Context: One to three years after Roux-en-Y gastric bypass (RYGB) surgery, patients demonstrate progressive loss of bone mineral density (BMD) and accelerated bone turnover, especially at weight-bearing sites. Objective: The objective was to measure BMD and bone metabolism in relation to extent of weight lost long-term after RYGB. Design and Setting: This retrospective study was conducted ten years after RYGB in a university laboratory and bone metabolism unit. Patients: Fifty subjects (38 females, 12 males) aged 33-69y were recruited from a university bariatric surgery clinic an average of 10.17±3.45y after RYGB. Main Outcome Measure: The primary outcome measurement was the association of total body weight loss with BMD and serum markers of bone turnover. Results: Patients lost 46.0±20.0 kg ten years post-operatively (p<.01). Percentage total body weight loss (%TBWL) was negatively correlated with BMD (total body: r=-.40, lumbar 1-4: r=-.36, and total hip: r=-.51, all p's<.01) and were positively correlated with serum levels of osteocalcin (r=.40, p<.05). When patients were collapsed into tertiles of %TBWL, weight loss >30% was associated with poorest bone health as indicated by lowest BMD scores at all sites (p<.05) and highest levels of osteocalcin (p<.005). Conclusions: The magnitude of total body weight loss long-term after RYGB may provide insight to patient skeletal health ten years post-surgery. Patients who lost >30% total body weight had low BMD and high levels of bone remodeling at the ten-year mark. Healthcare professionals should be aware the risk of fracture or osteoporosis may be elevated among those who lose >30% total body weight ten years after RYGB. / Contexte: Les patients qui ont subi une chirurgie bariatrique de type Roux- en-Y démontrent, un à trois ans après la chirurgie, une perte progressive de leur densité minérale osseuse ainsi qu'un remodelage accéléré de leurs os, surtout dans les régions où le poids est supporté. Objectif: L'objectif fut de mesurer la densité minérale et le métabolisme des os, en relation avec la perte de poids à long terme après une chirurgie bariatrique de type Roux-en-Y.Désign: Cette étude rétrospective a été conçue dix ans après la chirurgie bariatrique de type Roux-en-Y, dans un environnent de laboratoire universitaire et une unité de métabolisme osseuse. Patients: Cinquante patients (38 femmes, 12 hommes), âgés de 33 à 69 ans, ont été recrutés par une clinique de chirurgie bariatrique universitaire environ 10.17±3.45 ans après avoir subi leur chirurgie bariatrique de type Roux-en-Y.Mesure principale: Le résultat des mesures d'intérêts primaires fut l'association entre la perte de poids totale et la perte de densité minérale osseuse ainsi que les marqueurs de sérum pour le remodelage osseux.Résultats: Les patients ont perdu en moyenne 46.0±20.0 kg au cours des dix années suivants la chirurgie (p<.01). Le pourcentage total de poids perdu (%TBWL) était négativement corrélé avec la densité osseuse (corps complet: r=-.40, lombaires 1-4: r=-.36, et hanches: r=-.51, tous p<.01) et positivement corrélé avec le niveau de sérum d'ostéocalcine (r=.40, p<.05). Quand les patients furent séparés en tiers de %TBWL, la perte de poids >30% était associée avec les pires indices de santé osseuse, dont les moins hauts rangs de densité minérale osseuse dans tous les sites et les niveaux les plus élevés d'ostéocalcine.Conclusions: L'ampleur de la perte de poids totale à long terme après une chirurgie bariatrique de type Roux-en-Y peut fournir des indices par rapport à la santé squelettique, dix ans après la chirurgie. Les patients qui ont perdu >30% de leur poids total initial avaient la plus basse densité minérale osseuse et le plus haut niveau de remodelage osseux, dix ans suivant la chirurgie. Les professionnels de la santé devraient être avertis des risques de fractures ou d'ostéoporose élevés, parmi les patients qui ont une perte de poids totale >30%, dix ans après une chirurgie bariatrique de type Roux-en-Y.

