Browsing by Author "Theron, Elzarie"

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    Emergency registrars' and physicians' perceptions and preparedness to respond to the health impacts of climate change: a survey study
    (2024) Theron, Elzarie; Stassen, Willem; Ziervogel, Gina
    Climate change has many significant impacts on health. These impacts occur on top of existing conditions, which places a disproportionate burden on those who are already vulnerable. Emergency healthcare, which is responsible for all acute and urgent aspects of illness and injury, often serves as the first point of contact in the health system for patients who have been affected by climate change. However, it is expected that many emergency medicine specialists are not well versed on the health impacts of climate change, making it essential to assess their current perception of and preparedness to address these impacts in clinical practice. To create an understanding of emergency medicine registrars' and physicians' perceptions about climate change and health, climate-related health education, and self-perceived preparedness to respond to these impacts, this study followed a survey design, using an online questionnaire to collect data. Data were collected from emergency medicine registrars' and physicians' who are currently working in South Africa. The data were first analysed descriptively, and Mann-Whitney U tests were conducted to explore differences amongst sub-groups. Results indicated that most (80%, n = 16) participants recognised the health impacts of climate change and felt that it would impact their own and their patients' health. None of the participants however received any formal training on the topic and only 3 (15%) participants indicated that they probably have enough information to prepare for the health impacts of climate change. Exploratory analysis indicated that the extent to which participants agreed with the statement that climate change will affect their personal health scores was statistically significantly higher for those who identified as women than for participants who identified as men (p = .024). There is a need for better integration of climate-related health education into medical curricula to prepare emergency medicine specialists in response to the health impacts of climate change. Key Terms: emergency medicine, emergency healthcare professional, climate-related health impacts, climate-related health education, medical curriculum, emergency healthcare preparedness, gender differences.
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    Emergency registrars' and physicians' perceptions and preparedness to respond to the health impacts of climate change: a survey study
    (2024) Theron, Elzarie; Stassen, Willem; Ziervogel, Gina
    Climate change has many significant impacts on health. These impacts occur on top of existing conditions, which places a disproportionate burden on those who are already vulnerable. Emergency healthcare, which is responsible for all acute and urgent aspects of illness and injury, often serves as the first point of contact in the health system for patients who have been affected by climate change. However, it is expected that many emergency medicine specialists are not well versed on the health impacts of climate change, making it essential to assess their current perception of and preparedness to address these impacts in clinical practice. To create an understanding of emergency medicine registrars' and physicians' perceptions about climate change and health, climate-related health education, and self-perceived preparedness to respond to these impacts, this study followed a survey design, using an online questionnaire to collect data. Data were collected from emergency medicine registrars' and physicians' who are currently working in South Africa. The data were first analysed descriptively, and Mann-Whitney U tests were conducted to explore differences amongst sub-groups. Results indicated that most (80%, n = 16) participants recognised the health impacts of climate change and felt that it would impact their own and their patients' health. None of the participants however received any formal training on the topic and only 3 (15%) participants indicated that they probably have enough information to prepare for the health impacts of climate change. Exploratory analysis indicated that the extent to which participants agreed with the statement that climate change will affect their personal health scores was statistically significantly higher for those who identified as women than for participants who identified as men (p = .024). There is a need for better integration of climate-related health education into medical curricula to prepare emergency medicine specialists in response to the health impacts of climate change. Key Terms: emergency medicine, emergency healthcare professional, climate-related health impacts, climate-related health education, medical curriculum, emergency healthcare preparedness, gender differences.
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    Initiating the development of a South African curriculum for education in Neonatal Critical Care Transfers
    (2022) Williams, West; Stassen, Willem; Theron, Elzarie; Khan, Waseela
    Background Owing to limited neonatal care resources, the transfer of neonates to district and tertiary facilities is inevitable in a Low- and Middle-Income Country (LMIC) such as South Africa. The lack of neonatal transport is one of the top ten avoidable causes of under-5 mortality. In South Africa, these transfers are mostly conducted by Advanced Life Support (ALS) Providers with limited neonatal specific education. The transfer of neonates by teams with limited neonatal knowledge can lead to high adverse event rates. Dedicated Critical Care Retrieval Services (CCRS) teams have providers with additional education in neonatal critical care transfers and have shown a lower risk of adverse events in developed settings. Given the limited neonatal education of ALS providers that conduct transfers and the lack of dedicated CCRS teams in South Africa, it is the aim of this study to initiate the development of a neonatal critical care transfer curriculum. Methods A general and targeted needs assessment was conducted through semi-structured interviews with experts in the field and a focus group discussion with a learner group. The voice recordings were transcribed verbatim and data were analysed inductively, using content analysis to the manifest level. Results Six experts in neonatal critical care transfers participated in semi-structured interviews with a mean duration of 59 minutes (51-68min). Following transcription and analysis, 372 codes were extracted. Seven learners that involved in neonatal transfers in South Africa participated in a semi-structured focus group discussion with a duration of 91 minutes. The audio recording was transcribed and analysed with 97 codes extracted. The main categories were: Current status of neonatal CCR in South Africa; Learning and education in neonatal CCR; and proposed curriculum structure. The proposed curriculum structure described 13 broad course outcomes to be delivered as a blended postgraduate programme. Participants noted that funding, employer buy-in and internet resources would be required. The targeted student group should be all ALS providers with a change in their scope of practice on completion. Conclusion This study described the specific needs of prehospital learners as it pertains to the teaching, learning and assessment (TLA) of a curriculum in neonatal critical care transfers. It also described some of the limitations in the current and past education systems in neonatal critical care transfers. This study provides broad course outcomes and the results can be used to inform the next steps in curriculum development for education in neonatal critical care transfers.
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    South African emergency medical service personnel perceptions of research and evidence-based practice
    (2025) Dlamini, Zamasiba Cynthia; Saunders, Colleen; Theron, Elzarie
    Background: Evidence based practice (EBP) is the deliberate application of up to date, best available evidence to make decisions about health care. The implementation of EBP includes five steps: asking the right question, accessing relevant evidence, appraising evidence for reliability and validity, applying evidence to patient care, and lastly assessing clinical practice. The aim of this study was to assess strength of beliefs about EBP, and the frequency of implementation of EBP in South African emergency medical service (EMS) personnel. Methods: In this cross-sectional study we deployed an online survey of South African EMS personnel using two validated scales for measuring individual beliefs about EBP, their ability to implement it, and the extent of actual EBP implementation. Results: There were 67 respondents who were predominantly male (77,6%, n=52), had a mean age of 41,1 (± 9,8) years, and represented a wide range of operational, management and education experience. Measured by the EBP beliefs scale, respondents had a favourable attitude towards EBP (Median score: 60, IQR:51-69). There was no significant difference between the median beliefs score between qualification categories (p=0,578). Responses to the EBP implementation scale items indicate that respondents were not routinely implementing EBP. The median score was 21 (IQR: 8-37). The three EBP activities that were implemented most frequently were informally discussing evidence from a research study with a colleague (n=25), accessing the clinical practice guidelines (n=25), and promoting the use of EBP to colleagues (n=25). Availability of, and access to, appropriate evidence, and a perceived lack of critical appraisal skills, were identified barriers to EBP. In addition, the nature of the patient-provider relationship and the lack of feedback loops limits the application of EBP in EMS. Conclusion: The findings from this study indicate that respondents held favourable beliefs in EBP but identified several barriers to implementation of EBP. Supportive environments and training can facilitate the implementation of EBP principles in prehospital emergency medical care. Deidentified data is available upon request to the corresponding author for use in accordance with the participant consent obtained and pending appropriate ethical approvals.