Primary health care providers' views on managing substance use among people living with HIV.

Background: The growing culture of substance use among people living with human immunodeficiency virus (PLWH) is a serious threat to the human immunodeficiency virus (HIV) pandemic. As the gatekeepers of comprehensive care, primary care providers are responsible for screening, assessing, and managing individuals who use substances.

Aim: This study aimed to evaluate primary care providers' views and approaches to substance use management among PLWH who attend primary care services in Mthatha.

Prevalence of hepatitis-B virus co-infection among people living with HIV in Mthatha region of South Africa.

Background: Hepatitis-B virus (HBV) co-infection among people living with HIV (PLWH) is highly endemic in South Africa. Despite the availability of an effective vaccine for the last four decades, chronic HBV infection is a major cause of morbidity and mortality among PLWH. Although the incidence of most opportunistic infections has been reduced in individuals with HIV since the implementation of the universal test and treat program in South Africa, HBV co-infection among PLWH is still accounting for high morbidity and mortality.

The effect of substance uses on antiretroviral treatment adherence in primary health care.

Background: Adherence to antiretroviral treatment (ART) is the primary factor determining how an individual responds to their treatment. Unfortunately, individuals who use substances experience suboptimal adherence to their treatment, but little is known about the exact effects of their use on ART adherence in primary health care settings.

Methods: The authors used a prospective cohort study to evaluate substance use's effects on ART adherence among people living with HIV (PLWH) who attend primary health care services in the Mthatha region of South Africa.

Evaluating the impact of a multicountry interprofessional training programme to improve HIV knowledge and clinical confidence among healthcare workers in sub-Saharan Africa: a cohort study.

Objective: To assess the impact of an interprofessional case-based training programme to enhance clinical knowledge and confidence among clinicians working in high HIV-burden settings in sub-Saharan Africa (SSA).

Setting: Health professions training institutions and their affiliated clinical training sites in 12 high HIV-burden countries in SSA.

Participants: Cohort comprising preservice and in-service learners, from diverse health professions, engaged in HIV service delivery.

When disruption strikes the curriculum: Towards a crisis-curriculum analysis framework.

Introduction: COVID-19 has severely disrupted health professions training globally. This pandemic has been preceded by several other interferences on a smaller scale, setting the scene for crises in perpetuity. With a reactive stance adopted, these crises may result in rapid shifts to curricula, minimizing the opportunity for thorough planning and critical analyses.

Identifying research priorities for health professions education research in sub-Saharan Africa using a modified Delphi method.

Background: Recent increases in health professions education (HPE) research in sub-Saharan Africa (SSA), though substantial, have predominantly originated from single institutions and remained uncoordinated. A shared research agenda can guide the implementation of HPE practices to ultimately influence the recruitment and retention of the health workforce. Thus, the authors aimed to generate and prioritise a list of research topics for HPE research (HPER) in SSA.

Prevalence of substance use amongst people living with human immunodeficiency virus who attend primary healthcare services in Mthatha, South Africa.

Background: About 13.3% of the South African population use some kind of substance during their lifetime. The incidence of substance use disorders is twice the global average.

A framework for distributed health professions training: using participatory action research to build consensus.

Background: There is a global trend towards providing training for health professions students outside of tertiary academic complexes. In many countries, this shift places pressure on available sites and the resources at their disposal, specifically within the public health sector. Introducing an educational remit into a complex health system is challenging, requiring commitment from a range of stakeholders, including national authorities.

The Medical Education Partnership Initiative (MEPI): Innovations and Lessons for Health Professions Training and Research in Africa.

MEPI was a $130 million competitively awarded grant by President's Emergency Plan for AIDS Relief (PEPFAR) and National Institutes of Health (NIH) to 13 Medical Schools in 12 Sub-Saharan African countries and a Coordinating Centre (CC). Implementation was led by Principal investigators (PIs) from the grantee institutions supported by Health Resources and Services Administration (HRSA), NIH and the CC from September, 2010 to August, 2015. The goals were to increase the capacity of the awardees to produce more and better doctors, strengthen locally relevant research, promote retention of the graduates within their countries and ensure sustainability.

Teaching Medical Students in a New Rural Longitudinal Clerkship: Opportunities and Constraints.

Background: Medical schools in Africa are responding to the call to increase numbers of medical graduates by up-scaling decentralized clinical training. One approach to decentralized clinical training is the longitudinal integrated clerkship (LIC), where students benefit from continuity of setting and supervision. The ability of family physician supervisors to take responsibility for the clinical training of medical students over a longer period than the usual, in addition to managing their extensive role on the district health platform, is central to the success of such training.

Designing faculty development: lessons learnt from a qualitative interpretivist study exploring students' expectations and experiences of clinical teaching.

Background: Clinical teaching plays a crucial role in the transition of medical students into the world of professional practice. Faculty development initiatives contribute to strengthening clinicians' approach to teaching. In order to inform the design of such initiatives, we thought that it would be useful to discover how senior medical students' experience of clinical teaching may impact on how learning during clinical training might be strengthened.

