Medical education and the quality improvement spiral: A case study from Mpumalanga, South Africa

• Main Authors: Martin Bac (Author), Anne-Marie Bergh (Author), Mama E. Etsane (Author), Jannie Hugo (Author)
• Format: Book
• Published: AOSIS, 2015-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2071-2928; 2071-2936; 10.4102/phcfm.v7i1.738
• Keywords: medical education; quality improvement; mother- and baby-friendly hospitals; district health rotations; Medicine; R; Public aspects of medicine; RA1-1270
• Source: African Journal of Primary Health Care & Family Medicine, Vol 7, Iss 1, Pp e1-e10 (2015)

Background: The short timeframe of medical students' rotations is not always conducive to successful, in-depth quality-improvement projects requiring a more longitudinal approach. Aim: To describe the process of inducting students into a longitudinal quality-improvement project,using the topic of the Mother- and Baby-Friendly Initiative as a case study; and to explore the possible contribution of a quality-improvement project to the development of student competencies. Setting: Mpumalanga clinical learning centres, where University of Pretoria medical students did their district health rotations. Method: Consecutive student groups had to engage with a hospital's compliance with specific steps of the Ten Steps to Successful Breastfeeding that form the standards for the Mother- and Baby-Friendly Initiative. Primary data sources included an on-site PowerPoint group presentation (n = 42), a written group report (n = 42) and notes of individual interviews in an end-of-rotation objectively structured clinical examination station (n = 139). Results: Activities in each rotation varied according to the needs identified through the application of the quality-improvement cycle in consultation with the local health team. The development of student competencies is described according to the roles of a medical expert in the CanMEDS framework: collaborator, health advocate, scholar, communicator, manager and professional. The exposure to the real-life situation in South African public hospitals had a great influence on many students, who also acted as catalysts for transforming practice. Conclusion: Service learning and quality-improvement projects can be successfully integrated in one rotation and can contribute to the development of the different roles of a medical expert. More studies could provide insight into the potential of this approach in transforming institutions and student learning.