- Aseptic hand wash
- Donning on sterile gloves
- Taking a patients Blood pressure, pulse, respiration and temperature
- Draw venous blood
The procedures are discussed with the students and they are allowed to practice the procedures in the CSC under supervision of the clinical educator. They are encouraged to return to the CSC as often as they like to practice. They also get a booklet with the theory supporting the procedures, which they can use as a guide when practicing.
The 3rd year students follow a similar program for the following procedures:
- Insertion of an intravenous catheter
- Taking an arterial blood sample
- Inserting a nasogastric tube
- Suturing
- Administering an intramuscular injection
Fourth year students are taught inhaler technique, examining the ear etc. I spoke with on of the 3rd year students on Friday and was amazed to find that he has not had the opportunity to practice many of the procedures following the initial teaching and learning sessions. The students are exposed to formative and summative assessment of these procedures. The reality is that many of them have not yet performed these procedures on real patients by the time they get evaluated. As they progress to their fourth and fifth year of study more and more demands are placed on their skills and knowledge, and these basic procedures fall by the wayside.
The initiative to set up a website and to produce learning material that will be accessible to the student in the work environment was suggested to support clinical skills training. The material, once available on CD-ROM, can also be used by students placed in the rural rotations where access to internet may be problematic. As was discussed at the recent SAAHE conference the concept of creating open educational resources is becoming an accepted approach to teaching and learning. One has only to look at the vast amount of learning material available on internet to realise that information is at our fingertips, no longer contained in the books and minds of educated people. It is out there, available to anyone who wishes to explore the world wide web.
But, there is one problem... We live in Africa. Resource constraints, inadequate band width, language barriers, to name but a few, are challenges that students and registrars placed in the rural areas of South Africa face on a day to day basis. Just establishing a website may therefor not be enough as it will only allow students with access to computers and internet the opportunity to utilize the resource. Putting the learning material on CD may therefor add value by allowing the student to access the material from any computer with a CD reader. The format in which material will be saved would be important as computers in rural areas may not have the latest software installed.
Some work has already been done on creating learning material that would be published on the website, but that would also be available on a CD. As you can imagine the production of DVD's is no simple task. Acquiring the expertise to jump start the project was just one of the many challenges we faced thus far. Thankfully there was money available to buy a video camera and to pay the people involved in recording the practical demonstrations on the video camera. As none of us had the expertise to merge the recorded material with the written text of the procedure, an expert had to be bought in to teach us how it is to be done.
I am not sure how many clinical procedures we have successfully put together thus far. In my next discussion I will share with you the challenges we faced thus far and what we did to overcome them. I will also refer you to very useful websites I have used to help me in writing the text for the procedures.
I welcome your comments and suggestions should you have any.
Keep well until next time.
Estelle
Dear Estelle
ReplyDeleteAs you know, I am one of the CSC’s biggest fans and use your facilities often for teaching of students rotating through Obstetrics and Gynaecology. I am excited about the development you refer to. I think I saw an example during a recent meeting in Slanghoek. I am not too surprised by what the 3rd year student told you, because their practical experience will depend on the order of their clinical rotations. As I see it, there should be ample opportunities to apply all four skills taught in the second year when the 3rd year student rotates through Obstetrics. It will depend largely on the students' enthusiasm, which unfortunately differs. However, there are other rotations where these opportunities are less common.
On the other hand, it will be unlikely for students rotating through Obstetrics and Gynaecology during the early or mid-clinical phases to have to take an arterial blood sample, insert a nasogastric tube or administer an intramuscular injection. I am uncertain when the skills training takes place in the third year, but our students may need to be able to suture (episiotomies) when they rotate through the periphery early in their 3rd year. Should the assessments not take place at the end of pre-specified clinical rotations? As part of the Analysis Phase it may be worthwhile to liaise with the different departments to inform them about the available program and to enquire which skills they expect from the students at specific stages.
I am looking forward to your management of the challenges you met.
Regards.
Wilhelm.
Dear Estelle
ReplyDeleteVery interesting project! I am glad you are considering all the constraints - especially with regards to bandwidth and the issue of Open educational resources (OER) in your analysis phase. You are right that there are quite a lot of resources that are freely available, but at a recent conference on open and distance learning that I attended in Maastricht, some people were quite critical about OER because of the (mostly) North American / European bias of the material and the lack of peer review. And this was at a conference where OER was one of the main tracks - so there were a lot of enthusiasts but I was pleasantly surprised by the very critical, constructive conversations about OER.
I also agree with Wilhelm's suggestion to liaise with the different departments to find out from them what specific skills they expect from students. Also, maybe, jumping ahead to the evaluation phase, build in feedback from the students as to what procedures they would like to add? How they experience the material? Maybe even get students in the development phase / pilot phase to look at the material and give feedback?
Kind regards
Antoinette
Estelle, I am glad you made this very strong start. The Analysis is deep and the extra inputs and questions so far will lead you to more thourough design and development planning.
ReplyDeleteThe context it is designed in and for indeed makes this project something special. I agree with Antoinette's remarks about incorporating piloting and getting feedback. Maybe your project can include drawing up a useful survey that one can use to test the impact of the final products?