form of time logs documenting first-year PG activities was collected by intern doctors without the awareness of the PGs. In addition, a PG and attending physician survey on PG ward performance was carried out. These data informed a root cause analysis from which an intervention to change the mode of lecture delivery from daily lecturers across the semester to a set of block lectures was undertaken. Postimplementation time logs and survey data were compared with the pre-intervention data.ResultsPost-intervention, during a period of 50 ward round observations, PGs missed 3/50 (6%) ward rounds as compared with 10/50 (20%) pre-intervention. PGs arrived on wards before attending physicians 18/24 (75%) times post-intervention and on average had 59 min to prepare for ward rounds as compared with 5/26 (19.2%) times and 30 min, respectively, pre-intervention. Both PGs and physicians believed PGs had enough time for patient care post-intervention (17/17 (100%) vs 4/17 (23.5%) and 7/8 (87.5%) vs 2/8 (25%)), respectively.ConclusionThe baseline data collected confirmed the anecdotal reports and a change to a block week lecture system led to improvements in PGs’ clinical work time and both resident and physician approvals of PG clinical work.

Perceptions of Lecturers, Administrators, and Students About the Workplace as Learning Environment for Undergraduate Medical Students at a National Referral and Teaching Hospital in Uganda.

PurposeThe workplace is an important element of the learning ecosystem for medical students during their competence development. It offers engagement opportunities that enable students to participate in clinical activities as part of learning in their preparation for future clinical practice. The purpose of this study was to explore the perceptions and experiences of lecturers, administrators, and students of Makerere University College of Health Sciences about the workplace, at Mulago National Referral and Teaching Hospital, as a learning environment for the undergraduate medical students with the ultimate aim of identifying opportunities and challenges to learner competence development in the learning environment for purposes of improvement.MethodsThe study design was cross-sectional descriptive with a qualitative approach using key informant interviews for the lecturers and administrators and focus group discussions for the students. The framework method was used to perform thematic data analysis.ResultsThe workplace was perceived to be well endowed with adequate patient numbers, a suitable case mix and unrestricted access to patients which enhanced competence development. The challenges reported included inadequate resources, such as infrastructure, equipment and supplies and overcrowding, which compromised competence development. The resource challenge appeared insurmountable in the context of two autonomous institutions with divergent planning priorities in terms of teaching, research, and patient care.ConclusionThere were mixed perceptions about the learning environment at the hospital with both enabling and challenging factors on the backdrop of two autonomous institutions with divergent planning priorities in terms of teaching, research, and patient care. In order to improve the workplace as a learning environment, it is imperative that the two institutions find common ground in terms of clinical care, students’ teaching and provision of supplies that are essential not only for patient care but competence development of the learners who are the clinicians of tomorrow.

Factors Affecting Students’ Attitude towards Learning Chinese as a Second Language: A Case Study of the Confucius Institute at Makerere University and Luyanzi College, Uganda

The relationship between Uganda and China has promoted trade and people-to-people contact. In recent years, Chinese enterprises and other investments have been established in Uganda. Many Ugandans visit China for trade, tourism, and education. Learning Chinese in Uganda is becoming more and more important because the language opens up so many doors. The study focused on students learning Chinese as a second language at the Confucius Institute, Makerere University, and Luyanzi College. The research article explored the factors affecting attitude toward learning Chinese as a second language as well as their goals for learning Chinese. This study employed a quantitative approach by sending questionnaires to students learning Chinese at the Confucius Institute, Makerere University, and Luyanzi College. A total of 82 students were recruited for the study; 50 from Makerere University and 32 from Luyanzi College. The study unequivocally revealed that a positive attitude remains the most vital factor in learning Chinese as a second language at the Confucius Institute at Makerere University and Luyanzi College. Learners showed a positive attitude towards learning the Chinese language since most of the responses indicated that they enjoyed learning the Chinese language and learned Chinese for better jobs and business opportunities. However, there are factors such as limited learning materials, lack of opportunities to practise the language, the age of the students and their gender that negatively affect students’ attitude towards learning the Chinese language. Therefore, the researchers recommend that scholarships be granted to students with a desire and passion for the language. Chinese language teachers should develop teaching strategies that yield motivation and also try to bridge the gap between the teachers and students. Furthermore, more exchange programmes should be established between Uganda and China so that more students can travel between the two countries. This would give people more opportunities to learn and practice the Chinese language.

Development of a feedback framework within a mentorship alliance using activity theory.

