Patient-centredness with Elize Archer

Welcome to a new SAAHE initiative where we have conversations with people doing interesting work in health professions education. In this conversation I talk to Elize Archer, a recent PhD graduate from the University of Stellenbosch. Elize conducted her research on patient-centred approaches to clinical practice among medical students. In our conversation we discuss different aspects of patient-centred practice, how to think about developing this mindset in students, and some of the challenges to its implementation.

You can read more about Elize’s work here: Archer, E. & van Heerden, B. (2016). Undergraduate medical students’ attitudes towards patient-centredness: a longitudinal study. DOI: https://doi.org/10.15694/mep.2017.000161.

We hope that this is the first of many such conversations and your comments and feedback are welcome. In particular, we’d love to hear your suggestions about PhD and group research projects that have the potential to change practice. If you know of anyone doing work that you think would be valuable to be shared more widely, please do let us know. I apologise for the audio quality at times during the recording. This is something that we’ll work on improving in the future. The conversation is just short of 50 minutes. I hope that you enjoy it.

Two presentations on health professions education, by Paul Worley

Last week Prof. Paul Worley, the previous Dean of Flinders University School of Medicine in Adelaide, hosted two seminars during his visit to Cape town. He very kindly agreed to let us record both sessions and share them here. You can also visit the SAAHE Western Cape Facebook page for more opportunities to engage with the videos.

The future of health professions education

The video is about one and half hours but it is well worth the time invested. Please note that the audio recording for this session is not great.


Decentralised clinical training for the health professions


Thank you to colleagues at Stellenbosch University for hosting the sessions and for their efforts in making the recordings available.

New SAAHE President: Prof. Francois Cilliers

We would like to congratulate Prof. Francois Cilliers on his new position as the incoming President of SAAHE and Chair of the National Executive and Council. Francois has been a member of SAAHE from the very earliest days of the organisation, when it was little more than an informal group of like-minded colleagues in the Western Cape, and has always been an active member at the regional and national levels. We have no doubt that SAAHE will continue to grow and develop under his leadership, as a positive force for health professions education in the country.

We would also like to take this opportunity to thank Prof. Gert van Zyl for his enormous contribution to SAAHE as President over the past few years. His commitment and dedication to the organisation have set a high standard indeed, and we wish him all the best for the future.

Consensus Statement on Decentralised Training in the Health Professions

At the closing ceremony of the 2017 SAAHE national conference in Potchefstroom, delegates adopted a conference declaration in the form of the Consensus Statement on Decentralised Training in the Health Professions, which was endorsed by the SAAHE national council.

This statement was the culmination of discussions over the last two years at SAAHE conferences and national workshops, driven by the Stellenbosch University Collaborative Capacity Enhancement with Districts (SUCCEED) project and the Forum for Rural Clinical Education (FORCE), a SAAHE special interest group which is being re-constituted as a special interest group for decentralised education, amongst others. The focus of these discussions has been on the importance and value of decentralised training in terms of transforming teaching and learning and in addressing the human resources for health needs of our country.

The consensus statement positions decentralised training as being part of the solution to the challenges we face in health care, and calls on all those involved – particularly education and service partners – to work together towards developing a shared vision for such training. It is part of a process that includes the development of a framework that will provide practical guidance for implementing decentralised training.

We invite SAAHE members to support the statement, to use it in advocating for decentralised training and to request organisations that you are part of to consider adding their formal endorsement of it. Please let us know about any such endorsements or formal institutional support via the comments field below.

Download the statement.

Winner 2017 Distinguished Educator award – Prof. Jose Frantz

SAAHE is proud to announce that Professor Jose Frantz is the 2017 winner of the SAAHE Distinguished Educator award.

Professor Frantz has an outstanding track record as a researcher in her disciplinary field and HPE. With more than 80 peer reviewed publications, 2 book chapters and 43 conference presentations she plays a key role in promoting dialogue, exchanging ideas and disseminating research findings about the education of healthcare professionals. The footprint of dissemination is large; SA universities (UWC, UCT, Fort Hare, UL, UKZN), African universities in Nigeria, Kenya, Sudan, Uganda, Rwanda and Zimbabwe, and international universities in Norway and USA.

