SURMEPI

Equipping medical graduates to address health systems challenges in South Africa: An expressed need for curriculum change

F K Mukinda, C D Goliath, B Willems, M Zunza, L D Dudley

Abstract


Background. Stellenbosch University Rural Medical Education Partnership Initiative (SURMEPI) aims to enhance health systems knowledge and
skills to empower medical graduates to address health systems challenges especially in rural and underserved areas.
Objectives. To assess the content of health systems research (HSR) and strengthening, and understand perceptions of medical graduates and faculty
about HSR in the undergraduate medical curriculum at Stellenbosch University.
Methods. We defined HSR and strengthening competencies for medical graduates through a literature review and expert consultations. Learning
outcomes in terms of knowledge, skill or attitude in the 64 module guides of the curriculum were compared with the competencies required. A survey
of recent medical graduates assessed whether their training equipped them to address health systems challenges. Interviews with faculty assessed their
views on teaching health systems competencies.
Results. HSR foundational competencies were covered at a basic knowledge level, with little progression of learning levels, and several key
competencies were not taught at all. Teaching was not integrated throughout the curriculum. Of 189 graduates, 63 (33.3%) agreed while 67 (35.4%)
disagreed that their training prepared them to address health system challenges; 128 (67.7%) agreed on the importance of learning health systems
competencies as undergraduates, and proposed learning areas of health system knowledge, leadership and management, problem solving, community
service, evaluation methods and health economics. They wanted more practical, problem-oriented HSR training. Faculty supported the relevance and
inclusion of HSR and strengthening in the curriculum.
Conclusion. The curriculum needs adaptation to better equip students with HSR and strengthening competencies.


Authors' affiliations

F K Mukinda, Centre for Health Systems and Services Research and Development, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Community Health Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

C D Goliath, Centre for Health Systems and Services Research and Development, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Community Health Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

B Willems, Community Health Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

M Zunza, Community Health Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

L D Dudley, Centre for Health Systems and Services Research and Development, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Community Health Division, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

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Keywords

Health systems research; Competencies; Undergraduate; Curriculum; Medical education

Cite this article

African Journal of Health Professions Education 2015;7(1):86. DOI:10.7196/AJHPE.511

Article History

Date submitted: 2014-08-30
Date published: 2016-01-26

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