17th Wonca World Rural Health Conference

‘Learning in Rural Settings’ Webinar

October 31, 2020
Ian Couper and Jana Muller

South Africa: Stellenbosch University and Ukwanda Centre for Rural Health

PowerPoint Presentation

Chat Transcript

Chat Transcript

01:32:47 Heather McGrath: I am Heather McGrath from Jamaica
01:36:57 Ntawuyirushintege Rodrigue: Hello, Ntawuyirushintege from Burundi, 4th year medical student. I am sorry i am following you from a place where i can’t speak loud; i am just listening.
01:37:58 Tamkin Khan: hi
01:38:08 Tamkin Khan: tamkin from india
01:38:59 Prof Zakiur Rahman: welcome
01:41:19 Nicholas Torres: Welcome everyone on behalf of The Network Toward Unity for Health.
01:45:12 Bruce Chater: please add comments to chat and mute your microphone if not talking \
01:55:40 Ian Couper: The SUCCEED Framework paper referred to in the video has sicne been published:
01:55:44 Ian Couper: Van Schalkwyk, S.C., Couper, I.D., Blitz, J. et al. A framework for distributed health professions training: using participatory action research to build consensus. BMC Med Educ 20, 154 (2020). https://doi.org/10.1186/s12909-020-02046-z
01:56:08 Ozden Gokdemir: Thank you very much for sharing
01:56:08 Heather Wilkinson: Were Speech Therapy students involved?
01:56:54 Ntawuyirushintege Rodrigue: thank you for sharing
01:56:54 Ian Couper: Yes, they are involved, doing short term rotations
01:57:50 Ian Couper: Comment above referred to SLHT students
01:59:06 Ntawuyirushintege Rodrigue: What should be the attitude of a learner in the learner_patient relationship?
01:59:44 Ian Couper: Good question. Let’s pick this one up in the discussion after the video.
01:59:58 Jana Muller: As a collaborator… first a listener, an eager learner and then a facilitator and collaborator
02:00:42 Anthony Cordero: Question: All the students for a particular rotate in this rural program? Or these are only for some students while the rest are in the traditional year? Thank you.
02:00:44 Nandita Hazra: Very meticulous work. As in perception management, it is essential to understand your community at various levels, esp with ref to what engages their interest to enhance their learning. Regards to all
02:00:49 Mershen Pillay: @heather Wilkinson – this paper covered speech therapy involvement and other so-called ‘’allied health: PILLAY, M et al. Allied health professional rural education: Stellenbosch University learners’ experiences. African Journal of Health Professions Education, [S.l.], v. 8, n. 2, p. 169 – 173, sep. 2016. ISSN 2078-5127. Available at: <http://www.ajhpe.org.za/index.php/ajhpe/article/view/578/420>. Date accessed: 31 Oct. 2020. doi:10.7196/AJHPE.2016.v8i2.578.
02:01:26 Anthony Cordero: Question: All the students for a particular year level rotate in this rural program? Or these are only for some students while the rest are in the traditional year? Thank you.