Behaviours common among youth (e.g., inconsistent condom use, substance use) place them at increased risk for sexually transmitted infections (STIs). Despite decades of prevention efforts, STIs in youth continue to be a major public health challenge in Canada. Factors affecting school-based intervention success or failure have yet to be explained; contextual factors external to the individual, yet to be defined; and the involvement of youth in the design and evaluation of curriculum interventions, remains poorly documented.A three-phase exploratory study was conducted in two Prince Edward Island schools to describe: (a) factors youth identify as being important to facilitate their ability to take control of their sexual health behaviour, (b) what these youth perceive their needs to be in terms of sexual health education, (c) how they perceive newly developed curriculum resources, and (d) what can be learned about their participation in a curriculum development process.In Phase I, 15 girls and 13 boys participated in focus groups (n=8) and engaged in participatory activities (e.g., reflective writing, role-play, drawing) in order to identify their sexual health education needs and to contribute to the form and content of educational resources to be developed. In Phase II, curriculum experts assisted with refining the youth-generated materials so that they might become resources for use in schools. Eventually this process led to a set of resources (e.g., vignettes, sexual-risk assessment activities, and games) that promote STI/HIV prevention. In Phase III, 22 of the 28 participants from Phase I participated in focus groups (n=4) to evaluate the curriculum resources refined in Phase II. Inductive analyses of data (thematic and content analysis) from student focus groups were undertaken. Youth described positive and negative influences (factors at the intrapersonal, interpersonal, organizational, and community levels) on their ability to take control of sexual health behaviour. The findings from this study offer insight into the social composition of sexual risk that needs to be considered in future intervention studies. A tailored approach to the development of sexual health curriculum resources for youth may improve school-based intervention success toward preventing STIs in this high-risk group. / Certains comportements courants adoptés par les adolescents (l'usage irrégulier du condom ou la consommation d'alcool et de drogues, par ex.) augmentent le risque de contracter une infection transmissible sexuellement (ITS). Malgré les efforts déployés depuis des décennies en matière de prévention au Canada, les ITS continuent de poser un grand défi pour la santé publique au sein de cette population. Les facteurs responsables de la réussite ou à l'échec des interventions en milieu scolaire sont mal connus; les facteurs contextuels (extérieurs à l'individu) restent à définir; enfin, la participation des jeunes à la conception et à l'évaluation des programmes scolaires a fait l'objet de peu d'analyses.Nous avons mené dans les écoles de l'Île-du-Prince-Édouard une étude exploratoire en trois volets qui visait à décrire: a) les facteurs jugés importants par les adolescents afin de favoriser leur propre responsabilisation en matière de santé sexuelle; b) les besoins qu'ils expriment en matière d'éducation sur le sujet; c) leurs perceptions à l'égard des ressources pédagogiques récentes; d) ce qu'on peut apprendre sur leur participation à la conception de programmes scolaires sur le sujet.Dans le cadre du volet I, 15 jeunes filles et 13 jeunes garçons ont pris part à des groupes de discussion (n=8) ainsi qu'à des activités participatives (exercice de réflexion par écrit, jeu de rôles, dessin) dans le but de définir leurs besoins en matière de santé sexuelle et de déterminer le format et le contenu de ressources pédagogiques éventuelles. Dans le volet II, des pédagogues ont contribué à peaufiner le matériel produit par les jeunes en vue de son utilisation en milieu scolaire. Cette démarche a conduit à la production d'un ensemble de ressources axées sur la prévention des ITS et du VIH (par. ex., sketches, activités d'évaluation du risque, jeux). Dans le volet III, 22 adolescents parmi les 28 qui avaient participé au premier volet ont évalué dans le cadre de nouveaux groupes de discussion (n=4) le matériel pédagogique conçu au cours du volet II. Nous avons procédé à une analyse inductive des données recueillies (analyse thématique et analyse de contenu). Les participants ont décrit l'incidence positive ou négative d'un ensemble de facteurs (de nature intrapersonnelle, interpersonnelle, organisationnelle et sociale) sur leur capacité de se responsabiliser. Nos conclusions jettent un éclairage sur la nature sociale du risque sexuel, une dimension qui demandera à être approfondie dans des recherches subséquentes. La conception de matériel pédagogique adapté aux besoins des jeunes pourrait accroître le succès des interventions en milieu scolaire en matière de prévention des ITS au sein de ce groupe à risque élevé.

