Submitted in fulfillment of the requirements for the Master of Health Sciences in Radiography, Durban University of Technology, Durban, South Africa, 2016. / Introduction: Continuing Professional Development (CPD) has been introduced as a means to ensure that professionals continuously update their knowledge and skills. In addition, CPD has become a mandatory requirement by the Health Professionals Council of South Africa (HPCSA). However despite CPD being mandatory, health professionals nationally and internationally alike have experienced numerous challenges obtaining the required CPD points/hours. Some of these challenges included lack of awareness of the CPD requirements, lack of available activities, lack of employer support, lack of funding and a lack of time to participate. No studies have been conducted amongst radiographers working in the province of KwaZulu-Natal (KZN), to determine if they are affected by similar challenges hence the need for this study. Purpose The purpose of this study was to identify the opinions, level of awareness, participation, and challenges related to CPD compliance by radiographers in KwaZulu-Natal, and to ascertain their suggestions for improvement to CPD practices in order to make recommendations to the HPCSA. Method A quantitative, descriptive research approach using a questionnaire with both open-ended and closed-ended questions was utilized. Radiographers from all four disciplines in Radiography, working in the province of KwaZulu-Natal were included in this study. A five point Likert scale was used for most of the closed questions. The open ended questions allowed respondents to express their opinions freely. The quantitative data was analyzed using the Statistical Package for Social Sciences (SPSS) version 23.0. The inferential statistics included bivariate correlations and Chi-square testing. Open ended questions were analyzed by means of thematic analysis. Results Two hundred and ninety two questionnaires were administered and one hundred and forty six were returned which resulted in a 50% response rate. The mean age of respondents were 31.3 years. The majority of respondents were females (85.6%). Most of the respondents were diagnostic radiographers (80.8%) hence 59.6% were shift workers. Fifty percent of the respondents were employed in the public health sector. Respondent’s acknowledged the importance of CPD however majority indicated engagement due to the mandatory requirements by the council. The most common challenges identified were lack of funding and time. Suggestions for having formal polices in place and allocation for financial support were recommended. A number of respondents suggested having an online database for the systematic recording of CPD points in order to improve the audit process. In this study relationships between different variables were tested. It was noted that a progression in rank resulted in a greater level of agreement that CPD does improve professional competence. The infrequency of CPD engagement was directly affected by the difficulties associated with evidence and record keeping of CPD activities. The lack of funding was a greater challenge amongst the public health sector employees as opposed to the private sector. It was also noted that a lack of employer support affected how often respondents engaged in CPD activities hence support from employers was deemed crucial. Conclusion Radiographers working in KwaZulu - Natal were experiencing numerous CPD challenges. Suggestions were made to overcome these challenges as well as improving the auditing system by the HPCSA. / M

The shortage of skilled professionals in the health sector has been an ongoing problem. This has resulted in poor service delivery and ultimately increased patient deaths. The primary objective of this study was to develop a conceptual model to retain scarce skilled professional workers in the health sector. An exploratory study was conducted which included both professionals and non-professionals in the pathology sector. Recruitment was done from a population of 207 employees. In total 188 employees responded, of which 116 were professionals and a comparator group of 72 being the non-professionals. The study was conducted in three phases. In the first phase, quantitative data collection methods such as the job diagnostic survey, career orientation inventory, organisational commitment questionnaire and intention to quit questionnaire were used to assess the characteristics of the groups of interest. The relationship between the independent and dependent variables were calculated. The results revealed that only a few of the traditional predictors influenced retention in the professional group. The predictors worked much better for the non-professional group. It was concluded that traditional retention strategies are not suitable to retain professionals in the health sector. The second and third phases utilised qualitative methods. The second part of the study related to identifying factors which retain professional staff. Following interviews with 15 professionals, ten themes were identified which relate to the retention of professionals. The third phase of the study consisted of interviews with 3 managers, and this was to determine what the managers can do to influence retention. A retention model for the professionals was then developed. This model not only contributes to the body of knowledge, but is also a useful managerial tool to manage professionals in the health sector / Graduate School of Business Leadership (SBL) / D.B.L. (Business Leadership)

