Research Reports

Medical Education in Decentralized Settings: How Medical Students Contribute to Health Care in 10 Sub-Saharan African Countries

Talib, Zohray MD; van Schalkwyk, Susan PhD, MPhil; Couper, Ian MBBCh, MFamMed; Pattanaik, Swaha MPH; Turay, Khadija PhD, MPH; Sagay, Atiene S. MBChB; Baingana, Rhona MSc; Baird, Sarah PhD, MS; Gaede, Bernhard PhD, MBBCh, MMed; Iputo, Jehu PhD, MBChB; Kibore, Minnie MBChB, MPH; Manongi, Rachel MD, PhD, MPhil; Matsika, Antony MBA, MICHA; Mogodi, Mpho MBChB, MPH; Ramucesse, Jeremais PhD, MPH; Ross, Heather MPH; Simuyeba, Moses MBChB, MPH; Haile-Mariam, Damen MD, PhD, MPH

Author Information
Academic Medicine 92(12):p 1723-1732, December 2017. | DOI: 10.1097/ACM.0000000000002003

Abstract

Purpose 

African medical schools are expanding, straining resources at tertiary health facilities. Decentralizing clinical training can alleviate this tension. This study assessed the impact of decentralized training and contribution of undergraduate medical students at health facilities.

Method 

Participants were from 11 Medical Education Partnership Initiative–funded medical schools in 10 African countries. Each school identified two clinical training sites—one rural and the other either peri-urban or urban. Qualitative and quantitative data collection tools were used to gather information about the sites, student activities, and staff perspectives between March 2015 and February 2016. Interviews with site staff were analyzed using a collaborative directed approach to content analysis, and frequencies were generated to describe site characteristics and student experiences.

Results 

The clinical sites varied in level of care but were similar in scope of clinical services and types of clinical and nonclinical student activities. Staff indicated that students have a positive effect on job satisfaction and workload. Respondents reported that students improved the work environment, institutional reputation, and introduced evidence-based approaches. Students also contributed to perceived improvements in quality of care, patient experience, and community outreach. Staff highlighted the need for resources to support students.

Conclusions 

Students were seen as valuable resources for health facilities. They strengthened health care quality by supporting overburdened staff and by bringing rigor and accountability into the work environment. As medical schools expand, especially in low-resource settings, mobilizing new and existing resources for decentralized clinical training could transform health facilities into vibrant service and learning environments.

Copyright © 2017 by the Association of American Medical Colleges

You can read the full text of this article if you:

Access through Ovid