"But This Is the New Reality, and I Will Adapt": Understanding Lecturers' Experiences of COVID-19 Lockdown Online Learning and Teaching

Following the 2020 COVID-19 pandemic national lockdown in South Africa, the University of the Free State launched various support initiatives for academic staff and students. Teaching and learning activities and assessments were adapted for emergency remote teaching. Students and academic staff members experienced disruption due to the migration to the online environment. This study aimed to investigate the experiences of academic staff members in an undergraduate medical programme using a mixed-methods approach in the form of a sequential exploratory design in two phases. Quantitative data were obtained through an online questionnaire survey that were triangulated and complemented with qualitative data obtained from responses to open questions in the questionnaire survey and online reflective essays. Quantitative data revealed that although most academic staff members had received training in and used mostly administrative functions in the learning management system (Blackboard) prior to lockdown, its uses almost doubled during the lockdown. Qualitative data analysis gave an in-depth understanding of academic staff members' experiences identified in the themes Teaching and Learning, Assessment, Technology, Communication, and Personal Experience. Concerns were expressed regarding students' access to technology and adaptation to online learning, and training needs and challenges were identified. The lessons learnt through the resilient, transformative responses to this global disruptor can guide future strategies for medical education.

A high incidence of injury among male university student rugby players requires urgent injury prevention strategies

OBJECTIVES

Determine the epidemiology and clinical characteristics of training and match injuries in university student rugby players over a two-season period.

DESIGN

Prospective cohort.

SETTING

Varsity Cup (VC) and Young Guns (YG) rugby tournaments (2018 and 2019).

PARTICIPANTS

171 male university student rugby players.

MAIN OUTCOME MEASURES

For time-loss injuries: injury incidence (injuries per 1000 player-hours), injured player proportion (% of injured players) and the frequency (n, %) of injury characteristics (new or recurrent, anatomical region, body area, severity.

RESULTS

The injury incidence was 2.4 per 1000 player-hours for training injuries and 131.1 per 1000 player-hours for match injuries. The overall injured player proportion was 59.6%. New injuries (83.9%) were more frequent than recurrent injuries. Most injuries occurred in the lower limb involving muscle/tendon (56.7%) and ligament/joint capsule (27.2%). The shoulder (19.6%) and ankle (15.7%) were the most common body areas of injury during matches and training, respectively.

CONCLUSIONS

There was a high injured player proportion and match injury incidence among university student rugby players. Most injuries were new. Lower limb injuries were most common in training whereas upper limb injuries were most common in matches. These findings highlight the need to prioritise future injury prevention among university student rugby players.

Chronic diseases of lifestyle curriculum: Students' perceptions in primary health care settings

BACKGROUND

Community-based primary health care (PHC) forms the foundation of healthcare in South Africa. Medical programmes need to equip future health practitioners to face the challenges of the rising burden of chronic diseases of lifestyle (CDL) in different communities. Community-based education (CBE) contributes to developing knowledge, skills and attitudes appropriate to the challenges experienced in the PHC context.

AIM

To explore medical students' perceptions of the current CDL curriculum and related programmes during CBE rotations.

SETTING

The study was conducted among fourth- and fifth-year medical students at the University of the Free State, South Africa.

METHODS

Focus group discussions were conducted and data were analysed thematically.

RESULTS

Themes included perceptions of the CDL curriculum, relevance thereof for the PHC setting and barriers and challenges to implementing PHC programmes. This study identified foundational CDL content that needs to be incorporated or revisited at strategic points. Participants identified the need to contextualise educational programmes and focus on affordable, culturally acceptable and holistic healthcare prevention strategies. Barriers and challenges included high patient load, resource constraints, the lack of continuous care and focus on communicable diseases. Community-based education rotations were described as meaningful opportunities to develop professional attributes, competencies and skills.

CONCLUSION

This study identified foundational concepts to consider at key points throughout the curriculum. Incorporating creative and reflective learning activities in CDL modules can prepare students for the realities of PHC settings.Contribution: This study provides insight into medical students' perceptions of the CDL curriculum and informs future curriculum content for CDL modules.

A Comparison of the Socio-Behavioral-Metabolic Risk Profiles and Associated Factors for Chronic Diseases of Lifestyle in Urban and Rural Communities in Central South Africa

Background: The global escalating prevalence of lifestyle-related non-communicable diseases places a significant burden on health systems. Chronic diseases of lifestyle (CDL) are a group of diseases that share similar modifiable risk factors that can result in long-term disease processes. Considering the socio-behavioral-metabolic risk profiles of communities and risk factors predictive of the presence of CDL can assist in the development of focused and effective community-based prevention, intervention, and treatment programs for CDL.

Aim: To determine the socio-behavioral-metabolic risk profiles and identify associated factors for the following CDL: obesity, cardiovascular disease, hypertension, and type 2 diabetes mellitus in rural and urban communities in central South Africa.

Methodology: This cross-sectional study included adults aged 25–65 years in the rural Southern Free State and urban Mangaung. Social determinants, behavioral and metabolic risk factors, and inflammatory biomarkers for CDL were determined.

Results: In total, 575 rural (mean age: 42 years; 71% female) and 429 urban (mean age: 44 years; 76% female) participants were included in the study. More than 20% of participants in both communities reported being previously diagnosed with cardiovascular diseases; with reported hypertension and diabetes mellitus more prevalent among rural participants. Insufficient intake of fruit and vegetables, alcohol use, and high blood pressure were among the top five risk factors in both communities. Physical inactivity ranked among the top two risk factors in the urban community; while alcohol and tobacco use was significantly higher in the rural community. Fibrinogen was the most prevalent inflammatory marker in both communities (32.9 rural vs. 48.3% urban). High sensitivity C-reactive protein (Hs-CRP), only available for rural participants, was high with increased levels in more than 80% of participants. In both communities, being female, having high blood pressure and increased fibrinogen levels were associated with obesity.