Professor Frantz has hosted international, national and regional workshops that span more than a decade. She has specialised in faculty development workshops that focus on promoting research in both physiotherapy as well as HSE. She is widely recognised as an excellent mentor and supervisor of postgraduate research. Her track record of student supervision, 81 higher degree candidates in 15 years – a remarkable achievement, and the highly prestigious National Research Foundation award for capacity development (see below) speak of her major contribution to developing other HSE practitioners and researchers. Many of her students, under her ongoing mentorship, have achieved great success, including professorial status, head of department appointments and deanship.

Her role as a mentor of African HSE practitioners in the sub-Sahara Africa FAIMER Institute (SAFRI) since its inception in 2008 has been, and continues to be, invaluable. She has worked closely with many fellows in this programme, promoting their own professional development as well as the development of their institutions. Over the past 10 years Professor Frantz has presented her work at six of the annual SAAHE conferences. Professor Frantz’s CV shows ample evidence of national and international collaboration – both disciplinary and HSE, over the past decade. To date she has received more than R 3 million in the form of grants to support all her collaborative research work with SA universities and work in Sudan, Zimbabwe, Zambia and Tanzania. She is currently involved in six collaborative projects focusing on building education and research capacity in Africa. She has also hosted numerous workshops in African countries, and further abroad, which have fostered and developed scholarship in higher education.

Professor Frantz holds national and international leadership positions in which she has made, and continues to make, a significant contribution to the discourse about the adequate preparation of health care professionals in physiotherapy. She was Dean of the Faculty of Community Health Sciences at UWC, is currently the DVC for Research and Innovation at UWC, and is a member of key structures in the national Department of Health, including the Health Deans Forum, Health Platform Committee, Joint Standing Advisory Committee, National Physiotherapy forum and a representative on the Physiotherapy Clinical Committee for the clinical placement of physiotherapists. She is also a member of the South African Society of Physiotherapists, the World Confederation of Physiotherapists and the sub-Sahara African FAIMER Regional Institute which focuses specifically on developing HPE who are equipped to provide appropriate training for HPE in Africa. In these roles she has contributed to the development of policy documents regarding physiotherapy education in South Africa and elsewhere is Africa, including Sudan and Zimbabwe. As editor of the South African Journal of Physiotherapy and Deputy Editor of the African Journal of Health Professions Education she plays a pivotal role in advancing the dialogue about the delivery of adequately prepared health care professionals and HPE.

Over the past 15 years Professor Frantz has made, and continues to make, a major contribution to the development of the scholarly career paths of HSE in sub-Saharan Africa. To date she has graduated 47 higher degrees (39 Masters degrees and 8 PhDs) in the training and/or clinical practice of physiotherapy, and she is currently supervising another 8 Masters students and 11 PhD candidates. Her postgraduate students include practitioners from South Africa, Rwanda, Kenya, Uganda, Zambia and Sudan. Her unique skills in higher education capacity development were recently recognised in 2016, when she was awarded the National Research Foundation award for Champion of Research Capacity Development and Transformation at South African Higher Education Institutions.

Professor Frantz is also a reviewer for the three largest national research organizations in South Africa (National Research Foundation, Medical Research Council, and SANPAD) which provide the vast majority of funding for health professions research in South Africa. In this role she makes a strategic contribution to the national process of acknowledging and rewarding excellence in HSE and promoting the scholarly career paths of HPE in SA.

Call for SAAHE 2017 awards

Note: This page has been updated to reflect extensions to the submission deadlines for the two awards.

We are pleased to announce the call for nominations for both the Distinguished Educator and Best Publication awards for 2017.

The annual SAAHE Distinguished Educator Award recognises an individual in health sciences education who has made a significant contribution either in teaching in the health sciences or who has contributed to the development of scholarship in the discipline of health sciences education. The award seeks to recognise excellence at a national level and to create an awareness of what constitutes excellence in health sciences education. As such, this is the premier award of its kind in South Africa.

The award for Best Publication is made annually to promote excellence in research in health sciences education (HSE), as an important component of advancing the field of HSE. This award is for a peer-reviewed publication (paper; book chapter) on HSE or HSE research, with a South African first author, published anywhere.

The closing deadlines for nominations are:

Western Cape regional symposium: Teaching with technology

On the 17th October the SAAHE Western Cape regional committee hosted a symposium for members on Teaching with Technology (see programme below).

 

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While 50 participants initially registered to attend, we ended up with about 30 who actually managed to make it, owing to the challenges experienced by academics at the 4 institutions at the time. We are grateful to those who gave up their time to attend and present at the symposium and look forward to hosting more of these initiatives in the future.

