Paula Diab

Communication in diabetes management: overcoming the challenges

Abstract Medicine is both a science and an art; a delicate balancing act of scientific diagnostic reasoning and management on the one hand, and the development and nurturing of a relationship with another person, on the other. Patients seek a healthcare provider who can provide them with a service. They want someone who will provide explanations, answer their questions, and alleviate their fears. Patient adherence to chronic medication regimens is greatly improved if a bond of trust exists, to sustain a strong doctor-patient relationship.

Cross-cultural medical education : using narratives to reflect on experience

Introduction. Educating students in a multi-cultural society is a challenge as teachers, students and the community they serve all tend to represent various social groups. Skills alone are not adequate for competency in understanding cultural aspects of consultations. A combination of knowledge, skills and attitude is the most widely accepted current approach to teaching culturally competent communication to medical students. Collaborative reflection on narratives of experienced clinicians’ cultural encounters served to construct an understanding of how to develop these attributes. Process. An interest group of medical teachers met to address the specific needs of teaching a relevant cross-cultural curriculum. Participants offered narratives from their professional life and reflected on these encounters to understand how to improve the current curriculum to better address the needs of the students and patients they serve. Results. Through narratives, participants were able to reflect on how their experience had allowed them to develop cultural awareness. All stories represented how attitudes of respect, curiosity and unconditional positive regard were held above all else. The process of collaborative reflection with peers unpacked the complexity and potential in the stories and different learning opportunities were discovered. Learning was personalised because the stories were based on real experiences. Conclusion. The use of collaborative reflection on narratives of clinical encounters could facilitate insights about cultural aspects of medical practice. Elements such as curiosity, respect and unconditional positive regard are illustrated in a unique way that allows students to appreciate the real-life aspects of cross-cultural clinical encounters.

The UCT class of 2000 reunion.

It was with mixed emotions that we prepared for our 15-year reunion at the University of Cape Town in November 2015. Certainly the nationwide student protests and shutdowns made administration and organisation quite challenging, but they also gave us a chance to reflect on our own medical education and training. As graduates of UCT in 2000, we started our professional careers as young interns in the middle of the HIV epidemic. As medical students we joked about including HIV or TB on every differential list, but as young doctors it was no longer a joke but a grim reality. With no antiretrovirals to offer our patients, a limited supply of fluconazole and Bactrim and HIV ELISA results that took 6 weeks to return from a tertiary centre, we found ourselves signing piles of death certificates every week and standing helplessly in front of our patients despite having been trained as curative clinicians.