This study reviewed the methods of teaching orthopedics to family practice residents. It explored the areas of how, when, and to what end. Questionaires were sent to all family practice residency programs in the United States. The complied results showed that most residents are taught during a block assignment for four weeks in the second year of residency. The results showed preceptorships being utilized most frequently and for at least 50% of the teaching time. Lectures were used next most frequently and usually for 20% or less of the teaching time. Nearly all of the respondants felt their residents were qualified to initially manage athletic injuries, simple fractures, and low back pain. On the management of infant foot problems, 63% felt their residents were qualified and 36% felt they were not. This difference was felt to be due to a difference in content and not process. Suggestions for future research were put forth.Ball State UniversityMuncie, IN 47306

Thesis (MFamMed)--Stellenbosch University, 2014. / BACKGROUND:Family physicians are trained to enable them to staff community health centres and primary care hospitals. Part of this training is teaching them procedural skills for anaesthetics and surgery. Knysna hospital is a training facility for family medicine registrars and this article aims to evaluate if sufficient learning opportunities exist in Knysna hospital’s theatre to teach family medicine registrars procedural skills. METHODS:A descriptive study was undertaken of the number and type of procedures performed in Knysna hospital theatre for a one year period, and compared with the required skills,as stipulated in the national training outcomes, for the discipline. RESULTS:Three thousand seven hundred and forty one procedures were performed during the study period. Anaesthesia was the most common procedure, followed by caesarean section. There were adequate opportunities for teaching most core skills. CONCLUSIONS: There were sufficient opportunities for a registrar to be taught all the core skills that are exclusive to theatre. Further research is needed to evaluate Knysna hospital as a training facility for all procedural skills. / AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: A portfolio of learning is one way of showing evidence of performance over a period of time. Worldwide, the need for social accountability and health services reforms has led to an increased interest in competency-based medical education with specific outcomes. Postgraduate training increasingly focuses on life-long adult learning, placing emphasis on close supervision with feedback and workplace-based assessment. South Africa, although better resourced, faces many similar socio-political and health services challenges as the rest of Africa. The democracy is less than 20 years old, with 80% of the previously disadvantaged population now having access to health services. In this new era medical schools have aligned their curricula to focus on patient-centred primary health care. The huge demand for appropriately trained family physicians has become a national priority. Subsequently, the College of Family Physicians of the Colleges of Medicine of South Africa developed a national exit examination for postgraduate family medicine training. One component of the examination is the submission of a satisfactory portfolio of learning. The aim of this thesis was to develop a national portfolio for postgraduate family medicine education in South Africa. It needed to be valid, acceptable, useful for learning, and be assessed in a reliable way. The research process involved a collaboration with registrars, supervisors and programme managers from all eight medical schools in the country over four years and culminated in the first national portfolio for family medicine in the country. The thesis was done by way of publication, which involved four articles being published in international journals, outlining the development, implementation and assessment of our portfolio. Content and construct validity of the draft portfolio was established through a Delphi process. Subsequently, the portfolio was implemented at all eight medical schools. Workshops over two years at all the universities facilitated implementation and provided feedback on the use of the portfolio across the country. After implementation of this initial portfolio, the acceptability, educational impact, and usefulness for assessment were evaluated through a national survey and in-depth interviews. A portfolio assessment tool was developed and its reliability was established for the overall score. The assessment tool has also been implemented nationally. The portfolio’s requirements have made the expectations and challenges of workplace-based learning and assessment more visible, with supervision, safe learning environments and more user-friendly learning and assessment tools needing further research. / AFRIKAANSE OPSOMMING: ‘n Portefeulje met bewyse van opleiding is een manier om bevoegdheid en prestasie oor ‘n periode van tyd te demonstreer. Sosiale verantwoordelikheid en hervormings in gesondheidsdienste wêreldwyd het gelei tot vaardigheids-gebaseerde mediese opvoeding met spesiefieke uitkomste. Nagraadse opleiding fokus toenemend op lewenslange volwasse leermetodes met ‘n groot klem op nabye toesig, terugvoer en werksgebaseerde evaluasies. Alhoewel Suid-Afrika beter toegerus is as meeste lande in Afrika, staar die land baie soortgelyke sosiaal-politiese en gesondheids uitdagings in die gesig. Met die jong demokrasie van 20 jaar het 80% van mense wat voorheen nie toegang gehad het tot goeie gesondheidsdienste nie nou wel toegang. Mediese skole het hul kurrikulums aangepas om te konsentreer op pasient-gefokusde primêre gesondheidsorg. Die Kollege van Huisartse van die Kolleges van Geneeskunde van Suid-Afrika het ‘n nasionale eksamen vir nagraadse opleiding in huisartskunde in die land geimplementeer. Een van die komponente van die eksamen behels die inhandiging van ‘n bevredigende opleidingsportefeulje. Die doel van hierdie tesis was om ‘n nasionale portefeulje vir nagraadse opleiding in huisartskunde in Suid-Afrika te ontwikkel. Die portefeulje moes geldig en aanvaarbaar wees, asook nuttig vir leer en ook op ‘n betroubare manier evalueer kon word. ‘n Proses van samewerking tussen kliniese assistente, toesighouers en programbestuurders van al agt mediese skole in die land oor ‘n periode van vier jaar het die eerste nasionale opleidingsportefeulje vir huisartskunde in Suid-Afrika die lig laat sien. Hierdie is ‘n tesis by wyse van publikasie deur vier artikels wat in internasional journale verskyn het, wat die ontwikkeling, implementering, en evaluering van die portefeulje beskryf. Die geldigheid van die inhoud en samestelling van die portefeulje was ontwikkel deur ‘n Delphi proses. Nadat die portefeulje geimplementeer was, was die aanvaarding, leerimpak en nuttigheid vir evaluering ondersoek deur ‘n nasionale opname en in-diepte onderhoude. Werkswinkels by al die universiteite het die geldigheid en implemetering van die portefeulje verder versterk. ‘n Instrument om die portefeulje te evalueer was ontwikkel en in gebruik geneem landwyd, en betroubaarheid van die totale telling was bewerkstellig. Die behoeftes van die portefeulje het die verwagtinge en uitdagings van werksgebaseerde opleiding en evaluering meer sigbaar gemaak, met toesighouding, veilige leeromgewings en meer gebruiksvriendelike leer- en evalueringsinstrumente as areas identifiseer wat aangaande navorsing benodig.