Background.Mentorship is useful in enhancing student learning experiences. The provision of feedback by faculty mentors is a central activity within a fruitful mentorship relationship. Therefore, effective feedback delivery by mentors is key to the development of successful mentorship relationships. Mentorship is a social interactive relationship between mentors and mentees. Therefore, activity theory, a sociocultural theory, has been applied in this study to develop a framework for feedback delivery within the mentorship educational alliance between mentors and mentees.Objective.The purpose of the study was to explore experiences of students and faculty mentors regarding feedback in a mentorship relationship, and to develop a feedback delivery framework in a mentorship relationship underpinned by activity theory.Methods.This was a mixed-method sequential study conducted at Makerere University College of Health Sciences using both quantitative and qualitative data collection methods. The study involved undergraduate medical students and faculty mentors. Data were collected through self-administered questionnaires, focus group discussions and interviews. Descriptive statistics were used for quantitative data, while thematic analysis was used for qualitative data.Results.Most students reported negative experiences with feedback received during the mentorship process. Of the total of 150, a significant number of students (n=60) reported receiving no feedback at all from their mentors. One hundred students reported that feedback received from mentors focused on only weaknesses, and 80 reported that the feedback was not timely. A total of 130 students reported that the feedback sessions were a one-way process, with limited involvement of mentees. The feedback also tended to focus on academics, with limited emphasis on psychosocial contextual aspects that may potentially influence student learning. The focus group discussions with students confirmed most of the quantitative findings. The interviews with faculty mentors led to the emergence of two key themes, namely: (i) limited understanding of feedback delivery during mentorship; and (ii) need for feedback guidelines for faculty mentors. Based on the findings of the mixed-method study as well as the theory guiding the study, a feedback framework for mentorship interactions has been suggested.Conclusion.While students generally reported low satisfaction with feedback received from mentors, faculty suggested the need to have feedback guidelines for mentors to frame their feedback during mentorship interactions. A feedback framework to guide mentorship interactions has therefore been suggested as a result of this study, guided by principles of activity theory.

What Influences Students Choice for Health Professions Education at Makerere University?

BackgroundMotivation to pursue health professions education may stem from external incentives such as wealth, fame, and popularity. For others it is for internal reasons like the desire to serve society. In this study, we aimed to identify what influences students’ choice for an undergraduate health professions program at Makerere University College of Health Sciences (MakCHS).MethodsA cross-sectional qualitative study was conducted among first-year undergraduate students pursuing bachelor degrees in medicine and surgery (MBChB), nursing (BNur), pharmacy (BPharm), medical radiology (BMR), and dental surgery (BDS). A self-administered questionnaire with open-ended questions was distributed to the students during a tutorial session in the second week of the first semester (academic year 2010/2011). Completed questionnaires were entered into a Microsoft Access database. Median (Interquartile range-IQR) and frequencies of respondents were used to describe the study sample. Content analysis with emergent coding was used to analyze the qualitative data.ResultsOverall, 145 students (response rate = 72%, N = 201) with a median age of 20 (IQR: 19–20) years responded to the study. The majority of the participants were male (75.2%, n = 109), and were pursuing MBChB (65.5%, n = 91). Two themes identified showed that students appeared to be motivated by internal motivation and external motivation factors. Personal desire, and a calling to serve, were the significant internal motivating factors, while nature of the education system and the need to upgrade were prominent external motivating factor.ConclusionMultiple factors that are both extrinsic and intrinsic influence the choice for medical education among health professions student at this African institution.

Microbiological Contamination of Mobile Phones and Mobile Phone Hygiene of Final-Year Medical Students in Uganda: A Need for Educational Intervention.

IntroductionContaminated mobile phones act as reservoirs for organisms causing hospital-acquired infections (HAI). Little is known about medical school students’ awareness of infection prevention and control (IPC) regarding mobile phone use among medical students. We demonstrated the presence of organisms on mobile phones of final-year medical students at Makerere University College of Health Sciences and evaluated their awareness of IPC regarding mobile phone hygiene and use in a hospital setting.MethodsIn this cross-sectional study, organisms from swabs obtained from 79 medical students’ mobile phones were identified and antimicrobial susceptibility test carried out using standard biochemical tests and the automated BD Phoenix instrument. Data were collected using a self-administered questionnaire to assess the students’ awareness. The analysis was carried out using STATA software version 16.ResultsSeventy (88.6%) mobile phones were contaminated with at least one organism. One hundred forty-eight bacteria were isolated, of which 123 (83.1%) were Gram-positive, 24 (16.2%) were Gram-negative, and 1 (0.7%) was yeast (Candida spp). Coagulase negative staphylococci were the most frequently isolated among Gram-positive bacteria. Acinetobacter baumannii were the most frequently isolated among Gram-negative bacteria. The average IPC practical score regarding mobile phone hygiene (34%) was significantly lower than the average IPC awareness score (77%) (p ≤ 0.0001). Seventy-four (93.7%) students use their phones while rotating in the various wards. Forty (50.6%) of the students cleaned their phones with alcohol-based sanitizer after rotations in the ward. Thirty-five (44.3%) students were aware of IPC programs in the hospital they rotated in.ConclusionThere is a high prevalence of bacterial contamination from mobile phones of medical students. The students had lower IPC practical scores compared to IPC awareness scores regarding mobile phone hygiene irrespective of the ward of rotation. Curriculum of final-year medical students should include IPC-related topics, which incorporate practical skills.