The historical roots of traditional and modem Western medicine have been the same, but during the past century these systems have diverged modem medicine has became dominant, replacing traditional systems in much of the world and denigrating them as quackery. In recent years there has been a resurgence of interest in traditional systems, with a remarkable change in attitude among health care professionals in many parts of the world. There is an increasing emphasis upon the importance of health care providers familiarizing themselves with specific culture-bound syndromes and their manifestations, in order to provide quality care to culturally diverse clients seeking health care services. Thus, there is a need for a complementary relationship between traditional healing practices and modem medicine in the world, reflecting the importance of respect for cultural diversity in health planning. The research problem assumes a relation between three distinctive dimensions of reality, namely, the industrial mentality, culture, and education. These dimensions will be discussed - according to the relation-axes model introduced by Wielemans and Chan (1992:19), which investigates the complexity of relationships between man and himself, man and fellowmen, man and nature, and man and the transcendental. In Kuwait the traditional healing practices will be examined according to Islamic medicine and its contribution to health care. A comparison of modem and Islamic medicine is formulated and recommendations are made for the training health care professionals in Kuwait. / Educational Studies / D. Ed. (Comparative Education)

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 126 leaves, Annexures A-N / Emergency medical personnel have a number of occupational risk factors that are listed in the reviewed literature (Davis and Heaney 2000, Volinn 1997 and Andersson 1999) as risk factors for low back pain. Physical lifting and carrying of patients and equipment increases stress on the lower back, while occupational stress and a high level of patient responsibility are mental risk factors (Davis and Heaney, 2000). Emergency medical personnel that spend long hours in response vehicles, ambulances or helicopters are exposed to vibrational stressors and may therefore have an increased risk of low back pain due to this whole body vibration (Palmer et al, 2000). In addition it has been noted that the number of motor vehicle accidents will also increase the risk of low back pain due to mechanical injury (Cassidy et al, 2003). Low back pain could therefore interfere with their ability to carry out their duties, affect their attitude towards patients and colleagues, impact on the level of patient care required of them, and result in increased absenteeism. Persistence of chronic low back with the inability to perform their duties may result in the need to find alternative employment or result in premature dismissal. The objectives of this study were: to determine if emergency medical personnel have a higher risk factor for the development of low back pain due to their occupation than the general population; as well as determine if an increase in the number of years working in the field (i.e. years of exposure) leads to an increased incidence and / or prevalence of low back pain.

published_or_final_version / abstract / Nursing Studies / Master / Master of Philosophy

Aim and objectives: To describe the ideal doctors' shift handover process in a systematic fashion, and to identify tasks that should be performed, but are not consistently done. To understand the types of communication problems that may occur during the handover process, their causes, their likelihood of occurrence and their effect on patient safety. Method: Three studies were conducted in two, Scottish Acute Medical Units. A Hierarchical Task Analysis was performed and data was collected by means of interviews and focus groups. Observations of doctors' actual shift handover process were compared against the description of doctors' ideal handover process. To examine potential failures modes, a Healthcare Failure Modes and Effects Analysis was performed using focus group interviews. Results: The handover process entailed the pre-handover, the handover, and the post- handover phases. Multiple critical steps in the process were omitted by outgoing shift doctors. The pre-handover was particularly vulnerable to information omission, with over 50% of its critical tasks not being performed across a total of 62 observations. Nonetheless, most of these omissions were typically caught during the handover meeting, especially if incoming doctors participated in pre-handover activities. Post-handover activities involved prioritizing and delegating clinical tasks. However these were observed not to happen consistently due to multiple interruptions. Thirty-four failure modes were identified, with eight of them posing a significant risk to patient safety. The studies found that interruptions, patient workload, and a lack of standardised procedures were the biggest causes for information loss during the handover process. Conclusions: There are key critical tasks necessary for an ideal doctors' shift handover process. A simple, handover process checklist may ensure critical handover tasks have been achieved prior to any shift change. Interruptions, patient workload, peer trust, and a lack of standard operating procedures are areas that future handover research should examine.