Health care workers are finding themselves in an era of change with regard to service rendering. Health care workers need to be prepared for these changes during their training. The most important change in the transformation process of health care is the focus on primary health care and associated community-orientated and community-based services. To ensure that the training of prospective speech therapists and audiologists (the health care workers) is applicable with regard to preparing for service, the curriculum must be such that the expected outcome will be achieved through the education and training students receive. There are, however, also changes with regard to training in the policies and regulations of higher education that must be adhered to. In order to adapt to all the changes in health care service and the changes in policies and regulations for training, it is necessary to change and adapt the strategies for training too. Training and service rendering can only be effective if it meets with the requirements of the relevant professional board, health care bodies and the regulating bodies of higher education. The requirements of health care and education and the associated changes, however, necessitate a review of curricula for education and training programmes. When a new curriculum has to be developed or an existing curriculum is reviewed, the process is to be conducted according to specific steps and various factors need to be attended to. If these steps are defined and the factors that influence the education and training together with the requirements regarding content, the education and training process and the desired outcomes are described, it is called a framework for the programme. The research problem defined, was that no guidelines or framework existed according to which a curriculum for a training programme for speech therapy and audiology could be adapted, revised or developed. This led to the formulation of the research question, namely: What should be included in a framework for an undergraduate education and training programme to ensure that the training programme meets the requirements of the above mentioned bodies? The main purpose of this study was to make a contribution to health care in South Africa by making a contribution to the education and training of a group of health care workers. The goal was to compile a framework for undergraduate education and training programmes for speech therapy and audiology. In order to achieve the goal, a comprehensive literature study was conducted to study curriculum development, existing curricula and the requirements of relevant bodies. A concept framework was developed and verified by an empirical study through the application of the Delphi technique. The data were processed and analysed and the final product, a framework for the training programme for undergraduate speech therapy and audiology, was established. The literature study served as the basis of this investigation. The Delphi technique was applied to verify the concept framework that had been developed on the basis of the literature study. The concept framework initially consisted of 183 statements, describing aspects and elements of the curriculum design process and content of the curriculum. Each statement was to be judged according to a three-point rating scale, namely essential, desirable and irrelevant. The criterion for reaching consensus was predetermined, namely 75% of the number of ratings on any of the items in the questionnaire had to correspond. The panel of experts (eight) that took part in the Delphi process included heads of departments of the various training institutions in South Africa, an educational expert and an expert representative of the Professional Board for Speech, Language and Hearing Therapy. A pilot study to determine the validity and reliability of the research instrument (the questionnaire) had been conducted before the research instrument was sent to the participants in the Delphi process. With the completion of round three, consensus on the items in the Delphi questionnaire was on 96.77%. Stability was also reached in round three, as the items on which consensus was not reached, showed the same responses with regard to rating since round one. The Delphi process was therefore ended after round three and the final framework was compiled based on the results of the Delphi investigation, in other words, the responses of the participants. The framework is of great value for programme development, as professionspecific information and requirements of stakeholders are contained within the framework, thereby facilitating the task of experts in educational development involved with programme development for speech therapy and audiology. It is recommended that the programme be used by institutions as a guideline for the development of innovative undergraduate training programmes for speech therapy and audiology. It can also be used for revising and/or evaluating existing training programmes, as well as for the accreditation of a training programme. The content elements of the framework may be adapted and changed, if and when the requirements of the relevant professional board and the requirements of health care services and education change, as well as according to changes in the needs of students and needs of the community.

