Susan B. Higgins-Opitz

The small group in problem-based learning: more than a cognitive 'learning' experience for first-year medical students in a diverse population

In problem-based learning (PBL) curricula, first-year students need to adapt to a new learning environment and an unfamiliar new pedagogy. The small-group tutorial potentially offers a learning environment where students can become self-directed learners, collaborating with other group members to achieve individual and group learning goals. At the end of the first six-week theme in a relatively new PBL curriculum, new medical students were canvassed about coping with PBL (self-directed learning; content; time management; resources) and the value of the small-group tutorial, the latter of which is currently being reported. Almost 84% of students (n = 178) responded. The benefits of participating in small groups were categorized into three domains—cognitive, affective and social—as identified from student responses. Results were analysed in terms of gender and prior educational experience (secondary school vs. prior tertiary educational experience). For almost 94% of students, the small-group tutorial provided a conducive learning environment that influenced their personal development (i.e. tolerance, patience) and socialization into the faculty. Significantly more males indicated that they had developed social skills, while more school-leavers (matriculants) than mature students felt more receptive to the views of others. More mature students claimed to have made friends. Irrespective of some conflicting opinions in the literature, the present results suggest that the PBL tutorial may be important in facilitating student socialization into a new and unfamiliar academic environment, particularly when the pedagogy differs markedly from their past educational experiences. Through interacting with fellow students from diverse origins who hold different views in the intimate setting of the small group, students felt that they had not only increased their knowledge but had also developed personally and socially. It is proposed that the small group may be useful for integrating a diverse population of students into a new academic environment.

Perspectives of student performance in the Health Sciences: how do physiology and professional modules compare?

Physiology has an anecdotal track record of having lower pass rates than other professional modules in the Health Sciences (HS). The aim of this study was to compare the performance and associated contributory factors of students in physiology modules with professional modules at the same level of study. This was done by way of overall pass rates and average, maximum, and minimum marks for the period 2008-2010 stratified by programme/qualification, matriculation/National Senior Certificate achievement and language. The latter two served as proxies for alternative access and previously disadvantaged students, respectively. There was a notable difference in the mean 2008-2010 pass rates of students from the different professional qualifications and students generally performed considerably better in their professional modules as compared with their performance in the physiology modules. The performance in physiology modules of English first language (EFL) students was not significantly different from that of English second language students (ESL). The implications of these findings require further discourse on, inter alia, issues around physiology teaching; student learning modes; admission criteria; student preparedness for university; and student monitoring and support mechanisms. There also needs to be a greater interaction between physiologists and health professionals involved in the curriculum design.

An evaluation of stress in medical students at a South African university

Background: Medical educational programmes strive to produce competent and skilled graduates. However, studies have shown that undergraduate medical students experience varying degrees of stress which impacts on their health, academic performance and social functioning. This study explored the prevalence and causes of stress, its impact on students and their coping strategies in a racially diverse cohort of final-year medical students exposed to a problem-based learning curriculum in South Africa. Method: This descriptive cross-sectional study was undertaken by final-year medical students in 2008 at a South African medical faculty with a racially diverse student population. Semi-structured interviews were conducted. Data were thematically analysed. Results: Ninety-four students, representing 47% of the final-year medical student cohort, participated in the study. Seventy-eight per cent of the participants (n = 73) experienced stress during the programme, and the majority (n = 49) were females. Ethnic and gender differences were observed for the variables studied. Academic and personal problems were the main sources of stress. Coping strategies included individual lifestyle adaptations, family support, religious structures and study groups. Conclusion: Maladaptive stress impacts negatively at multiple levels on undergraduate medical students. Mentorship and educational support programmes should be integrated into the undergraduate medical curriculum and made available to all preclinical and clinical students. Students need to be taught and guided to identify and monitor their own well-being and to select positive strategies to overcome stress. These measures should assist students to manage their workload and time effectively.

Perceptions of final-year medical students towards the impact of gender on their training and future practice

Introduction Following policy implementations to redress previous racial and gender discrepancies, this study explored how gender impacted on the clinical experiences of final-year medical students during their undergraduate training. It also gathered their perceptions and expectations for the future. Methods This cross-sectional, mixed-method study used a purposive sampling method to collect data from the participants (n=94). Each respondent was interviewed by two members of the research team. The quantitative data were entered into Excel and analyzed descriptively. The qualitative data were transcribed and thematically analyzed. Results The majority of the respondents still perceived clinical practice as male dominated. All respondents agreed that females faced more obstacles in clinical practice than males. This included resistance from some patients, poor mentoring in some disciplines, and less support from hostile nurses. They feared for their personal safety and experienced gender-based stereotyping regarding their competency. Males thought that feminization of the profession may limit their residency choices, and they reported obstacles when conducting intimate examinations and consultations on female patients. Both males and females expressed desire for more normalized work hours to maintain personal relationships. Conclusion Social redress policies have done much to increase equal access for females to medical schools. Cultural values and attitudes from mentors, peers, and patients still impact on the quality of their clinical experiences and therefore also their decisions regarding future clinical practice. More mentoring and education may help to address some of the perceived obstacles.

Medical physiology education in South Africa: what are the educators’ perspectives?

Context. Most South African medical schools have, in the past decade, introduced changes in their curricula. In our experience we have found that such changes can affect students’ knowledge and understanding of physiology. Aim. The current study was undertaken to determine the perceptions of educators regarding the impact of curricular change on the knowledge and understanding of physiology by medical students in South Africa. Methods. A survey of physiologists teaching medical students in South African medical schools was undertaken by means of a questionnaire. Results. There were 20 participants in the current study. Demographic data revealed that they came from 6 out the 8 South African medical schools; 80% had PhDs; 70% had been teaching physiology for more than 10 years and that a similar percentage (80%) were experienced in teaching three or more physiological systems. In addition, 20% of the current participants had additional educational qualifications. In the opinion of the physiologist educators surveyed, 60% felt that although current medical students found it more difficult to understand basic physiology concepts and that, compared with students 5 - 10 years ago, their knowledge of physiology was more limited, the students nevertheless were better able to integrate their physiology knowledge with clinical subject knowledge. The respondents were divided as to whether or not current medical students found it more difficult to understand pathophysiology than those students 5 - 10 years ago. In addition, nearly 60% of the staff surveyed were concerned that physiology, as a cognate discipline in South Africa, was under threat due to medical curricular change. Discussion and conclusion. The results of the survey provide a snapshot of the current state of medical students’ knowledge and understanding of physiology in South Africa from the educators’ perspective. It would be interesting to know whether the concerns raised by the participants reflect an international trend. Physiologists and curriculum planners/organisers need to take cognizance of the issues highlighted in the current study.