An Open Letter to the State President and the Ministers of Higher Education and Finance

Save our public universities

We, academics of South African universities, call on our government to address the funding crisis in higher education.

A key strategy that post-apartheid governments undertook to reduce race and class inequality after apartheid was to substantially increase access to universities in South Africa. Between 1994 and 2014, the number of students in our public universities more than doubled.(1) During the same period the proportion of black students at universities increased from 52% to 81% of the student population.(2) We have welcomed the massification and deracialisation of access to universities as a necessary democratisation of higher education after apartheid, and as our contribution to building a better society.

The problem is that massification has not been matched by adequate funding. Year on year we have seen a decrease in real terms of government funding to public universities. The effect of this has been to create conditions of austerity in universities, as well as to force universities to grow their revenue by increasing tuition fees and ‘third stream’ income. Despite increases in NSFAS, high student fees continue to cause exclusions and our students are increasingly stressed by mounting debt, which has risen staggeringly since the mid-1990s.(3) Public universities have thus been put in slow decline: the quality of teaching and infrastructure of our institutions of higher learning is deteriorating because of long-term austerity, and this has been accompanied by a submission to privatisation and debt.

Our public universities can in fact barely be called public, with national government subsidies to university budgets falling from an already low 49% in 2000 to 40% in 2012.(4) This has placed enormous pressure on the maintenance and improvement of core educational infrastructure such as laboratories, libraries, lecture theatres and student residences. Furthermore, staff:student ratios have continuously increased because the employment of full-time academic staff has not matched increases in student numbers. There is also a growing tendency to casualise academic labour through short-term appointments, which has led to the exploitation especially of younger academics, while undermining the quality of teaching, and increasing the administrative burden on full time academic staff. Crucially, casualisation and increased workloads at universities undermine our research capacity. The impact of high quality original research on national development cannot be overstated, and the threat to research capacity has enormous consequences for the future of our country.

Lack of investment in our public universities is not only a national crisis, but has negative effect on our standing in Africa. Since the end of Apartheid, our universities have trained cohorts of postgraduate students from the region and across the continent. South Africa’s tertiary institutions currently educate many of the continent’s best students, who are increasingly turning to South African universities as Africans are de facto excluded from British and North American institutions. Investing in our universities would maintain our reputation on the continent, create strong connections between future African leaders, and produce goodwill and opportunities for South Africa in decades to come.

The Council on Higher Education, established by the Department of Higher Education and Training itself, argues that despite the fact that ‘higher education in South Africa has been regarded as a key to social and economic development… its expenditure on higher education is much lower than desirable or needed.’(5) South Africa spends a mere 0.6% of GDP on its universities, lagging behind many other countries (Russia at 1.8%, Argentina and 1.4, India at 1.3%).(6)

With government not funding in full the financial shortfall resulting from the 0% fee freeze in 2016, universities have had to cut costs further from their already-stretched budgets. This has impacted all of us in our daily work, but Historically Black Universities have been the hardest hit because of a historical deficit in reserves and reduced access to private income. Thus, a further hierarchisation of our universities is taking place, compounding older race and class divisions in higher education.

In short, our universities are chronically underfunded. We are being threatened with cuts to our teaching programmes, our research budgets, hiring is being frozen, posts down-graded, and the core functions of universities are being put under threat. We have reached a limit. We simply cannot weather any further cuts without jeopardizing the academic project.

As academics responsible for the quality of South African universities, we call on government to take seriously the worth of university education as a public good, and to reverse the decline in public higher education by substantially increasing the state subsidy to universities.

Circulated by the academics of the School of Social Sciences, University of the Witwatersrand

  1. Student numbers rose from 495,000 in 1994 to almost a million students in 2014. Council on Higher Education. 2016. South African Higher Education Reviewed: Two Decades of Democracy. Pretoria.
  2.  Higher Education South Africa. 2014. South African Higher Education in the 20th Year of Democracy: Context, Achievements and Key Challenges, pp.1-2. These numbers do not of course capture the manner in which institutions remain differentially racialised.
  3.  Steyn and De Villiers. 2006. The Impact of changing funding on higher education institutions in South Africa. Higher Education Monitor, No.4, March.
  4.  PriceWaterhouseCooper, Funding of public higher education institutions in South Africa. www.pwc.co.za/en/higher-education/Funding-public-higher-education-institutions-SA.html
  5.  Council on Higher Education. 2016. South African Higher Education Reviewed: Two Decades of Democracy. Pretoria.
  6.  Bozzoli, ‘Behind the university funding crisis’ Politicsweb 19 October 2015. www.politicsweb.co.za/news-and-analysis/behind-the-university-funding-crisis.

