It is with great pleasure that SAAHE congratulates Professor Ian Couper as the winner of the 2014 SAAHE Distinguished Educator award. In recognition of his tireless efforts and significant contribution to health professions education in South Africa and abroad, Professor Couper is invited to present a special address at the 2014 SAAHE conference.
Acknowledgement: Special thanks to Julia Blitz and Abigail Dreyer for nominating Prof. Couper, and for writing the text for this post.
Ian Couper, Professor and Director of the Centre for Rural Health at the University of the Witwatersrand has long been seen as a maverick. He started contributing to a community of practice in 1988 when he completed his internship at Livingstone Hospital. His service as a doctor extended to Dora Nginza Hospital in Port Elizabeth, Paraguay, South America, and Boksburg-Benoni Hospital. His time spent at Manguzi Hospital in Northern KwaZulu-Natal demonstrated his commitment to rural health care where he inspired and supported many others working at this facility to improve community health and where he engaged directly in primary health care planning. During this time he also became involved as a part-time lecturer in the distance-based Masters in Family Medicine programme of Medunsa, a programme that produced many leaders in both family medicine and health professions education in South Africa, subsequently moving to work as a joint appointee of Medunsa and the North West Province. From July 2002, Ian has been at the Centre for Rural Health at Wits and Principal Specialist for Rural Medicine in the North West Province. His work has been acknowledged in the form of significant awards that have demonstrated his individual achievements but also the achievements of the team he leads.
In 2003, the team established a scholarship scheme, the Wits Initiative for Rural Health Education (WIRHE), for disadvantaged rural students who want to become health professionals, in partnership with the North West provincial department of health. Students are linked to their local district facilities, working there during their vacations, are supported and mentored during their training, and are required to work back in their districts on completion of their studies. By the end of 2012, there were 33 graduates already serving their communities, or completing internships prior to undertaking this service, and 57 students being supported across 7 health science programs. In 2007, the Vice-Chancellor’s Team Award for Academic Citizenship was received from University of the Witwatersrand for this programme. In 2008, he received an Honorary chieftainship awarded by the Okoyong Council of Traditional Rulers and Chiefs in Nigeria, for his role in supporting Calibre to host the 8 th WONCA World Rural health conference as well as his ongoing contribution to rural health care internationally.
In 2008, the Vice-Chancellor’s Team Teaching Award was received for the Integrated Primary Care block at Wits. The Integrated Primary Care (IPC) rotation is a unique 6-week clerkship for final year medical students, which integrates the learning from all other disciplines at primary care level, in rural and underserved sites, with a focus on the management of patient problems rather than disease, in the context of understanding and seeking to improve health systems and the health of communities. Seven departments in the faculty work together to deliver this program, under his leadership. With this support, the IPC rotation has been adapted and is being used in district-based medical student rotations in two other countries in the region, at the University of Malawi College of Medicine and the Universidade Catolica de Mozambique in Beira. The IPC rotation continues to be innovative, constantly experimenting with new approaches to learning for and assessment of medical students.
In 2012, the Vice-Chancellor’s Team Award for Academic Citizenship was received by the Rural Health Advocacy Project (RHAP). In cooperation with the Rural Doctors Association of Southern Africa (RuDASA) and the AIDS Law Project, the Centre for Rural Health has launched an Advocacy Project. The aim of the project is to address specific identified high priority issues in rural health in South Africa by systematically bringing them to the attention of relevant stakeholders in order to achieve measurable improvements in rural health services. This is done through providing a voice for rural health care workers and patients, Rural-Proofing Policies, examining the financing of health care, addressing the Human Resource needs of rural communities, and monitoring the implementation of policies. In addition to chairing the steering committee, Ian’s particular contributions are in the areas of human resource development and research.
Ian was involved nationally in developing the curriculum framework for the Clinical Associates (midlevel medical workers), launched in 2009. This involves students becoming involved in patient care at district hospital level from early in their first year and integrating theoretical input (including basic sciences) around patient problems, with a single integrated course being delivered per year. Ian led the development of the Bachelor of Clinical Medical Practice (BCMP) degree at University of Witwatersrand with the team of staff who received the Vice-Chancellor’s Team Teaching Award in 2013. The curriculum objectives are structured around the needs of district hospitals, based on a national collaboration. The programme places medical and clinical associate students in remote and rural areas, where they are supported by a network of local generalist medical and nurse practitioners. In one of these sites, Lehurutshe Community Hospital, the team has established a district training centre, in collaboration with the North West provincial department of health, where students from a range of programs – medical, clinical associate, physiotherapy, occupational therapy and dentistry – are accommodated and can learn together. This model is being rolled out to other districts.
Ian initiated the adaptation and roll out of two educational programmes for practising rural doctors in South Africa, viz. a neonatal resuscitation training program and the Basic Emergency Skills Training (BEST) program, in collaboration with Australian and local colleagues. Both followed a training-the-trainers model by identifying and equipping locally based trainers who have continued to provide the training to doctors and nurses in their districts, with minimal fees involved. This demonstrates his Midas-touch when it comes to the teaching, development of teaching expertise, the innovative educational processes and the development of excellent educators in the team. Ian has been a visiting professor at Flinders University in Adelaide, Australia, and the University of Washington in Seattle, USA, and an adjunct faculty member of James Cook University in Townsville, Australia. He has been invited to conducted evaluations of educational programmes at Flinders University (2006) and at the Northern Ontario School of Medicine in Canada (2008). He is a founding member of the Collaboration for Health Equity through Education and Research (CHEER),which has advanced the cause of education for equity in health care in South Africa and developed a peer review approach to cross-institutional learning and development.
Recently he was one of only seven recipients of an international Special Award for Outstanding Health Professional Educators, presented by the annual Prince Mahidol Award Conference (PMAC) 2014, in Pattaya, Thailand. Upon receiving this Award Ian was quoted as saying: “The Centre for Rural Health is seeking to develop and nurture STAR health workers in rural areas, through Service support, Training, Advocacy and Research in rural health care, thus impacting on the health of rural people. I could not have done it without the team and the award is a reflection on the people I am privileged to work with!”
Ian has helped to develop the field of medical education by advancing and delivering on the concepts of community based medical education, service learning, and aligning the curriculum and schools’ programs with priority health needs in South Africa, particularly rural areas. Recently he was approached by Nelson Mandela Metropolitan University to develop a blueprint for the creation of a new medical school which would deliver on these fundamental concepts, and is part of a team developing a plan for a health professions school in the North West province on behalf of the provincial Department of Health. He is a member of the editorial team that, over the last 5 years, has developed an international Guidebook on Rural Medical Education, with 71 chapters written by 74 volunteer authors (including himself), which launched this month (April 2014) as a free, open access, online educational resource.
He currently serves on 5 different faculty committees at the university and contributes to the leadership on these committees with tireless engagement. He has a record of 66 publications, membership of 5 professional organisations, and has delivered over 50 presentations at local and international conference in the last three years, many of these as an invited keynote speaker. The projects and awards received demonstrate Ian Couper’s leadership impact and his contribution to teaching and administration of the discipline of health science education in South Africa. It is the teaching he does in the classroom, the field, the boardroom and the office that really warrants him receiving this award.