The Number and Determinants of Nutrient foramina among dry human femur bones from the East African population: A Cross-section study

Background: Nutrient foramina form important landmarks on the femur and other bones as the portal of entry for nutrient arteries. Nutrient arteries are important sources of blood supply for growing bones; and their variations may be due to congenital or acquired causes. These variations are important in anatomical comparisons, orthopaedic surgical practice and forensic medicine. Aims: This study aimed at establishing the number and determinants of the nutrient foramina among dry human femur bones from the East African population. Materials and methods: This was a cross-section study of 333 dry femur bones from the East African population, at the Galloway osteological collection of Makerere University college of health sciences. The number of nutrient foramina on the shaft of each femur, the corresponding demographic, clinical and morphometric characteristics were documented. Data were entered in an Excel sheet and exported to STATA 14 for analysis. Univariate, bivariate and multivariable analyses were performed to obtain the summary statistics and the measures of association. At all levels of analysis, a p-value of less than 0.05 was considered statistically significant. Results: Of the 333 femurs, 291 (87.4%) were from males; and 137(50.15%) were right femurs. The age ranged from 20 to 75 years with a mean age of 35 (SD± 12) years. Nutrient foramina ranged from one to four; mean of 1.4 (SD±0.5) and median of 1 (IQR: 1 to 2). Of the 333 femurs, 199 (59.8%) had one foramen, 129 (38.7%) had two foramina, four femurs had three foramina and one femur had four foramina. There was a statistically significant association between the number of nutrient foramina and the femur’s: mid-shaft circumference (p=0.014; 95%CI: 0.003 to 0.028), nationality (p=0.016; 95%CI: -0.284 to -0.030) and sex (p=0.012; 96%CI: -0.405 to -0.050). Conclusion: Nutrient foramina among femurs from the East African population range from one to four per femur, with predominantly one foramen. The key determinants of the number of foramina are: mean mid-shaft circumference, nationality and sex. These findings are significant in anatomical comparisons; forensic and orthopaedic practices. KEY WORDS: Nutrient foramina, dry human femur, East African population, morphometric characteristics.

Knowledge on Infection Prevention and Control and associated factors among undergraduate health professional students at Makerere University College of Health Sciences, Uganda.

To practice adequate Infection Prevention and Control (IPC) measures, health professional students need to have adequate knowledge of IPC. In this study, we assessed the knowledge of health professional students at Makerere University College of Health Sciences on Infection Prevention and Control. We conducted a cross-sectional online survey among health professional students studying at Makerere University College of Health Sciences located in Kampala, Uganda. An adapted questionnaire was used to measure knowledge on Infection Prevention and Control among students. A total of 202 health professional students were included in the study. The mean age was 24.43 years. Majority were male 63.37% (n = 128), from the school of medicine 70.79% (n = 143) and used one source of information for IPC 49.50% (n = 100). Being in year three (Adjusted coefficient, 6.08; 95% CI, 2.04-10.13; p-value = 0.003), year four (Adjusted coefficient, 10.87; 95% CI, 6.91-14.84; p < 0.001) and year five (Adjusted coefficient, 8.61; 95% CI, 4.45-12.78; p < 0.001) were associated with a higher mean in total percentage score of knowledge on IPC compared to being in year one. IPC knowledge was good among health professional students in Makerere University although more emphasis is needed to improve on their IPC knowledge in various sections like hand hygiene. Infection Prevention and Control courses can be taught to these students starting from their first year of university education.

The workplace as a learning environment: Perceptions and experiences of undergraduate medical students at a contemporary medical training university in Uganda

Background. One of the most effective ways of translating medical theory into clinical practice is through workplace learning, because practice is learnt by practising. Undergraduate medical students at Makerere University College of Health Sciences, Kampala, Uganda, have workplace rotations at Mulago National Referral and Teaching Hospital (MNRTH), Kampala, for the purpose of learning clinical medicine. Objectives. To explore undergraduate medical students’ perceptions and experiences regarding the suitability of MNRTH as a learning environment to produce competent health professionals who are ready to meet the demands of contemporary medical practice, research and training. Methods. This was a cross-sectional study with a mixed-methods approach. Students’ perceptions and experiences were assessed using the Dundee Ready Educational Environment Measure (DREEM), as well as focus group discussions (FGDs). Data from DREEM were analysed as frequencies and means of scores of perceptions of the learning environment. FGD data were analysed using thematic analysis. Results. The majority of students perceived the learning environment as having more positives than negatives. Among the positive aspects were unrestricted access to large numbers of patients and a wide case mix. Negative aspects included overcrowding due to too many students, and inadequate workplace affordances. Conclusions. The large numbers of patients, unrestricted access to patients and the wide case mix created authentic learning opportunities for students – they were exposed to a range of conditions that they are likely to encounter often once they qualify. The areas of concern identified in the study need to be addressed to optimise learning at the workplace for undergraduate medical students