The research study was undertaken to determine the needs of Heads of Department in the School of Medicine, UFS; management models available to them; and the factors impacting on their academic environment. The rationale for the study can be found in the need expressed by Heads of Department to manage their departments in the new academic setting. The aim of the study was to create and establish a management model for experienced as well as new Heads of Department in the School of Medicine, measured against the background of good management practices. This aim was achieved by performing a literature study regarding the needs of Heads of Department; factors influencing their academic environment, and the composition of available management and leadership models that could apply to Heads of Department in the School of Medicine. Heads of Department are appointed in the academic environment with the primary focus on their educational achievements. Throughout the process it was demonstrated that this is still relevant and needs to be part of the appointment process of Heads of Department in the School of Medicine. It was also indicated throughout this study that there is an increasing expectation from Heads of Department to take on sole responsibility for the management of their departments. In the light of these developments, it was important to consider solving this problem for them, and also to establish a management model for Heads of Department, thus empowering them to manage their departments in the future. The research took the form of a descriptive, explanatory survey comprising a literature review, a questionnaire survey and a Delphi process. The literature study covered a few aspects, including assessing the possible needs of Heads of Department, exploring factors impacting on their environment, as well as the difference between management and leadership, and the difference between various management models that may be applicable to management in an academic setting such as a Medical School. The second part of the empirical study was a Delphi process, which involved six experts from the areas of management, health management, and education. The overall goal and objective was to make a significant contribution to the managerial needs of Heads of Department, and to establish a management model, thus empowering Heads of Department to manage their departments in the future. A quantitative approach with open-ended questions was followed. The Delphi technique also focussed on these areas through statements in order to measure the experts' feelings about these areas. As part of the Delphi process, the experts had to participate in two rounds. The main findings from the questionnaire to Heads of Department, the Delphi technique, and information obtained via the literature study enabled the researcher to make a recommendation on a management model for Heads of Department, UFS. The management model had to be flexible, individualized, relevant, and adaptable. It had to include the seven main areas of management, namely strategic management; office administration, postgraduate education and training; undergraduate teaching research, academic administration, and service delivery. The recommendations on the clinical management model were extensively detailed, as these will also form the basis of an implementation plan for implementing the management model in the School of Medicine, UFS. In summary, the researcher is of the opinion that the overall goal and objectives of the study were addressed and realised, and that meaningful recommendations were made. The PRIME model was established as a management model for Heads of Department, School of Medicine, UFS, offering an ultimate solution to the managerial problems of Heads of Department. The management model is in line with the needs of the Heads of Department, legislation, and the policy documents referred to in earlier chapters. In addition, recommendations were also made on future research; the possible implementation in other Medical Schools; and the use of the PRIME model. The researcher realises the limitations of the study, which are discussed in detail. Although a number of limitations were listed, the majority of these could be seen as minor limitations and they do not have an impact on the final outcome of the study. It is recommended that the study be followed by a research process and the possibility of utilising certain principles of the PRIME model in other Medical Schools in South Africa in order to assist them with the managerial problems they might be experiencing. The aim of the model is not to address all the issues in detail, but to provide a model for academic management of departments based on the needs indicated, and the academic management models available for such management. It is the researcherâs opinion that the PRIME model for the management of academic departments will contribute significantly to the overall management of academic health, the best possible utilisation of resources, and the improvement of health services at large. Furthermore, the researcher believes that this study has achieved all these aspects. It is in line with the current trend to improve quality within health services, and it is ultimately about improving the lives of Heads of Department in the academic sphere. The thesis also provides an extensive and comprehensive reference source for Heads of Department on leadership, management, needs, management models available; and factors that have an impact on the academic environment. As a management model, the PRIME model aims to create a win-win situation for the Heads of Department, their departments, and management and authorities. With this PRIME model, we can reach for the stars!

