Browsing by Author "Moodley, Kubendhren"

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    Development of a framework to guide community engagement in paramedic education and training in the Western Cape
    (2023) Moodley, Kubendhren; Saunders, C.; LWallis, L.; Bhagwan, R.
    Emergency Medical Services in South Africa provide healthcare to a vast array of culturally and socio-economically divided communities against the backdrop of slow economic growth, limited resource capacity, and high emergency care caseloads. In such settings, community engagement, as a key function of the higher education mandate, presents an opportunity for strengthening university-community partnerships for reciprocal benefits through undergraduate emergency medical care education. This study was conducted at five higher education institutions in the Western Cape Province, two of which offer emergency medical care qualifications. The objectives of the study were fivefold: (1) to establish the views of community engagement academics at higher education institutions regarding best practices on community engagement within health science education; (2) to ascertain how emergency medical care academics conceptualise community engagement and implement it within the context of teaching, learning and research (3) to explore the views of emergency medical care students about their experiences of community engagement; (4) to investigate the experiences of community engagement partners with regards to how they engage with emergency medical care students and academics from higher education institutions; and (5) to develop a framework to guide community engagement in emergency medical care, as an emerging health profession to effect positive change in its professional response to community engagement. This study employed an exploratory, descriptive qualitative research methodology. Semi-structured in-depth interviews and focus group interviews were utilised to collect the qualitative data. Study participants comprised academics from health science faculties with experience in community engagement, emergency medical care academics, paramedic students and community partners. The researcher sought to understand how the participants conceptualised community engagement, the values and principles underpinning community engagement, and what processes and activities can be used to advance community engagement at local universities. Through thematic analysis, six key themes emerged, which, together with supporting literature, served as a basis for developing a community engagement framework for emergency medical care education. The crucial structural elements of the developed community engagement framework were underpinned by a conceptual understanding of community engagement; the processes that fostered community engagement in health-related projects; the nature of community engagement projects in health sciences; and how the learning experiences of paramedic students could be enhanced. The framework is intended to guide emergency medical care academics to strengthen paramedic education with community engaged practices to ensure the development of socially responsive paramedic graduates while improving healthcare in impoverished communities through mutually beneficial university-community partnerships.
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    Validity and reliability of the South African Triage Scale in prehospital providers
    (2021-01-15) Mould-Millman, Nee-Kofi; Dixon, Julia M; Burkholder, Taylor; Pigoga, Jennifer L; Lee, Michael; de Vries, Shaheem; Moodley, Kubendhren; Meier, Maxene; Colborn, Kathryn; Patel, Chandni; Wallis, Lee A
    Background The South African Triage Scale (SATS) is a validated in-hospital triage tool that has been innovatively adopted for use in the prehospital setting by Western Cape Government (WCG) Emergency Medical Services (EMS) in South Africa. The performance of SATS by EMS providers has not been formally assessed. The study sought to assess the validity and reliability of SATS when used by WCG EMS prehospital providers for single-patient triage. Methods This is a prospective, assessment-based validation study among WCG EMS providers from March to September 2017 in Cape Town, South Africa. Participants completed an assessment containing 50 clinical vignettes by calculating the three components — triage early warning score (TEWS), discriminators (pre-defined clinical conditions), and a final SATS triage color. Responses were scored against gold standard answers. Validity was assessed by calculating over- and under-triage rates compared to gold standard. Inter-rater reliability was assessed by calculating agreement among EMS providers’ responses. Results A total of 102 EMS providers completed the assessment. The final SATS triage color was accurately determined in 56.5%, under-triaged in 29.5%, and over-triaged in 13.1% of vignette responses. TEWS was calculated correctly in 42.6% of vignettes, under-calculated in 45.0% and over-calculated in 10.9%. Discriminators were correctly identified in only 58.8% of vignettes. There was substantial inter-rater and gold standard agreement for both the TEWS component and final SATS color, but there was lower inter-rater agreement for clinical discriminators. Conclusion This is the first assessment of SATS as used by EMS providers for prehospital triage. We found that SATS generally under-performed as a triage tool, mainly due to the clinical discriminators. We found good inter-rater reliability, but poor validity. The under-triage rate of 30% was higher than previous reports from the in-hospital setting. The over-triage rate of 13% was acceptable. Further clinically-based and qualitative studies are needed. Trial registration Not applicable.