A-M Bergh

Medical student participation in community-based experiential learning: reflections from first exposure to making the diagnosis

Abstract Background: Fifth-year medical students from the University of Pretoria participated in a four-week rotation in the primary care clinics of a large metropolitan centre. An academic service-learning (ASL) approach was introduced into this rotation to improve the integration of theoretical learning and clinical practice through relevant community service and structured reflection. Methods: Students wrote semi-structured reflective journals as a means to gaining greater insight into their learning experiences. These reflections were analysed qualitatively with a view to improving the community-based curriculum. Results: Four major themes were identified: expectations and the reality of primary care; service and learning; becoming a doctor; and making a difference. Conclusion: While students gained a deeper insight into their development as clinicians, using an ASL approach also assisted the faculty in making an informed educational diagnosis of the curriculum.

Taking kangaroo mother care forward in South Africa: The role of district clinical specialist teams.

The global agenda for improved neonatal care includes the scale-up of kangaroo mother care (KMC) services. The establishment of district clinical specialist teams (DCSTs) in South Africa (SA) provides an excellent opportunity to enhance neonatal care at district level and ensure translation of policies, including the requirement for KMC implementation, into everyday clinical practice. Tshwane District in Gauteng Province, SA, has been experiencing an increasing strain on obstetric and neonatal services at central, tertiary and regional hospitals in recent years as a result of growing population numbers and rapid up-referral of patients, with limited down-referral of low-risk patients to district-level services. We describe a successful multidisciplinary quality improvement initiative under the leadership of the Tshwane DCST, in conjunction with experienced local KMC implementers, aimed at expanding the districts KMC services. The project subsequently served as a platform for improvement of other areas of neonatal care by means of a systematic approach.