Text in English / In Swaziland, family nurse practitioners (FNPs) are professional nurses who have undergone preparation as general nurse, midwife and FNP. These nurses play an important role in the delivery of primary health care (PHC). Family nurse practice is an evolving concept introduced in Swaziland in 1979. It is a means of exploring nursing roles and primary health care services for deployment in under-served areas and to enable nurses to serve as the primary providers of health care services in clinics, health centres and in the outpatient departments of hospitals. Changing responsibilities within the health care setting require different skills and more knowledge. The expansion and extension of the nurses' role, including the techniques of diagnosing and treating, was a priority of the Ministry of Health and Social Welfare (MOH&SW) in Swaziland's five-year development plan for 1978-1983. It was regarded as a necessary component for raising the quality and effectiveness of PHC services. Some of the major and urgent challenges that confront FNPs today are the advent of the human immune virus/acquired immuno-deficiency syndrome (HIV/AIDS) scourge and the re-emergence of the tuberculosis epidemic. Both these health problems require proficient diagnosis and case management skills as well as new approaches. If FNPs are to remain relevant and to continue to provide quality services in spite of prevailing challenges, they have to engage in continuing education (CE). The main aim of this study was to investigate the perceptions of the FNP role, CE needs and issues relevant to the current practice of FNPs in Swaziland. A further aim was to establish a structure or framework for a CE programme that would contribute to the strengthening of CE for FNPs and identify enabling factors and barriers in the practice and education ofFNPs. Both quantitative and qualitative research methods were used for data collection. A survey was conducted to collect data from 5 7 FNPs and 11 nurse managers and nurse educators. The transcript from the questionnaires was subjected to quantitative-based content analysis. A total of thirty nurse managers, nurse educators and MOH&SW nurse executives participated in the focus group interviews. The collected data was subjected to qualitativebased content analysis. The findings identified the role of the FNP as manager, clinical practitioner, educator and researcher. The analyses highlighted the CE needs of FNPs, and the question of updating and upgrading the skills of practising FNPs. The identified enabling factors and barriers, although perceived as issues that are peripheral and auxiliary to the curriculum, appeared to have a strong bearing on programme planning. The findings from this study have implications for a structured CE programme for FNPs at the University of Swaziland. / Health Studies / D. Litt et Phil. (Nursing Sciences)

Text in English / In Swaziland, family nurse practitioners (FNPs) are professional nurses who have undergone preparation as general nurse, midwife and FNP. These nurses play an important role in the delivery of primary health care (PHC). Family nurse practice is an evolving concept introduced in Swaziland in 1979. It is a means of exploring nursing roles and primary health care services for deployment in under-served areas and to enable nurses to serve as the primary providers of health care services in clinics, health centres and in the outpatient departments of hospitals. Changing responsibilities within the health care setting require different skills and more knowledge. The expansion and extension of the nurses' role, including the techniques of diagnosing and treating, was a priority of the Ministry of Health and Social Welfare (MOH&SW) in Swaziland's five-year development plan for 1978-1983. It was regarded as a necessary component for raising the quality and effectiveness of PHC services. Some of the major and urgent challenges that confront FNPs today are the advent of the human immune virus/acquired immuno-deficiency syndrome (HIV/AIDS) scourge and the re-emergence of the tuberculosis epidemic. Both these health problems require proficient diagnosis and case management skills as well as new approaches. If FNPs are to remain relevant and to continue to provide quality services in spite of prevailing challenges, they have to engage in continuing education (CE). The main aim of this study was to investigate the perceptions of the FNP role, CE needs and issues relevant to the current practice of FNPs in Swaziland. A further aim was to establish a structure or framework for a CE programme that would contribute to the strengthening of CE for FNPs and identify enabling factors and barriers in the practice and education ofFNPs. Both quantitative and qualitative research methods were used for data collection. A survey was conducted to collect data from 5 7 FNPs and 11 nurse managers and nurse educators. The transcript from the questionnaires was subjected to quantitative-based content analysis. A total of thirty nurse managers, nurse educators and MOH&SW nurse executives participated in the focus group interviews. The collected data was subjected to qualitativebased content analysis. The findings identified the role of the FNP as manager, clinical practitioner, educator and researcher. The analyses highlighted the CE needs of FNPs, and the question of updating and upgrading the skills of practising FNPs. The identified enabling factors and barriers, although perceived as issues that are peripheral and auxiliary to the curriculum, appeared to have a strong bearing on programme planning. The findings from this study have implications for a structured CE programme for FNPs at the University of Swaziland. / Health Studies / D. Litt et Phil. (Nursing Sciences)