Health services in a country are affected by many factors, one of which is the human resources that render those services. One of the dimensions of human resources that will impact on the effectiveness of the health services is their competence. There are three phases of health education, namely basic health professions education; postgraduate health professions education; and continuous professional development. This study will focus on the third phase of continuous professional development of health professionals. The purpose of continuous professional development is defined in this study as high quality patient care and the outcomes to improve, maintain and further develop competencies regarding skills, knowledge and attitude in order to meet the changing needs of both patients and the health care delivery system. Globally there is more emphasis on the role of higher education institutions in continuous professional development. It was evident from the literature that higher education institutions should have a strategy as continuous professional development providers in order to be effective and efficient in contributing to attaining the outcomes of continuous professional development. The question that has arisen was, âHow should the model to manage continuous professional development for alumni of a private higher education institution (PHEI) be composed in order to be conducive to the outcomes of continuous professional development, which are improved competencies of health professionals?â Given the situation the problem that was addressed was that there was no model to be implemented by the Foundation for Professional Development [a Provisionally Accredited Private Higher Education Institution in terms of section 54(3) of Act No. 101 of 1997 (RSA 1997)] focusing in the health sector to enable it to take accountability to plan, organise, lead and control continuous professional development for its alumni which will support attainment of the purpose of continuous professional development. The aim of this study was to develop a model to manage continuous professional development for alumni of private higher education institutions in an effective and efficient manner. In the attempt to attain the aim the objectives pursued were a literature study to develop a framework of the model to manage continuous professional development inclusive of the most effective and efficient components of continuous professional development, while a questionnaire survey followed to identify the most preferred components of a model to manage continuous professional development for alumni of a PHEI to ensure effective implementation of the model. This was done by means of a custom designed questionnaire. The final objective in attainment of the aim was the triangulation of the information from the literature study, the results of the questionnaire survey, and conclusions to develop a model to manage continuous professional development. An empirical, non-experimental research design was followed in this quantitative study. A cross-sectional survey was employed because the respondents were approached only once to complete questionnaires and it was possible to make comparisons between subgroups and look at relationships between variables. Descriptive and inferential statistics were calculated and used to answer the research questions. The custom designed self-administered questionnaires collected information on respondentsâ personal profiles, professional profiles, employment backgrounds, geographical profiles, communication preferences in an alumni network, alumni network interaction preferences, accreditation preferences by an alumni network, educational product needs in an alumni network, areas of expertise and interest, alumni network membership needs, and the alumni patient profile. The sample population for the current study was defined as: âLearners at the Foundation for Professional Development during August 2006 to November 2006â. On completion of their training these learners would become alumni of the Foundation for Professional Development and would become eligible for inclusion in a continuous development alumni programme. This population were therefore best positioned to test certain assumptions about a continuous professional development alumni network and start the building of a model to manage continuous professional development. A total number of 1968 learners attended workshops during this period and the entire population were presented with an opportunity to participate in the study. No sampling technique was therefore required. The objective of the literature review was to gather information to develop a framework for the model to manage continuous professional development. Continuous professional development with specific attention to the origin and the purpose of continuous professional development was reviewed. Then the purpose was defined, the process was reviewed and subsequently the trend of regulation of continuous professional development globally. The concept of credentialling was reviewed in relation to continuous professional development and integrated to assessment in continuous professional development. To gain a global perspective a review on international and South African trends in providers of continuous professional development and coordination of the function was provided. It was also necessary to review adultsâ learning preferences, needs assessment, and continuous professional development learning methods as part of identifying best practices in composing the framework for managing continuous professional development for alumni of a PHEI. For the same reason learning networks, mentoring and personal continuous professional development plans were reviewed. The model to manage continuous professional development for the alumni of a PHEI is a triangulation of the literature study, the research results and conclusions. Application of the model will ensure fulfilment of the continuous professional development functions of a PHEI in their responsibility towards their alumni in a planned and coordinated manner. It is supportive of continuous professional development in a cyclic and continuous manner, applying the principles of adult learning and credentialling. Assessment is an integral part of the quality assurance on the various levels. It is based on a network principle in that it utilises existing infrastructure and expertise in a decentralised manner to make