Re-imagining doctor-patient relationships in an African context: a transformative educational perspective

dc.contributor.advisorReid, Stephen
dc.contributor.authorRas, Tasleem
dc.date.accessioned2023-09-12T07:57:08Z
dc.date.available2023-09-12T07:57:08Z
dc.date.issued2023
dc.date.updated2023-09-12T07:39:45Z
dc.description.abstractClinician-patient relationships are central to health care, health systems and medical education. Current educational practice of doctor-patient relationships emerged from an episteme rooted in a biomedical understanding of disease, having epistemic and pedagogical roots in Global North contexts. The thesis offers an analysis of clinician-patient relationships that includes medical ethics, communication skills, and the development of the widely accepted (in Family Medicine) Biopsychosocial model of the clinical consultation. Using a South African clinical postgraduate Family Medicine training programme as a case study, this project answered two central research questions: (i) How do students learn to navigate relationships with patients in this training programme? And (ii) Can we develop an educational model of doctor patient relationships based on local experiences? Mezirow's transformative learning theory, Mbiti's conceptualisation of Ubuntu as an African philosophy, and Foucault's thoughts on structural power provided a conceptual framework. Aim The project aimed to understand the process of student learning about the doctor-patient encounter and to develop a model for teaching about the doctor-patient relationship. Methodology A qualitative longitudinal case study was conducted, drawing data from postgraduate students, educators, and patients. Data was collected from educational, clinical, and reflective activities, and analysed thematically using an inductive approach. Findings The key themes describe students' learning in relation to critical self-awareness, contextual awareness, the dialogic nature of learning, and the impact of transformed perspectives. Patients valued that their patient-hood and personhood were validated, and educators highlighted the theme that vulnerability has pedagogical implications. A new perspective of power dynamics in the clinical encounter is described and an Ubuntu-inspired episteme and pedagogy is synthesised from the findings. Conclusion This decolonial project provides evidence and proposes a model for incorporating an indigenous philosophy (Ubuntu) into mainstream health sciences education. Recommendations are made for educational and clinical practice, as well as future research.
dc.identifier.apacitationRas, T. (2023). <i>Re-imagining doctor-patient relationships in an African context: a transformative educational perspective</i>. (). ,Faculty of Health Sciences ,Department of Health Sciences Education. Retrieved from http://hdl.handle.net/11427/38536en_ZA
dc.identifier.chicagocitationRas, Tasleem. <i>"Re-imagining doctor-patient relationships in an African context: a transformative educational perspective."</i> ., ,Faculty of Health Sciences ,Department of Health Sciences Education, 2023. http://hdl.handle.net/11427/38536en_ZA
dc.identifier.citationRas, T. 2023. Re-imagining doctor-patient relationships in an African context: a transformative educational perspective. . ,Faculty of Health Sciences ,Department of Health Sciences Education. http://hdl.handle.net/11427/38536en_ZA
dc.identifier.ris TY - Doctoral Thesis AU - Ras, Tasleem AB - Clinician-patient relationships are central to health care, health systems and medical education. Current educational practice of doctor-patient relationships emerged from an episteme rooted in a biomedical understanding of disease, having epistemic and pedagogical roots in Global North contexts. The thesis offers an analysis of clinician-patient relationships that includes medical ethics, communication skills, and the development of the widely accepted (in Family Medicine) Biopsychosocial model of the clinical consultation. Using a South African clinical postgraduate Family Medicine training programme as a case study, this project answered two central research questions: (i) How do students learn to navigate relationships with patients in this training programme? And (ii) Can we develop an educational model of doctor patient relationships based on local experiences? Mezirow's transformative learning theory, Mbiti's conceptualisation of Ubuntu as an African philosophy, and Foucault's thoughts on structural power provided a conceptual framework. Aim The project aimed to understand the process of student learning about the doctor-patient encounter and to develop a model for teaching about the doctor-patient relationship. Methodology A qualitative longitudinal case study was conducted, drawing data from postgraduate students, educators, and patients. Data was collected from educational, clinical, and reflective activities, and analysed thematically using an inductive approach. Findings The key themes describe students' learning in relation to critical self-awareness, contextual awareness, the dialogic nature of learning, and the impact of transformed perspectives. Patients valued that their patient-hood and personhood were validated, and educators highlighted the theme that vulnerability has pedagogical implications. A new perspective of power dynamics in the clinical encounter is described and an Ubuntu-inspired episteme and pedagogy is synthesised from the findings. Conclusion This decolonial project provides evidence and proposes a model for incorporating an indigenous philosophy (Ubuntu) into mainstream health sciences education. Recommendations are made for educational and clinical practice, as well as future research. DA - 2023 DB - OpenUCT DP - University of Cape Town KW - Clinician-patient relationships LK - https://open.uct.ac.za PY - 2023 T1 - Re-imagining doctor-patient relationships in an African context: a transformative educational perspective TI - Re-imagining doctor-patient relationships in an African context: a transformative educational perspective UR - http://hdl.handle.net/11427/38536 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/38536
dc.identifier.vancouvercitationRas T. Re-imagining doctor-patient relationships in an African context: a transformative educational perspective. []. ,Faculty of Health Sciences ,Department of Health Sciences Education, 2023 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/38536en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Health Sciences Education
dc.publisher.facultyFaculty of Health Sciences
dc.subjectClinician-patient relationships
dc.titleRe-imagining doctor-patient relationships in an African context: a transformative educational perspective
dc.typeDoctoral Thesis
dc.type.qualificationlevelDoctoral
dc.type.qualificationlevelPhD
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