SAAHE AGM at the 2016 conference

Notice is hereby given of the SAAHE Annual General Meeting to take place on the 22nd June at the National Conference in Port Elizabeth.

Members are encouraged to review the documentation for the AGM below, and to attend the meeting at 16:00 on the 22nd.

SAAHE 2016 Distinguished Educator announced

It is with great pleasure and pride that we award the 2016 SAAHE Distinguished Educator award to Professor Marietjie de Villiers, from the Family Medicine and Primary Care Faculty of Medicine and Health Sciences at Stellenbosch University.

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From the nomination:

A true health professions educator is one who facilitates learning in every possible way from introducing a group of excited first-year students to the field of medicine, through supporting postgraduate students in their endeavours to become masters of their craft, to engaging a group of practicing clinicians around their continued professional learning. In addition, a true educator functions as advocate and activist for learning and teaching, challenges accepted norms with a view to enhancing teaching practice, and fosters the establishment of enabling environments where potentially transformative learning can take place. Marietjie de Villiers is such an educator. In a career of over 35 years (23 in academic medicine at the Faculty of Medicine and Health Sciences (FMHS), Stellenbosch University), Professor de Villiers progressed from being a lecturer to full Professor in 11 years and to Deputy Dean: Education in the Faculty of Medicine and Health Sciences in 2006. More importantly, however, she has been the catalyst for a whole range of learning and teaching innovations and projects that through the years have established the FMHS as a pioneer in the field of medical and health professions education. Her work is characterised by a dedication and commitment to her students and the staff with whom she works, and is informed by an enduring commitment to the provision of quality health outcomes within a socially just context. In this submission, we track the career of this remarkable educator and teacher, and present it as motivation for why she would be a worthy winner of the SAAHE Distinguished Educator award.

After matriculation at the Paarl Gymnasium in 1973, Marietjie spent a year at the SA Women’s Army College in George before embarking on her medical degree at Stellenbosch University in 1975. After graduation and internship she joined a general practice in Kuilsriver in the Western Cape before moving to Mfuleni where she worked in the local township for six years spurred on by a commitment during the apartheid years to care for the poor and the oppressed. As teacher at heart, however, she eventually took up a position in the FMHS at SU in 1993 having obtained her Master’s degree in Family Medicine (1988). Later she obtained her PhD in Family Medicine which focussed on the development of content and appropriate methods for maintenance of competence for generalist medical practitioners working in rural areas (2004), which was the first research on rural medicine in South Africa at the time

It is, however, her work in educational leadership and management – at faculty, institutional, national and international level – that sets Marietjie de Villiers apart as advocate for health professions education. Prof de Villiers is not only an educator who makes things happen, she is also a teaching scholar and is regularly called upon to present plenaries at national and international scientific meetings. More than 25 of her peer-reviewed publications focus on an aspect of education, with community based education being a strong theme in her research. She regularly presents her work at local and international health professions education conferences and has attended ten SAAHE meetings and conferences through the years. She was the FMHS representative on SAAME (the SAAHE precursor) and led the transition from SAAME to SAAHE at the FMHS at the time.

Prof de Villiers has earned international, African and national standing as a leader in health professions education. She has presented 172 papers at international and national conferences, and published 89 publications of which 40 original research articles and 12 book chapters. Marietjie de Villiers is a believer – she believes in people, she believes in the power of education to influence health outcomes, and she believes in South Africa. In 2007 she co-authored an article in Medical Teacher entitled: Medical Education in South Africa: Exciting times. The closing paragraph in that article says the following:

Despite all the odds, medical education in South Africa continues to produce excellent doctors using up to date educational strategies. We are proud of our political, economic and social changes. We are not complacent about further changes that need to take place. Watch this space and watch this country.

Since the publication of that article, Marietjie has continued to strive towards effecting the ‘further changes’ that are needed in health professions education on the African continent, influencing practice in the FMHS and beyond, doing so in a generative and meaningful way, taking others with her along the way. There can be no doubt that she would be a worthy winner of the SAAHE Distinguished Educator Award in 2016.