continuous professional development convenient and relevant to learners. Integrated in the model is managed communication with alumni based on the research results. Information to plan, organise, implement and evaluate continuous professional development is another integral component of the model. According to the level of assessment alumni will be accredited in the network on five levels with associated benefits to promote continuous professional development and nurture a culture of lifelong learning with an emphasis on planned learning and improvement of practice. The researcher is of the opinion that PHEIs shall be capacitated by the model developed and through implementation of the model to manage continuous professional development for alumni of a PHEI, the overall goal, aim and objectives of the study to facilitate continuous professional development in South Africa will contribute to the optimisation of health care in South Africa. The researcher did not imply that this model should be implemented in its original form, but that the intention is that each HEI should customise the model according to its own unique situation and alumni needs and expectations. However, the process followed and components of the model could be repeated without reinventing the wheel. The implementation plan could therefore be utilised as a useful guideline. The researcher is of the opinion that components of this contribution could also facilitate the management of continuous professional development in public HEIs in South Africa. Furthermore the researcher is also of the opinion that components of the contribution could be implemented internationally by HEIs. Therefore the overall goal, aim and objectives of the study were reached.

The changing of the evaluation systems used for Grade 12 scholars in South African schools and the transformation principles of the Department of Education, compelled the University of the Free State (UFS) to start looking into alternative criteria for the selection process of medical students. One of the alternative criteria explored is the Health Science Placement Tests (HSPTs). The overall aim of this study was to assess the relationship between the HSPTs, school performance and other factors and academic performance during the first two years of study at the UFS. The specific objectives of the study were to conceptualise and contextualise the problem of selection of medical students at the UFS and to identify factors in different regions of the world that play a role in the selection of medical students by means of a thorough literature survey, but also to assess the influence of the current selection criteria and additional criteria on the performance of first and second year medical students at the UFS. A quantitative research approach was followed. The study population comprised of the first year medical students of 2004 and 2005 and second year medical students during 2005 and 2006 at the UFS. The demographic information of the students, their HSPTs results, school performance and academic performance results during first two years of study were statistically analysed to detect associations. Data for the study was obtained from the several databases of the University of the Free State and was collated by the researcher. The data management and analysis in this study was conducted by the staff of Statistical Consulting Service, Department of Statistical Sciences, University of Cape Town, using a variety of available statistical techniques. The correlation between all the numeric and categorical variables and the outcome variable were checked. These results showed the degree to which the variables changed together and allowed the researcher to indicate those with a predictive relationship. Strong to moderate correlations were found to be present between the averages of the first two years of study and English, Mathematics, Science and Biology of the Grade 12 marks, the PTEEP, MACH, MCOM and SRT of the HSPTs and the M-score. A weak negative correlation was found between the age of the student and whether or not they had any tertiary education and both the first and second year averages. By using the simple linear regression technique of analysis, the researcher evaluated the effect that each of the individual variables had on the first and second year averages. The following variables had a significant influence on the first two yearâs average marks: English, Mathematics, Science and Biology average mark, School Poverty Quintile Index, M-score and the HSPTs average. By using a multiple regression analysis, the predictors of dependent variables upon the outcome variable were tested, while the independent variables were held fixed. After following a step-wise regression analysis, the best fit model was the model evaluating the relationship between the first and second year average marks independently and the age of the student, the English, Mathematics, Science and Biology scores of Grade 12 and the PTEEP, MACH, MCOM and SRT tests of the HSPTs and the School Poverty Quintile Index. This model explained 50% variance of score in the first year and 70% variation of score in the second year as a result of the combination of these variables. Although some of the variables were not statistically significant, they were still of conceptual significance. From this analysis it was clear that the more variables that were included, the more reliable or predictive the model was to determine how a student would perform academically at the end of the first two years of study. The conclusion of this study was that the application of different statistical approaches presents a case for the complimentarity of data for use in selection models and approaches. Through the exploration of different models of regression and association, a particular model was found acceptable as an indicator for good performance during the first two years of study. This choice was based on the fact that the multiple regression model was able to predict the effect that a variable would have on the outcome and the size of the effect. It was able to explain 50% variance of score in the first year and 70% variation of score in the second year and also took into account the effects of other confounding variables. This study and similar future studies will identify reliable and valid selection criteria for medical students who will perform well academically within the M.B.,Ch.B. tertiary education programme.

