Bachelor of Clinical Medical Practice (Clinical Associate ) student reflections during clinical rotations

Date
2014
Authors
Gibbs, Audrey
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Background: The BCMP degree (Clinical Associates) was introduced in South Africa in 2008 and at the University of the Witwatersrand in 2009. This first cohort of students produced challenges and questions around teaching and the learning environment. The clinical experience was mainly in district and regional hospitals, not tertiary academic hospitals, with clinical learning supervised by staff at these hospitals. Faculty therefore relied on student portfolios to ascertain learning and experiences in the clinical setting. This included reflective journals. Aim: To identify the issues that third year BCMP students in the clinical areas choose to write about in their reflective journals. Methods: The journals of 24 BCMP students written during the first two clinical rotations of their final (third) year were included in a retrospective study. Thematic content analysis of these journals was employed to examine emerging themes and subthemes. Each student’s narrative pieces were then further analysed in detail. Many of the journal entries contained more than one reflection and each of these reflections was analysed and the relevant themes and subthemes were identified. Results: The reflections show that students focused on staff and health care systems issues, especially resources, attitudes and work ethic. The majority of these staff and health care related reflections were negative but positive experiences and role models were also identified. There were differences noted between hospitals and rotations, with the paediatric rotation showing the most positive responses, and the emergency rotation the least. Conclusion: The students identified lapses in the health services and health providers which affected patient care. They also recognised positive experiences and role models. This reveals a mismatch between teaching and their clinical experience. These experiences will be used to advise future teaching and research, as well as to provide feedback to the hospitals used for clinical training. Discussions should be held as to ways of reporting these incidents and improving professional standards in the clinical teaching settings.
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