Medical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa

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dc.contributor.authorHutton, Lauren
dc.contributor.authorJenkins, Louis S.
dc.contributor.authorMash, Robert
dc.contributor.authorvon Pressentin, Klaus
dc.contributor.authorReid, Steve
dc.contributor.authorMorgan, Jennie
dc.contributor.authorKapp, Paul
dc.date.accessioned2023-09-13T13:17:56Z
dc.date.available2023-09-13T13:17:56Z
dc.date.issued2023-09-04
dc.date.updated2023-09-10T03:09:56Z
dc.description.abstractBackground In 2021, South Africa introduced a 6-month internship rotation in family medicine, in the second year of a 2-year internship programme for newly qualified doctors. This was a major change from the previous 3-months training in family medicine, and expanded the training platform to smaller district hospitals and primary health care (PHC) facilities, many of which had never had interns. The medical disciplines in South Africa needed to know if this change in the internship programme was worthwhile and successful. The aim of this study was to assess the new family medicine rotation for medical interns at district health facilities in the Western Cape Province. Methods Descriptive exploratory qualitative research included six intern programmes across the province. Purposeful sampling identified a heterogeneous group with maximum variation in experience. Overall, eight interns, four managers, four supervisors and four intern curators were included. Individual semi-structured interviews were audio-recorded and the transcripts were thematically analysed using the framework method and Atlas-ti software. Results Four major themes emerged around the varied structure and organisational characteristics of the rotations, the orientation and arrival of interns, their learning during the rotation, and impact on health services. A programme theory was developed that defined the key inputs (i.e. infrastructure, communication, orientation, preparation, prior learning and guidelines), processes (i.e. model of the rotation, clinical training and supervision, clinical teaching), outputs (i.e. more independent decision making, approach to undifferentiated problems, approach to chronic care and continuity, development of procedural skills, approach to sequential coordination of care and referrals, working in a multidisciplinary team and inter-professional learning, integration of multiple competencies, as well as becoming more person and community orientated). Conclusions The new rotation in family medicine was positively experienced by most interns, supervisors and managers. It should lead to improved quality of care, better preparation for obligatory community service, and an increased likelihood of considering a career in district level health services. This study will form part of an exploratory sequential mixed methods study that incorporates the key issues into a questionnaire for a descriptive survey of all interns in a subsequent study.
dc.identifier.apacitationHutton, L., Jenkins, Louis S., Mash, R., von Pressentin, K., Reid, S., Morgan, J., & Kapp, P. (2023). Medical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa. <i>BMC Medical Education</i>, 23(1), 636. http://hdl.handle.net/11427/38590en_ZA
dc.identifier.chicagocitationHutton, Lauren, Louis S. Jenkins, Robert Mash, Klaus von Pressentin, Steve Reid, Jennie Morgan, and Paul Kapp "Medical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa." <i>BMC Medical Education</i> 23, 1. (2023): 636. http://hdl.handle.net/11427/38590en_ZA
dc.identifier.citationHutton, L., Jenkins, Louis S., Mash, R., von Pressentin, K., Reid, S., Morgan, J. & Kapp, P. 2023. Medical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa. <i>BMC Medical Education.</i> 23(1):636. http://hdl.handle.net/11427/38590en_ZA
dc.identifier.ris TY - Journal Article AU - Hutton, Lauren AU - Jenkins, Louis S. AU - Mash, Robert AU - von Pressentin, Klaus AU - Reid, Steve AU - Morgan, Jennie AU - Kapp, Paul AB - Background In 2021, South Africa introduced a 6-month internship rotation in family medicine, in the second year of a 2-year internship programme for newly qualified doctors. This was a major change from the previous 3-months training in family medicine, and expanded the training platform to smaller district hospitals and primary health care (PHC) facilities, many of which had never had interns. The medical disciplines in South Africa needed to know if this change in the internship programme was worthwhile and successful. The aim of this study was to assess the new family medicine rotation for medical interns at district health facilities in the Western Cape Province. Methods Descriptive exploratory qualitative research included six intern programmes across the province. Purposeful sampling identified a heterogeneous group with maximum variation in experience. Overall, eight interns, four managers, four supervisors and four intern curators were included. Individual semi-structured interviews were audio-recorded and the transcripts were thematically analysed using the framework method and Atlas-ti software. Results Four major themes emerged around the varied structure and organisational characteristics of the rotations, the orientation and arrival of interns, their learning during the rotation, and impact on health services. A programme theory was developed that defined the key inputs (i.e. infrastructure, communication, orientation, preparation, prior learning and guidelines), processes (i.e. model of the rotation, clinical training and supervision, clinical teaching), outputs (i.e. more independent decision making, approach to undifferentiated problems, approach to chronic care and continuity, development of procedural skills, approach to sequential coordination of care and referrals, working in a multidisciplinary team and inter-professional learning, integration of multiple competencies, as well as becoming more person and community orientated). Conclusions The new rotation in family medicine was positively experienced by most interns, supervisors and managers. It should lead to improved quality of care, better preparation for obligatory community service, and an increased likelihood of considering a career in district level health services. This study will form part of an exploratory sequential mixed methods study that incorporates the key issues into a questionnaire for a descriptive survey of all interns in a subsequent study. DA - 2023-09-04 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Medical Education KW - Internship KW - Family medicine KW - Training KW - Rotation LK - https://open.uct.ac.za PY - 2023 T1 - Medical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa TI - Medical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa UR - http://hdl.handle.net/11427/38590 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12909-023-04605-6
dc.identifier.urihttp://hdl.handle.net/11427/38590
dc.identifier.vancouvercitationHutton L, Jenkins Louis S, Mash R, von Pressentin K, Reid S, Morgan J, et al. Medical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa. BMC Medical Education. 2023;23(1):636. http://hdl.handle.net/11427/38590.en_ZA
dc.language.rfc3066en
dc.publisherBioMed Central
dc.publisher.departmentFamily Medicine
dc.publisher.facultyHealth Science
dc.rights.holderBioMed Central Ltd., part of Springer Nature
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceBMC Medical Education
dc.source.journalissue1
dc.source.journalvolume23
dc.source.pagination636
dc.source.urihttps://bmcmededuc.biomedcentral.com/
dc.subjectInternship
dc.subjectFamily medicine
dc.subjectTraining
dc.subjectRotation
dc.titleMedical interns in district health services: an evaluation of the new family medicine rotation in the Western Cape of South Africa
dc.typeJournal Article
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