Developing a Psychiatry Residency Program in a Low- and Middle-Income Country: Botswana's Experience.

Like many other low- and middle-income countries, Botswana has struggled to address the shortage of doctors, particularly specialists. In 2009, the country's first medical school offering an undergraduate medical program was established. A needs and feasibility assessment was conducted with relevant stakeholders to explore the need for specialty training programs in all medical school departments.

Developing an evaluation approach for the in-depth review of a new undergraduate medical programme as a complex system.

Background: A new undergraduate medical programme was instituted at the University of Botswana in 2009. In 2016, the Faculty of Medicine decided to conduct a comprehensive review of the programme. Participants at a planning workshop decided the review had to lead to an in-depth understanding of the programme.

Prospective Intervention Study Using Immediate-Fit, Adjustable Prostheses for Persons With Lower Limb Loss in Botswana-A Feasibility and Patient Acceptance Trial.

Objective: The aim of the study is to test the feasibility of an immediate-fit, adjustable prosthesis (iFIT Prosthesis) for persons with limb loss in Botswana.

Design: As part of the University of Pennsylvania and University of Botswana's long-term partnership, 18 persons with limb loss were fit at four different locations in Botswana. Patients were followed for 4-9 mos after fitting with an interview and Prosthetic Comfort and Utility questionnaire.

Sociocultural factors affecting first-year medical students' adjustment to a PBL program at an African medical school.

Background: Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students' experiences during the first semester of an undergraduate problem-based learning medical program at an African medical school.

Design of a Learning Development Program to Support First-Year Undergraduate Medical Students in the Transition to a PBL Curriculum.

Unlabelled: While the evaluation of learning development interventions needs to be considered carefully and included at the curriculum design stage, there is limited literature on the actual design of interventions, especially on how these designs evolve and improve over time. This paper describes the evolution of a learning development program intended to support first-year medical students adjusting to a problem-based learning curriculum. We used a design-based research approach, articulating our theoretical grounding and incorporating students' voices to develop an "optimal" intervention for the specific challenges in our context.

Local design and manufacturing of patient-specific implant using Anatomage Medical Design Studio software: proof of concept - Botswana's 1st case report.

Background: Botswana, like most sub-Sahara African nations, uses conventional orthopaedic implants that are sourced from major manufactures in the West. The implants are mass-produced and designed with universal configurations to fit an average patient. During surgery, surgeons thus sometimes bend the implants to match the individual bone anatomy, especially for paediatric patients and those with unique deformities, thus risking implant failure.

Novel Education Modules Addressing the Underrepresentation of Skin of Color in Dermatology Training.

Background: Representative images of pathology in patients with skin of color are lacking in most medical education resources. This particularly affects training in dermatology, which relies heavily on the use of images to teach pattern recognition. The presentation of skin pathology can vary greatly among different skin tones, and this lack of representation of dark skin phototypes challenges providers' abilities to provide quality care to patients of color.

A country-specific FRAX model for Botswana.

Introduction: Hip fracture rates in Botswana were used to create a FRAX® model for fracture risk assessment.

Objective: This paper describes the development and characteristics of a country-specific FRAX model for Botswana.

Methods: Age-specific and sex-specific incidence of hip fracture and national mortality rates was incorporated into a FRAX model for Botswana.

Epidemiology of hip fracture in Botswana.

Unlabelled: A retrospective population-based survey in the Republic of Botswana determined the incidence of fractures at the hip over 3 years. The estimated number of such fractures nationwide for 2020 was 103 and is predicted to increase.

Objective: This article describes the epidemiology of hip fractures in the Republic of Botswana.

Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: a survey.

Background: The purpose of this study was to determine whether the first cohort of graduates from a new undergraduate medical programme in Botswana were adequately prepared for internship.

Methods: The authors surveyed 27 interns and 13 intern supervisors on site, who rated intern preparedness for 44 tasks using a previously validated instrument. Tasks were grouped according to the seven roles of the physician in the CanMEDS framework and Cronbach α values confirmed internal consistency.

Enhancing learning in longitudinal clinical placements in community primary care clinics: undergraduate medical students' voices.

Longitudinal clinical placements are increasingly adopted by medical training institutions. However, there seems to be little evidence regarding their implementation in primary care settings in the developing world. This paper explored medical students' perceptions of their learning experiences in longitudinal placements in primary care clinics.

Using a virtue ethics lens to develop a socially accountable community placement programme for medical students.

Background: Community-based education (CBE) involves educating the head (cognitive), heart (affective), and the hand (practical) by utilizing tools that enable us to broaden and interrogate our value systems. This article reports on the use of virtue ethics (VE) theory for understanding the principles that create, maintain and sustain a socially accountable community placement programme for undergraduate medical students. Our research questions driving this secondary analysis were; what are the goods which are internal to the successful practice of CBE in medicine, and what are the virtues that are likely to promote and sustain them?

Methods: We conducted a secondary theoretically informed thematic analysis of the primary data based on MacIntyre's virtue ethics theory as the conceptual framework.

Bring-your-own-device in medical schools and healthcare facilities: A review of the literature.

