Introduction Persons with disability make up the largest minority group in the world yet there is a dearth of research both internationally and nationally on how disability is included in professional training curricula for medical doctors. Aim of the study The purpose of this study is to add to the body of knowledge that would facilitate the inclusion of disability in the undergraduate medical curriculum in South Africa. Methods This is a mixed method, sequential study – Phase one followed by Phase two. Phase one, data was collected - via focus groups and in-depth interviews - from Medical Doctors, Medical Students, Physiotherapists, Occupational Therapists, Speech and Language Therapists and Persons with disability. Phase two used a modified Delphi Method with an expert panel of disabled and abled Disability Studies Academics, Medical Educators, Disability Rights Activists and Medical Doctors. The experts were asked to rate – using a 5-point Likert Scale - each competency according to its importance and language clarity. They were also asked in open-ended questions, to make any suggestions relating to the language of each competency and whether any competencies could be combined. 2 Findings Four main themes emerged from Phase one data: Experience of disability, Attitudes towards disability, Knowledge about Disability and Life beyond the disability. Data from these four themes contributed to the generation of an initial competency set – 17 competencies and 13 sub-competencies. In Phase two the initial competency set was presented to an expert panel as part of a modified Delphi Method. In the first iteration consensus was regarding the importance of each competency. In the second iteration consensus was reached regarding the language of each competency and a final competency set – containing 13 competencies and 9 sub-competencies - was generated. Competencies and sub-competencies 1-6 are clustered as knowledge competencies, 7-10 as attitudes and 11-13 as skills. Conclusion This study sets an important precedent for the inclusion of the subject of disability in undergraduate medical curricula. It proposes an approach to teaching and learning about disability inclusion for medical students. The list of disability specific competencies set forth by this study are a steppingstone in the process of curriculum transformation. The use of this guideline to improve the understanding of disability, and as a catalyst for undergraduate medical curriculum review is recommended.

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Global health is an emerging concern in a rapidly changing world in which health issues transcend international borders. This study developed and validated a new self-report questionnaire to assess self-perceived global health competencies among international medical students and how they are influenced by international clinical experiences. A tool consisted of two scales and four subscales with moderate internal consistency. Comparisons between participants who completed retrospective pretest (after the intervention retrospectively) and those who completed traditional pretest (before the intervention) revealed that those participants who completed the questionnaires retrospectively provided lower pretest scores, suggesting that response-shift bias had occurred. Significant increases in scores after international clinical experience were reported for the majority of global health competency measures in IFMSA group. Linear regression identified participant’s age, gross national income (GNI) of country of medical studies, GNI of the country visited, duration of international clinical experience and years of medical school completed, as significant predictors of global health scores. This study contributes valuable information about the newly developed global health competencies measurement tool.

The new Graduate Entry Medical Programme at the University of the Witwatersrand widens access to study and aims to change the learning process. Content is integrated horizontally and vertically and the learning is organized around facilitated, problembased learning (PBL) tutorials. This study investigated the approaches students have adopted to learning in the curriculum. Questionnaire data, PBL tutorial observation and focus group discussions revealed that uptake and adaptation were not the same for different groups of students. Those who were most mature in age showed the greatest tendency towards self-directed learning behaviour, while many students were unable to make appropriate use of the available time and resources. Although most students believed that they were able to integrate disciplinary information, they valued the psychosocial content areas less than the biomedical sciences. The attitudes, skill and identity of the facilitators were important for engaging students in the PBL process. These findings suggest that the social context of the learning may impact on the ability to access knowledge and develop a professional identity.

Global health is an emerging concern in a rapidly changing world in which health issues transcend international borders. This study developed and validated a new self-report questionnaire to assess self-perceived global health competencies among international medical students and how they are influenced by international clinical experiences. A tool consisted of two scales and four subscales with moderate internal consistency. Comparisons between participants who completed retrospective pretest (after the intervention retrospectively) and those who completed traditional pretest (before the intervention) revealed that those participants who completed the questionnaires retrospectively provided lower pretest scores, suggesting that response-shift bias had occurred. Significant increases in scores after international clinical experience were reported for the majority of global health competency measures in IFMSA group. Linear regression identified participant’s age, gross national income (GNI) of country of medical studies, GNI of the country visited, duration of international clinical experience and years of medical school completed, as significant predictors of global health scores. This study contributes valuable information about the newly developed global health competencies measurement tool.

It is well documented in the literature that Aboriginal peoples have a lower health status compared to the non-Aboriginal population in Canada. The underlining causes for this health disparity are found in the historical and contemporary practices of colonization and social, economic, and political deprivation. This thesis focuses on another of the complex factors which affect Aboriginal health status: the education and training provided to undergraduate medical students on Aboriginal health issues and the social determinants of health in British Columbia. I conducted a critical discourse analysis of the readings materials of three selected courses. I conclude from the analysis that although some of the themes covered by the courses critically present the historical, social and economic contexts for this health disparity, Aboriginal peoples are still characterized as a needy and sick population. Indigenous issues are far from being centrally positioned in the medical curriculum in British Columbia. / Graduate / 0326 / gabipere@hotmail.com

It is well documented in the literature that Aboriginal peoples have a lower health status compared to the non-Aboriginal population in Canada. The underlining causes for this health disparity are found in the historical and contemporary practices of colonization and social, economic, and political deprivation. This thesis focuses on another of the complex factors which affect Aboriginal health status: the education and training provided to undergraduate medical students on Aboriginal health issues and the social determinants of health in British Columbia. I conducted a critical discourse analysis of the readings materials of three selected courses. I conclude from the analysis that although some of the themes covered by the courses critically present the historical, social and economic contexts for this health disparity, Aboriginal peoples are still characterized as a needy and sick population. Indigenous issues are far from being centrally positioned in the medical curriculum in British Columbia. / Graduate / 0326 / gabipere@hotmail.com

Global health is an emerging concern in a rapidly changing world in which health issues transcend international borders. This study developed and validated a new self-report questionnaire to assess self-perceived global health competencies among international medical students and how they are influenced by international clinical experiences. A tool consisted of two scales and four subscales with moderate internal consistency. Comparisons between participants who completed retrospective pretest (after the intervention retrospectively) and those who completed traditional pretest (before the intervention) revealed that those participants who completed the questionnaires retrospectively provided lower pretest scores, suggesting that response-shift bias had occurred. Significant increases in scores after international clinical experience were reported for the majority of global health competency measures in IFMSA group. Linear regression identified participant’s age, gross national income (GNI) of country of medical studies, GNI of the country visited, duration of international clinical experience and years of medical school completed, as significant predictors of global health scores. This study contributes valuable information about the newly developed global health competencies measurement tool.

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