02:01:51 Ian Couper: Sadly the new curriculum we mentioned to be launched next year will now be launched in 2022 due to covid-19.
02:02:50 Elizabeth Sulastri Nugraheni: thank you so much
02:03:30 Anthony Cordero: Ian and Jana: Thank you so much for the presentation!!!
02:04:02 Ozden Gokdemir: Stellenbosch University learners’ experiences. African Journal of Health Professions Education, [S.l.], v. 8, n. 2, p. 169 – 173, sep. 2016. ISSN 2078-5127. Available at: <http://www.ajhpe.org.za/index.php/ajhpe/article/view/578/420
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02:04:14 Rick Botelho: In addition to this phenomenal work, which countries, policies and strategies have demonstrated the best practives in accelerating equity impact, social accountability and dissemination? What are the simple rules for doing that?
02:04:32 joice baliddawa: Hw long are the students in the field?
02:05:40 Ozden Gokdemir: Did you use portfolio to measure the outcomes for the student’s perspective?
02:05:47 Elhadi Miskeen: Thanks for the amazing presentation Elhadi Miskeen-Sudan
02:06:06 Ewen McPhee (Australia): Is the preceptor service a government or university funded service?
02:07:15 Anthony Cordero: Thank you for the answer Jana!
02:08:08 Heather Wilkinson: Excellent presentation. Thank you! And wishing you well from a semi-retired Speech Language Therapist and long time clinical educator.
02:09:38 Anthony Cordero: Question: Before their Interprofessional experience in this rural program, did the students from the different disciplines have interprofessional classes/modules in their earlier years in school? Thank you
02:09:58 Ozden Gokdemir: Thank you very much for answering; structured portfolios are usefull and more than grades-
02:10:55 joice baliddawa: how is inteprofessionall education promoted?
02:11:55 Elizabeth Sulastri Nugraheni: Any advice on how to develop moduls about interprofessional education/collaborator in early years of medical school ?
02:12:48 Anthony Cordero: Thank you Ian and Jana for the response!
02:13:36 Mershen Pillay: Has this way of training students to think ‘rural’ shifted their professions ‘ practices? For example does it allow them to re-imagine their professions at a broader level for things like health inequities – but broadly?
02:13:37 Jana Muller: Learning in parallel vs learning with from and about one another is very different
02:14:17 Elizabeth Sulastri Nugraheni: thank you Ian.
02:14:39 Elizabeth Sulastri Nugraheni: thank you Jana
02:16:45 Mershen Pillay: Thanks Jana – so does that mean we need to have professions engage scopes of practice to allow systemic changes? So rural health education must then marry health systems toward more effective outcomes?
02:20:11 Roger Strasser: Ian… You said that you would come back to Uppington. Please do… Roger.
02:20:35 Mershen Pillay: 🙂 thanks Jana
02:21:00 Jana Muller: Mershen what ideas do you think would work where you’re based ? 🙂
02:21:23 Mershen Pillay: Mostly I am arguing that health education is not about relocation…..
02:22:08 Anthony Cordero: Our university tries its best to assist the strengthening of the health system and health indicators of our partner communities by FIRST developing a SERVICE-ORIENTED Partnership Program between the community and the university (with faculty & staff only). Then the students come in to contribute to the SERVICE PROGRAM.
02:23:01 Bruce Chater: Like everywhere – The health services need to learn to be partners in the solutions they we both seek!
02:23:24 Elhadi Miskeen: Elhadi Miskeen-SudanI am working in University located in rural area in Saudi Arabia..We started curriculum update for Community based medical education ..what your advice ,,can we start from all the curriculum or to insert CBME modules in the current curriculum or to modify the courses
02:23:47 Jana Muller: @Anthony Cordero – Thank you. I am in complete agreement – It is so important on so many levels esp in terms of relationships and trust and also relevance
02:24:28 Ewen McPhee: Thanks Ian, we have a strong reliance on “private” Family Physicians as we have two levels of funding Federal GPs and States Hospitals -> GPs can claim money for teaching but often is done as an add on in busy clinics.The State run Hospitals are much more sought after by students because of the perceived acuity and inpatient work. Creates real challenges for primary care training. So great to hear your innovations are working.
02:25:31 Mershen Pillay: @Anthony – Nice one: would like to see how that shifts relationships …….
02:26:18 joice baliddawa: At College of Health Sciences at Moi it is within the respective curriculums for all the 8 programs.
02:27:00 Anthony Cordero: @Jana: Yes Jana. As one wise person said (I think it was Blumenthal) … the community is not a classroom, not a laboratory and not a charity case.
02:27:35 Mershen Pillay: @Anthony – yes, fully agree: which means then we provide a SERVICE not education……
02:28:26 Ewen McPhee: THanks
02:28:29 Jana Muller: But service can also be education right?
02:28:40 Anthony Cordero: @Mershen: Yes, you need the faculty field supervisors to be passionate about the public service nature of the partnership between the community and the university.
02:29:04 Jana Muller: using a service learning model can be very useful to accomplish both
02:29:47 Rick Botelho: For the old timers, what are the simple rules for advocacy and allyship to elevate rural health from medical schools to political and policy levels? Have these success stories been published?
02:30:25 Bruce Chater: yes Jana – students can be most useful as they learn
02:30:31 Arun Nair: thanks for the presentations Prof Couper and Jana. Arun Nair from Kimberley. look forward to the developments and impact in the Northern Cape as there certainly is the need for those principles to be developed here.
02:31:23 Bruce Chater: great points Roger
02:31:34 Anthony Cordero: @Mershen: Just 2 weeks ago, we were in a meeting with a Municipal Health Official. We explained that the university can deploy one faculty (me), one staff and one resident MD to the field and 13 medical interns online to assist them in their on-going programs. He said that they only need on-field presence. So since then, no medical interns are deployed to that town. They were re-assigned to another town
02:31:38 Jana Muller: Thank you Arun, we are learning so much with our involvement in the NC
02:31:42 joice baliddawa: student involvement takes the form of observations participation and service OPS and it is logged
02:35:35 Ewen McPhee: Are students from rural backgrounds, do they self select, or are they expected to go?
02:35:43 Jana Muller: In addition to what Ian was saying about students / university influence on the platform this includes: reigniting passion within clinicians, job satisfaction, desire to learn more, imporved clinical competence
02:37:45 Jana Muller: excuse the rushed spelling
02:42:51 Ian Couper: Impact of students: van Schalkwyk S, Blitz J, Couper I, de Villiers M, Lourens G, Muller J, van Heerden B. Consequences, conditions and caveats: a qualitative exploration of the influence of undergraduate health professions students at distributed clinical training sites. BMC Med Educ. 2018 Dec 19;18(1):311. doi: 10.1186/s12909-018-1412-y. PMID: 30567523; PMCID: PMC6299970.
02:48:19 Jana Muller: What are some of the ways that others are able to effect change within the health system ito practice?
02:49:58 Mershen Pillay: Thanks both 🙂
02:51:19 Ewen McPhee: Thanks Ian and Jana, this has been an excellent presentation and discussion
02:52:11 Elhadi Miskeen: Thank you very much
02:52:12 Roger Strasser: Thanks Ian and Jana… A great session!.. Many thanks… Roger.
02:52:29 Ozden Gokdemir: Thank you very much
02:52:49 Saad Uakkas: thank you Jana and Ian very much
02:52:57 Rick Botelho: Great session
02:52:59 Anthony Cordero: Thank you Ian and Jana!!!
02:53:08 joice baliddawa: thanks all