In this research, play was used to address negative perceptions about medical microbiology in the MBChB course. The Infections module is part of the second academic year in the MBChB curriculum at the University of the Free State (UFS), Bloemfontein, South Africa. Students' negative perception of medical microbiology and infectious diseases was identified by the researcher, who had been a lecturer in the module for many years. In an attempt to address students' complaints and dissatisfaction regarding the huge volume of work dealt with in the module, exposure to new terminology, and the complicated classification and nomenclature of microorganisms, the researcher resorted to investigating enjoyable forms of learning as a potential solution. Play is regarded by developmental and educational psychologists as an inherent part of human nature, which is employed in various settings and circumstances in the process of acquiring knowledge, information and skills necessary for social adaptation, integration and survival. The benefits of play are not limited to childhood â play can be enjoyed by individuals of any age, throughout their lives. Educational games are recognised as meaningful and effective teaching and learning instruments â also in higher education and medical training. Incorporating a fun component and positive affect into the learning process is known to promote intrinsic motivation, enhance quality of learning, and lead to better retention of knowledge. The researcher developed a quiz-style board game, Med Micro Fun With Facts (MMFWF), based on the principles of Trivial Pursuitâ¢. MMFWF can be used as a supplementary group work activity to expose students to the factual content of the vast discipline of microbiology in a non-threatening, healthy competitive environment. The game contains 700 colour-coded questions and answers divided into seven corresponding colour-coded categories, each containing 100 questions and answers. Six categories cover microbiological topics (bacteriology, virology, mycology, parasitology, and the diagnosis and treatment of infectious diseases), while a category on general medicine was included to prevent the potential risk of feeling overwhelmed or becoming bored by the numerous medical microbiology facts. The MMFWF board game was introduced to medical students shortly after they had successfully completed the Infections module. The game was evaluated by students by means of a self-administered, anonymous questionnaire and semi-structured focus group interviews, and by academic members of staff by means of direct observation of the play process and nominal group interviews. The overall feedback showed that both students and staff had a highly positive experience of MMFWF, and regarded it as a meaningful approach to mastering the factual content of medical microbiology. The students indicated that playing the game had a positive influence on their perception of and attitude towards the subject. The MMFWF board game was also converted into a multiple-choice web-based application (e-MMFWF), which was implemented as a compulsory directed learning activity in the Infections module. The students played e-MMFWF as part of their preparation for the forthcoming second semester test. The class average increased by 22% from Test I to Test II, and many students who were facing the possibility of failing an academic year due to poor performance in the Infections module were able to successfully complete their studies at their expected level of accomplishment. Eighty-five percent of the students who played e-MMFWF in preparation for semester Test II indicated their conviction that the directed learning activity contributed positively to the improvement in their test marks. The positive feedback on the MMFWF board game as a learning tool in medical microbiology, and students' improved marks after playing e-MMFWF, show that MMFWF can be used with good results as a supplementary learning modality in the Infections module of the undergraduate medical training programme.