Background: Enabling personal mobile device use through a bring-your-own device (BYOD) policy can potentially save significant costs for medical schools and healthcare facilities, as they would not always have to acquire facility-owned devices. The BYOD policy is also perceived as a driver for balancing user needs for convenience with institutional needs for security. However, there seems to be a paucity in the literature on BYOD policy development, policy evaluation, and evaluation of mobile device implementation projects.

Learning support interventions for Year 1 medical students: a review of the literature.

Context: The journey through medical school can be challenging, especially for undergraduate medical students who must deal with a demanding curriculum, coupled with the demands of transitioning into adulthood. Despite experiencing learning challenges, most students succeed with appropriate learning support. Many medical schools offer learning support programmes, particularly in the latter years, but it has been suggested that such support could be more beneficial, especially during the initial years.

Academic staff recruitment and retention challenges at the University of Botswana medical school.

Background: Sub-Saharan Africa has a greater share of the global burden of disease, poverty, and inadequate human resources for health compared with other regions of the world. Botswana, as other regional countries, is failing to successfully recruit and retain academics at its medical school.

Objectives: To document the medical school's staff recruitment and retention trends and challenges, and to propose possible solutions.

Rural exposure during medical education and student preference for future practice location - a case of Botswana.

Background: Botswana's medical school graduated its first class in 2014. Given the importance of attracting doctors to rural areas the school incorporated rural exposure throughout its curriculum.

Aim: This study explored the impact of rural training on students' attitudes towards rural practice.

The role of tablets in accessing information throughout undergraduate medical education in Botswana.

Background: Mobile learning (mLearning) uses wireless networks and mobile devices to expand physician trainees' and healthcare providers' access to and exchange of medical information. Opportunities to increase implementation and expand use of mobile devices to support health care information access and delivery in Africa are vast, but the rapid growth of mLearning has caused project implementation to outpace objective measurement of impact. This study makes a contribution to the existing body of literature regarding mLearning implementation in Africa through its focus on the use of smart devices (tablets) in undergraduate medical education and medical students' perceptions of the effects on their learning environment.

Establishing a new medical school: Botswana's experience.

Having adequate numbers of qualified human resources for health is essential for any effective health care system. However, there is a global shortage of skilled health care workers, especially in Sub-Saharan African countries. This shortage is exacerbated by a disproportionately high rate of infectious diseases, the burden of emerging chronic, noncommunicable diseases, and the emigration of medical doctors.

A systems approach to implementation of eLearning in medical education: five MEPI schools' journeys.

How should eLearning be implemented in resource-constrained settings? The introduction of eLearning at four African medical schools and one school of pharmacy, all part of the Medical Education Partnership Initiative (MEPI) eLearning Technical Working Group, highlighted the need for five factors essential for successful and sustainable implementation: institutional support; faculty engagement; student engagement; technical expertise; and infrastructure and support systems. All five MEPI schools reported strengthening technical expertise, infrastructure, and support systems; four schools indicated that they were also successful in developing student engagement; and three reported making good progress in building institutional support. Faculty engagement was the one core component that all five schools needed to enhance.

Strategies that improve paralyzed human quadriceps femoris muscle performance during repetitive, nonisometric contractions.

Objective: To determine the effect of combining different stimulation frequencies on the ability of paralyzed human quadriceps muscle to produce a 50 degrees knee excursion repetitively when starting at 90 degrees of flexion.

Design: Repeated-measures design.

Setting: Clinical research laboratory.

Strategies that improve human skeletal muscle performance during repetitive, non-isometric contractions.

Previous studies have suggested that during sustained maximal voluntary and evoked contractions, decreasing activation rates may minimize fatigue. The idea of gradually decreasing stimulation frequency to preserve force during fatiguing isometric contractions has, however, recently been challenged. The primary purpose of this study was to test the effectiveness of decreasing or increasing electrical stimulation rates during evoked, repetitive, submaximal, non-isometric contractions of healthy human quadriceps femoris muscles.

Effects of stimulation frequencies and patterns on performance of repetitive, nonisometric tasks.

The purpose of this paper was to determine the effects of stimulation pattern and frequency on repetitive human knee movements. Quadriceps femoris muscles were stimulated against a load equal to 10% of each subject's maximum voluntary isometric force. The main variable of interest was the number of repetitions in which the leg reached a target angle of 40 degrees of knee extension.

A novel stimulation pattern improves performance during repetitive dynamic contractions.

The purpose of this study was to determine the effect of three different stimulation patterns on repetitive knee movements. Each subject's quadriceps femoris was stimulated with: (1) a constant-frequency train (CFT) with an interpulse interval (IPI) of 50 ms; (2) a variable-frequency train (VFT)-similar to the CFT, except with an initial doublet with an IPI of 5 ms; and (3) a doublet-frequency train (DFT) with multiple doublets (doublet IPI 5 ms) separated by 50 ms, while the muscle was resisted by a load equal to 10% of the muscle's maximum voluntary isometric contraction. The muscle was stimulated while the knee moved through a 50 degrees arc of motion (90 degrees to 40 degrees of flexion).

Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics.

Objectives: To determine the effect of thoracic posture on scapular movement patterns, active range of motion (ROM) in scapular plane abduction, and isometric scapular plane abduction muscle force.

Study Design And Method: Repeated measures design. There were 34 healthy subjects (mean age, 30.