Twelve tips for distributed health professions training.

Increasing numbers of health professions students are being trained in healthcare facilities that are geographically removed from central academic hospitals. Consequently, studies have evaluated this distributed training, assessed the impact that it has on student learning as well as on the facilities where the training occurs, and explored factors that enable and constrain successful clinical training at such sites. The 12 tips presented in this article have been developed from a longitudinal project that has focused on developing a framework for effective distributed health professions training through an extensive review of the literature and a national consultative process.

Consequences, conditions and caveats: a qualitative exploration of the influence of undergraduate health professions students at distributed clinical training sites.

Background: Traditionally, the clinical training of health professionals has been located in central academic hospitals. This is changing. As academic institutions explore ways to produce a health workforce that meets the needs of both the health system and the communities it serves, the placement of students in these communities is becoming increasingly common.

Implications for faculty development for emerging clinical teachers at distributed sites: a qualitative interpretivist study.

Introduction: Medical faculties have the responsibility to graduate competent health professionals and a consequent obligation to assure the quality and effectiveness of their students' clinical teaching. Many institutions are responding to rural workforce needs by extending clinical training from the traditional academic teaching hospital to include rural and remote sites distributed away from the central training institution. It is incumbent upon medical schools to consider how this might impact on the faculty development of these clinicians as teachers.

Decentralised training for medical students: a scoping review.

Background: Increasingly, medical students are trained at sites away from the tertiary academic health centre. A growing body of literature identifies the benefits of decentralised clinical training for students, the health services and the community. A scoping review was done to identify approaches to decentralised training, how these have been implemented and what the outcomes of these approaches have been in an effort to provide a knowledge base towards developing a model for decentralised training for undergraduate medical students in lower and middle-income countries (LMICs).

Decentralised training for medical students: Towards a South African consensus.

Introduction: Health professions training institutions are challenged to produce greater numbers of graduates who are more relevantly trained to provide quality healthcare. Decentralised training offers opportunities to address these quantity, quality and relevance factors. We wanted to draw together existing expertise in decentralised training for the benefit of all health professionals to develop a model for decentralised training for health professions students.

Equipping family physician trainees as teachers: a qualitative evaluation of a twelve-week module on teaching and learning.

Background: There is a dire need to expand the capacity of institutions in Africa to educate health care professionals. Family physicians, as skilled all-rounders at district level, are potentially well placed to contribute to an extended training platform in this context. To play this role, they need to both have an understanding of their specialist role that incorporates teaching and be equipped for their role as trainers of current and future health workers and specialists.

Understanding rural clinical learning spaces: Being and becoming a doctor.

Context: Calls for health professions education that can foster transformative educational experiences have been voiced. Studies suggest that extended clinical training at rural sites potentially provides transformative learning spaces. This article explores 'being and becoming' as a construct for understanding the student experience at a rural clinical school (RCS).

Guiding the development of family medicine training in Africa through collaboration with the Medical Education Partnership Initiative.

Africa's health care challenges include a high burden of disease, low life expectancy, health workforce shortages, and varying degrees of commitment to primary health care on the part of policy makers and government officials. One overarching goal of the Medical Education Partnership Initiative (MEPI) is to develop models of medical education in Sub-Saharan Africa. To do this, MEPI has created a network of universities and other institutions that, among other things, recognizes the importance of supporting training programs in family medicine.

Community-based education programs in Africa: faculty experience within the Medical Education Partnership Initiative (MEPI) network.

Purpose: This paper examines the various models, challenges, and evaluative efforts of community-based education (CBE) programs at Medical Education Partnership Initiative (MEPI) schools and makes recommendations to strengthen those programs in the African context.

Methods: Data were gathered from 12 MEPI schools through self-completion of a standardized questionnaire on goals, activities, challenges, and evaluation of CBE programs over the study period, from November to December 2013. Data were analyzed manually through the collation of inputs from the schools included in the survey.

Medical education in South Africa-exciting times.

The dramatic political changes of the first ten years of democracy in South Africa have seen major shifts in vested power. Social change and political will have resulted in a new face of our medical student population. Diversity of colour, gender, religion and previously disadvantaged groups make student profiles as different as they could be from a decade ago.

The Delphi technique in health sciences education research.

The Delphi technique is a method of collecting opinion on a particular research question. It is based on the premise that pooled intelligence enhances individual judgement and captures the collective opinion of a group of experts without being physically assembled. The conventional Delphi uses a series of questionnaires to generate expert opinion in an anonymous fashion and takes place over a series of rounds.

The value of small group learning: an evaluation of an innovative CPD programme for primary care medical practitioners.

Introduction: A 'competence' model of CPD using facilitated small groups covering a range of clinical topics is an alternative model to lecture-based CPD. The aim of this study was to evaluate a new small group CPD programme and to determine whether the anticipated improvements in the quality of learning were realised.

Method: A nominal group technique (NGT) was used to compile two questionnaires for participants and facilitators, respectively, seeking quantitative and qualitative information.