Thesis (MPHM. (Curriculum Studies)) -- University of Limpopo, 2019 / The quality of mortality data in South Africa has been questioned because of the high percentage of deaths reported to be due to ill-defined causes. We sought to assess the level of knowledge of doctors on the International Classification of Diseases (ICD) rules for medical certification of cause of death and determine the factors influencing that knowledge. Methods A cross-sectional study was conducted across 12 hospitals in Limpopo Province among the five districts stratified by level of care. Doctors completed selfadministered questionnaire, which included the baseline characteristics and questions that tested their theoretical knowledge of the ICD rules of death certification. The outcome, an adequate level of knowledge was set at a score of ≥ 60%. A chi square test was used to determine the factors associated with the outcome. Ethical approval was obtained from Turfloop Research Ethics Committee, University of Limpopo. Results Of the 301 doctors who participated, 50.5% were female, 64% were junior doctors and 13% were specialists. Up to 49% of doctors worked in the two tertiary hospitals. Only 18% of the doctors have ever attended a Continuing Professional Development (CPD) on the topic. The mean overall score on knowledge of medical certification for all the doctors was 59.80% (±11.95) with 53% obtaining at least 60% on the questionnaire. Doctors lacked knowledge on identifying unnatural deaths and discerning the underlying cause of death. Factors associated with the adequate knowledge included years of clinical experience (p=0.01), previous training (p<0.001), awareness of guidelines (p=0.04), comfort level (p=0.01) and rank (p=0.02). Conclusion The study highlighted the need for training of all doctors in the province and identified the knowledge gaps. Interactive capacity-building workshops have been shown to improve knowledge of doctors on medical certification of cause of death in other studies. To improve the quality of mortality data in Limpopo Province, such workshops must be conducted in all hospitals. Key words: death notification, medical certification, cause of death

Thesis (Ph.D.)--Virginia Commonwealth University, 2010. / Prepared for: Dept.of Educational Studies. Title from title-page of electronic thesis. Bibliography: leaves 133-144

Abstract This quasi-experimental design study compared two small samples of Emergency medicine residents after one group had an educational intervention on death notification skills and the other did not. Comparisons were made on residents’ confidence in their communication, interpersonal skills and level of compassion fatigue/satisfaction and EM Residents’ level of Secondary Traumatic Stress after an event of patient death and subsequent notification of Secondary Patients. Residents were interviewed to gather recommendations for designing death notification curriculum. Over an eight month period, forty emergency medicine residents at two sites, control and intervention, completed surveys designed to provide quantitative data on self-confidence and stress related to recent patient deaths. Residents who participated in a death notification event completed the Secondary Traumatic Stress Scale. Interviews were conducted to gather information on the impact of the notification and recommend changes in curriculum at the experimental site. The data infer that an educational intervention on death notification skills increased residents’ confidence in their ability to give compassionate death notification to families as compared with the control group. Residents in the intervention and control group had no significant differences in their potential for compassion satisfaction. Residents who had the educational intervention showed less Secondary Traumatic Stress symptoms than their non-intervention counterparts. The intervention group showed less risk for burnout (although it would only be significant at p < 0.10). The overall conclusion is that there is some evidence for a positive effect of the intervention. However, due to the small sample size the conclusion is tentative and more research is needed to evaluate the training.