Registrars' profile and their perceived readiness for specialist training in the new family medicine registrarship programme in South Africa

Date
2016-01-10
Authors
Akinsanya, Olusegun Solomon
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Abstract
Background: Since the formal training of Family medicine registrars was launched in 2008, a number of graduates have been produced but factors that influence registrars’ readiness for this training remain unknown. Registrars in this new programme also enter into training with some attributes that influence their ability to learn and attain certain academic outcomes. It is important to explore these attributes in order to identify characteristics that may influence learning. Where skills gap exists, interventions could also be made to bridge the gap. The aim of this study was to describe family medicine registrars’ pre-training characteristics, the factors that influence their training and their perceived readiness for specialist training in family medicine. Methods: This study had a cross sectional design that used a structured web-based online questionnaire sent by e-mail to 218 registrars who were currently enrolled for at least one year in the new family medicine specialist training programme at the time of the study. Responses were anonymous and received through a secure web-host server. It was a multisite cross-sectional study of registrars across the eight training universities in South Africa. Information on participants’ demography, their pre-registrarship clinical, ancillary and self-directed learning skills, and their current training in family medicine were collected. Main outcomes of data analysis included descriptive statistics of participants’ pre-registraship characteristics, the barriers and enhancers of their current learning and the perceived readiness of registrars for specialist training. Results: Out of 218 registrars that received the online questionnaire, 123 completed the questionnaire (56.4% response rate). Of these respondents, 45 (36.6%) perceived themselves as being ready for registrarship training in family medicine. Pre-enrolment into the registrarship program, except for ambulatory general practice skills, only a minority of respondents perceived themselves good or excellent in any other clinical, ancillary or self-directed learning skills. The majority of respondents reported that pressure of clinical work (85.9%) assignment load (75.6%), research requirements (67.2%) and training program design (56.9%) are barriers to their current learning. Clinical experience post-basic medical qualification (99.0%), the last work setting prior to joining the registrarship programme (95.0%), prior communication skills (64.2%) and additional qualifications (52.7%) were the main reported enablers of learning. Registrars with postgraduate qualifications were found to be 2.6 times more likely to be ready for specialist training in family medicine than those without postgraduate qualifications (ρ = 0.015). Conclusions: Registrars joined the training in family medicine with gaps in requisite skills for successful training. This finding calls for context-specific strategies to bridge the gap in skills and knowledge at an early stage in the training programme.
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Submitted in partial fulfilment of the requirements for the award of the MMed (Family medicine) degree at the University of the Witwatersrand, South Africa October 2015
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