Background: Delivering research skills training to health professionals through short, applied sessions outside a formal higher education program, can help fill gaps in training and build research capacity in clinical settings. This has been the endeavor of some of the Applied Research Collaborations funded by the National Institute for Health and Care Research in England since 2014. How to evaluate this type of training in terms of the wider impact it may have, has not featured heavily in the literature and methods have largely borrowed from more generic approaches to training evaluation which can over-simplify outcomes and ignore longer-term impacts. Methods: We developed the framework in four stages: mapping potential impacts of our research skills training courses to identify key concepts; shaping into three domains in which impact could be expected, informed by established definitions of research capacity building; testing the initial framework and adapting wording of impacts; refining the framework into a practical tool. Results: The final framework specifies types of impact in three domains of influence - individual, group/organization and health system, and maps these against key questions to guide inquiry, as well as suggested methods for capturing the impact and expected timeframe for each type of impact. Discussion: The framework provides a structure for guiding the evaluation of research training as well as a focus on medium-longer term impacts, encouraging a broader and continuous approach to evaluation. It is hoped this will support educators in other contexts and fields, in the planning of a wider range of training evaluation activities, to capture impact more fully.
Background: The academic clinician-educator (CE) often has a career spanning 40 or more years. Retirement represents the last stage of one's professional identity. Planning for retirement can be both exciting and challenging. Although it would seem reasonable that there would be research addressing the transition to retirement that incorporates guidance on important decisions or pathways to retirement with outcomes related to satisfaction, adjustment, or fulfillment in retirement, in fact, there is minimal such research. As CEs, the recently retired authors have drawn on our experiences in pediatrics as the foundation for our inquiry. The authors suggest that retirement decisions and needs differ in academic health center (AHC) faculty from those in health-care private practice. As an example, we suggest that CEs in all specialties, and likely other senior faculty in the health sciences, may have unique opportunities in retirement to enrich their institutions and their specialty organizations. The gaps we have encountered and our experiences in the retirement process have resulted in this paper, in which we encourage research that will inform more substantial, timely, and practical advice going forward. Methods: Our exploration of retirement from AHC careers includes two foci: (1) A review of relevant literature on retirement issues the CE, AHC, and national educator organizations might consider important in this transition process; and (2) the description of a theoretical framework known as Conservation of Resources Theory simply to help organize perspectives on the losses, gains, or conservation of tangible and intangible resources to weigh in the planning and transition process. Results: Several considerations relevant to retirement planning, both specific to academic faculty retirement in the health sciences and to retirement planning more broadly, emerged from our literature exploration. However, there were virtually no studies addressing these considerations, both personal and professional, accompanied by tracking their impact on satisfaction or well-being once in retirement. Discussion: Emerging from our examination of literature and our experiences in transitioning to retirement are a number of questions deserving of further study, likely in longitudinal, comparative or more broadly in global inquiries, in the effort to develop models to guide the retiring academic CE. Over the next decade, there will be so many faculty members considering or negotiating retirement that there is an urgent need to develop and study models that both inform this process and monitor outcomes in terms of satisfaction with the retirement years.
Background: Perceptions of patients of the nature and quality of the interaction with their doctors during consultation are potentially an important factor determining patient satisfaction and doctors' success. Failure by medical doctors to understand how patients perceive them or what patients desire from them may hinder the establishment of strong, trust-based doctor-patient relationships. The purpose of this study was to explore the health service users' views in a region of Botswana on what constitutes optimal doctor-patient interaction during consultation and propose recommendations for integration into medical education curricula. Methods: A purposive sample of 12 individuals was selected in a setting where health and well-being are underpinned by principles of interdependence and interpersonal connections (botho/ubuntu philosophy) for semi-structured interviews using the critical incident technique to elicit desired behaviors and actions of medical doctors during consultation. The participants described their good and bad consultation experiences with medical doctors. The data were analyzed using thematic analysis. Results: Three themes, derived from 11 codes, were identified from the data: conversational skills (welcoming and focused), interpersonal skills (humane, respectful, empathetic, unprejudiced, and personal), and professional traits (humble, trustworthy, thorough, and empowering). Discussion: Many expressed desires or expectations correspond with humanistic attributes described in the literature, suggesting their universal value. More importantly, the desires and expectations align with the principles of the Bantu philosophy of botho/ubuntu. Accordingly, educators should intentionally provide learning opportunities for students to promote the development of the desired attributes that enhance an effective doctor-patient relationship but should employ culturally relevant pedagogy.
Background: Antibiotics are precious substances that have saved millions of lives since their discovery, resulting in significant advances in modern medicine. However, antibiotic resistance and a slowdown in the discovery of new antibiotics with novel mechanisms of action are affecting the sustainability of antibiotics. The objective of this study was to describe the content of South African and Nigerian medical students' curricula with respect to prudent antimicrobial prescribing. Methods: A content analysis framework was used to identify, describe, and count the keywords, key phrases, and sentences relevant to the teaching of prudent antimicrobial prescribing in the complete curricula content of two African countries' medical schools. The courses are taught in the Graduate Entry Medical Programme (GEMP) curriculum (years 3-6) of the South African medical school and years 4-6 of the Nigerian medical school. The frequency of keywords/key phrases relevant to prudent antibiotic prescribing such as antimicrobial stewardship, mechanisms of bacterial resistance, and principles of antibiotic therapy was determined. Results: The two curricula reviewed were found to be different. While the South African medical school uses an integrated curriculum in the GEMP (a stream where candidates with undergraduate degrees are enrolled into the 3rd year of medical school and spend 4 years), the Nigerian medical school operates a traditional (discipline based) curriculum from MBBS 1-6. A greater number of keywords and key phrases were found in the South African curriculum compared to the Nigerian curriculum in relation to prudent antibiotic prescribing and antimicrobial stewardship. The key phrase "antimicrobial stewardship" or "antibiotic stewardship" was absent in the Nigerian curriculum but appeared four times in the South African curriculum. Discussion: The findings of this curriculum review suggest a need for revision of the medical curricula of the two countries, to one that will better prepare learners for antimicrobial stewardship.