<p> Self care is more than a requirement for life. Working in a high stress hospital environment lends itself to having many personal and professional stressors that go beyond medical professionals job requirements. The purpose of this study was to explore how hospitals support medical staff through self care programs. Data was collected through semi-structured interviews of five medical professionals who work in various specialties. Results of this study indicated that self care was represented in various unstructured formats. Additionally, this study demonstrates the need for more support in the medical field to allow for more opportunities for self care to take place. Furthermore, this analysis of self care explains the importance of this practice to be implemented by medical professionals as it helps to reduce the high rates of burnout and compassion fatigue.</p><p>

<p> The purpose of this systematic review was to examine the factors associated with clinicians' effectiveness as first-time healthcare managers. The high demand for clinicians to become healthcare managers has been predicated on their strong clinical knowledge and their credibility among their peers. While existing medical expertise and credibility among peers are crucial when transitioning into management, there are other factors that could impact clinicians' effectiveness as first-time managers. Utilizing a conceptual framework that incorporates motivation theory, social identity theory, leader&ndash;follower theory, and leader&ndash;member exchange theory, this research sought to identify factors associated with the effectiveness of clinicians as first-time healthcare managers. Evidence from 67 studies was analyzed using a thematic synthesis approach. The following six major factors were identified as factors that are associated with clinicians' effectiveness as first-time healthcare managers: (1) clinicians' motivation to transition into management, (2) clinicians' ability to detach from their social identity as clinicians and adopt a new social identity associated with their new role, (3) quality and convenience of formal developmental programs, (4) utilization of succession planning, and (5) cultural alignment. Based on the findings of this study, implementation of evidence-based succession planning programs would allow organizations to identify current and future open management positions, to systematically screen high-potential clinicians who are motivated to solve healthcare issues and achieve excellence, and to provide convenient and high-quality in-house management training and mentorship programs prior to role transition.</p><p>

Genetic counselors are healthcare professionals who work with patients and families affected by or at risk for conditions with a genetic cause or component. They act as purveyors of genetic and genomic testing and support the translation of test results into targeted and personalized medical care. Innovations, which arise and are introduced into practice continuously, compel genetic counselors to update their skills, knowledge, and approach quickly to ensure adequate and appropriate care of patients. The purpose of this study was to explore the professional learning strategies utilized by genetic counselors, with particular attention to learning which occurs in response to innovation. Utilizing critical incident questionnaires, interviews, and a database of credits accrued for continuing education, this study sought to contribute to a detailed understanding of genetic counselors’ professional learning and how strategies may vary by specialty or years of experience. Genetic counselors were found to utilize reflection to identify learning needs arising within uncertain, complex, and ambiguous circumstances of practice, and match those needs to appropriate learning strategies. Prized learning strategies included reading to gather information, discussion with colleagues to curate alternative perspectives and past experiences, and experimentation to actively test ongoing apprehension. Through strategies which were permeable, complementary, and active, genetic counselors demonstrated their abilities to synergize learning, practice, and novel, complex, ambiguous, and uncertain environments.

My thesis develops an understanding of patient role and identity performances in psychiatric consultations. Recent increased attention to shared-decision making and patient-centred care in psychiatry is in large part influenced by changing ideas about the doctor-patient relationship, challenging power discrepancies and reconsidering notions of ‘expert' and ‘lay' contributions. Previous work surrounding this field has mostly focused on psychiatrists' talk, asking ‘how can psychiatrists improve shared-decision making skills?' While important, I argue that this focus is at odds with the principles behind shared-decision making by failing to consider patients' own performances in their talk with psychiatrists. I re-analyse recorded interactions in 92 psychiatric consultations with patients prescribed anti-psychotic medication. Drawing on the work of Goffman, I identify frames which are negotiated throughout the consultations and explore how these shape the roles and ‘footing' adopted by patients. I demonstrate techniques used by patients to maintain a balance between making credible and influential claims and maintaining an acceptable patient role. Finally I consider the impact of family members attending these consultations. I explore how they collaborate and compete with patients in making claims, and the impact of their presence on patients' own performances. The thesis makes the case for considering patients as active participants in constructing the interaction in psychiatric consultations and the need to understand the work being undertaken by patients to construct their place in the immediate discourse and in their wider social connections. It moves towards developing this understanding by providing a detailed review of various techniques seen in this data set. In using a frame analysis it also provides a relatively new perspective on considering discourse and demonstrates how this kind of approach can be useful when analysing institutional talk.