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This study originated from a need to provide staff development resources to health professions educators. The need for content to be delivered effectively at a time and place that suit staff best is a challenge that Faculties of Health Professions Education must meet. In this research project, an in-depth study was done by the researcher with a view to utilising video as primary content delivery medium for staff development of health professions educators. The problem that was addressed is how content can be delivered to health professions educators at a time that will suit them best and in a medium that can be consumed effectively. The aim of the study was to determine the value of the use of online video as primary medium for content delivery for staff development of health professions educators. The methods that were used and which formed the basis of the study comprised a literature review, and â as the empirical study - the development of an online video course. On completion of the course, a questionnaire survey to determine the value of the utilisation of video as primary content delivery medium for staff development of health professions educators was conducted. In order to provide a scientific basis, the researcher created on online course which was presented to health professions educators. These participants completed the course as well as the survey to supply the researcher with the necessary data as to their experiences while taking part in the course. The resulting data that was retrieved indicated to the researcher that the positive aspects of video as primary content delivery medium in health profession education, far outweighed the negative aspects and that it was also overwhelmingly embraced by the participants. The ability of staff to access content on demand, played a major role in the success of content delivery through video. From the literature study it is also clear that video as primary content delivery medium in Higher Education, as well as Health Professions Education has many advantages. It is clear to the researcher from the literature study and the feedback provided by participants, that using video as primary content delivery medium should be greatly considered and implemented in faculties of health professions. Recommendations in this regard were made. The sound research approach and methodology ensured the quality, reliability and validity of this study. This completed research study can form the basis for a subsequent research study.

An in-depth study was carried out with a view t compile recommendations for the use of clinical simulation as enhancement of undergraduate medical education and training at the University of the Free State. Clinical simulation plays an important role in the development of clinical skills and competence, and in creating a safe environment where students can learn without harm to patients while improving clinical reasoning and multidisciplinary training. Clinical simulation must be fully integrated with the curriculum, so that students can move between theory, simulation- and clinical training continuously. Assessment of skills and competence is a key component in clinical simulation-enhanced teaching and learning. In this study, the potential of clinical simulation was investigated as enhancement of undergraduate medical education and training. The extent to which clinical simulation could address the problems related to a decreasing clinical training platform, change in case mix and the demand for more health care professionals was investigated. Clinical simulation was considered as a complementary asset to enhance teaching and learning at the School of Medicine, UFS. The research methods comprised literature reviews, semi-structured interviews, focus group interviews, and observations during international visits. The literature review provided a background for a conceptual framework and contextualised the problem against related theory and research. Data were collected by means of semi-structured interviews with international experts to gain expert opinions on the use of simulation as teaching and learning tool, simulation-based assessment and the establishment of a simulation centre. Focus group interviews with lecturers and heads of departments at the UFS were conducted with the intent to evaluate the personal opinions and attitudes of the participants on these issues. The compilation of recommendations for the use of clinical simulation to enhance undergraduate medical education and training at the UFS and the planning and implementation of a simulation centre was achieved with the aid of the data collected. The premises, points of departure and role players were examined in order to make recommendations in this regard. The study originated from the recognition that a gap exists in the use of clinical simulation in the education and training of medical students at the UFS, but also in South Africa and the rest of Africa. To bridge the gap, the researcher compiled educational recommendations for the integration of clinical simulation as a required component and enhancement of the current curriculum. The development and implementation of a new simulation centre for the UFS School of Medicine was discussed in order to reach the goal of clinical simulation teaching and learning. A valuable contribution to knowledge was made by providing recommendations for developing and implementing a simulation centre for the School of Medicine, UFS. By developing the strategy, the identified gap is bridged, in that it can aid in integrating clinical simulation with current curricula, show how skills development and competence of medical students can improve and provide pointers for simulation-based assessment of medical students. Recommendations in this regard were made. The sound research approach and methodology ensured quality, reliability and validity. The completed research can form the basis for a further research undertaking.