Conclusion: This study illustrated the high prevalence of socio-behavioral-metabolic risk factors for CDL, and identified similarities and distinct differences in the risk profiles of rural and urban communities. Considering the CDL risk profiles of communities can assist in prioritizing health needs and contribute to the development of tailor-made community-based primary health care prevention, intervention, and health promotion programs.

Second and third year medical students' self-reported alcohol and substance use, smoking habits and academic performance at a South African medical school

Background

Health professional students frequently use alcohol and narcotics. The potential impact on academic performance and professional behaviour is concerning.

Aim

This study aimed to determine self-reported use of alcohol, illicit substances (e.g. cannabis, lysergic acid diethylamide [LSD], magic mushroom, cocaine, crack, ecstasy, methamphetamine and heroin), prescription medication and smoking habits, correlating academic performance.

Setting

Faculty of Health Sciences, University of the Free State.

Methods

An observational, descriptive, cross-sectional study design was used. Information was obtained using a self-administered questionnaire, capturing demographics, self-reported academic performance, drinking and smoking habits, and substance use. Coded responses were analysed using the Remark Office OMR 8 Software System. Descriptive statistics were calculated for categorical variables.

Results

Completed questionnaires comprised 171 students. A total of 78.4% of second year and 82.8% of third year students reported using alcohol. Twenty-two per cent of second year and 24.1% of third year students reported cannabis use. In the second year group, three (2.7%) students reported using magic mushroom, two (1.8%) reported cocaine, two (1.8%) reported ecstasy and one (0.9%) reported using methamphetamine. Only third year students reported using LSD or ‘crack’. Cigarette smoking was common – 31.5% and 35.1% in both groups, respectively. Smokeless tobacco devices were used by 8.5% of second year and 7.1% of third year students. Almost 40% of both groups reported that they had smoked a water pipe. Academic performance achieved was mostly 60% – 69% (38.9%) among second year students and 70% – 79% (46.6%) among third year students.

Conclusion

Self-reported use of alcohol and drugs and smoking among medical students is alarming. Additional student support, early identification and referral for management and/or rehabilitation should be a priority at tertiary institutions responsible for training future healthcare professionals.

A scoring framework for assessing anatomy competence of undergraduate preclinical students

Recent higher education changes toward outcomes-based education emphasize competent learners, but a widely accepted definition of competence is still lacking. Although the importance of anatomy in health professions education is recognized, there is still uncertainty about what anatomical competence entails and how to assess it. This study aimed to provide a framework for assessing anatomical competence, using an anatomy competence score, for the anatomy course in the undergraduate medical learning program at the University of the Free State in South Africa. All assessments within the dissection program of two student groups (July 2012 to June 2014) were explored to determine the representation of the three competence domains: knowledge, skill and application in context. Student performance in the final objective structured practical examination (OSPE) was investigated for the three domains and the different body regions. Knowledge had ±50% representation in assessments and the different body regions (in final OSPE) for both groups, and skill and application represented ±25% each in both groups. The best average student performance was in the skill domain (64% and 67% for the respective groups). All domains showed good reliabilities (> 0.75) and student performance correlated well between the domains (P < 0.001). This study suggests a representation ratio of 2:1:1 between knowledge, skill and application (i.e., 50% knowledge and 25% skill and application respectively), for anatomical competence assessment. However, this ratio depends on the assessment type, the stage of the anatomy course and the institutional context. Nonetheless, it provides a guideline for ensuring that assessments address all competence domains. Anat Sci Educ 9: 319-329. © 2015 American Association of Anatomists.

Risk-factor profiles for chronic diseases of lifestyle and metabolic syndrome in an urban and rural setting in South Africa

Background: Chronic lifestyle diseases share similar modifiable risk factors, including hypertension, tobacco smoking, diabetes, obesity, hyperlipidaemia and physical inactivity. Metabolic syndrome refers to the cluster of risk factors that increases the risk for developing type 2 diabetes mellitus (DM) and cardiovascular disease. Objectives: The study aimed to assess health status and identify distinct risk-factor profiles for both chronic lifestyle diseases and metabolic syndrome in rural and urban communities in central South Africa.Methods: The investigation formed part of the Assuring Health for All in the Free State (AHAFS) study. During interviews by trained researchers, household socio-demographic and health information, diet, risk factors (i.e. history of hypertension and/or diabetes) and habits (e.g. smoking and inadequate physical activity levels) were determined. Adult participants underwent anthropometric evaluation, medical examination and blood sampling.Results: The risk-factor profile for chronic lifestyle diseases revealed that self-reported hypertension and physical inactivity were ranked the highest risk factor for the rural and urban groups respectively. The cumulative risk-factor profile showed that 40.1% of the rural and 34.4% of the urban study population had three or more risk factors for chronic lifestyle diseases. Furthermore, 52.2% of rural and 39.7% of urban participants had three or more risk factors for metabolic syndrome.Conclusion: This study confirmed that the worldwide increase in the prevalence of chronic lifestyle diseases can be attributed to a more sedentary lifestyle, especially illustrated in the urban study population, and increasing obesity. The rural study population had a higher prevalence of risk factors for metabolic syndrome.