Strategies to implement competencies as it relates to a competency framework in a dental undergraduate curriculum: A systematic review.

INTRODUCTION: Worldwide, dental schools are underpinned by approved competency frameworks or competency statements developed for specific contexts or countries. Literature are replete with competencies required and assessed within this frameworks however limited literature that guides the incorporation of competencies and implementation of the competencies related to the competency framework in dental curricula. MATERIALS AND METHODS: A systematic review design was used. The research question addressed for this systematic review was: What are the strategies used to develop core competencies undergraduate dental curricula? Databases included in the searches were: MEDLINE(ebscoHost), Science Direct, MEDLINE(Pubmed), Wiley Online Library, ERIC. A meta-synthesis analysis consisting of a descriptive meta-synthesis to critically analyse and discuss emerging themes from the findings of the six included studies were completed. RESULTS AND DISCUSSION: Strategies used to develop core competencies were divided into four components namely organizational structure, faculty development, teaching strategies and assessment strategies. To consider a holistic approach to develop core competencies, changes in the organizational structure needs to be in place first. With the appropriate organizational structure in place, faculty development to implement competency strategies would be more supported and feasible. From the findings of the included articles, faculty development regarding teaching strategies and assessment methods were considered necessary to implement core competencies in a dental curriculum. CONCLUSION: A strong relationship between the suggested implementation strategies from this systematic review findings and the multifaceted approach for the CanMEDS exist. Teaching and assessments, faculty development strategies are common strategies. Surprisingly, organisational structure changes were not included as implementation strategy of CanMEDS.

Experiences of Mothers Living With HIV in a South African Prevention of Mother-to-Child Transmission of HIV Programme: A Qualitative Descriptive Study.

ABSTRACT: More than 90% of all HIV infections in children result from mother to child transmission. Elimination of mother-child transmission is a global priority and vital for the improvement of child survival in high-burden, limited resource settings. Retention in HIV care is vital to reduce transmission risk. This qualitative study explored the experiences and adherence challenges of mothers living with HIV of the Prevention of Mother-to-Child Transmission of HIV (PMTCT) programme in Khayelitsha, Cape Town, South Africa. Interviews were conducted with purposively selected participants enrolled in a PMTCT programme at a primary care facility. Thematic analysis generated six themes. Findings demonstrate the complexity of living as a woman with HIV in a socioeconomically disadvantaged and marginalized periurban community. For each woman, there is a set of concerns relating to person, home, community, and clinic which may affect her understanding, acceptance of, and adherence to the PMTCT programme.

Challenges experienced by community health workers and their motivation to attend a self-management programme.

BACKGROUND: Community health workers (CHWs) are change agents expected to assist in decreasing the global burden of disease in the communities they serve. However, they themselves have health risk behaviours, which predispose them to non-communicable diseases and thus need to be empowered to make better health choices. There is a gap in literature detailing the challenges faced by CHWs in addressing their own health risk behaviours. AIM: This study aimed to explore the challenges experienced by CHWs in carrying out their daily duties and the motivating factors to join a self-management programme. SETTING: The study was conducted in a low socio-economic urban area of the Western Cape, South Africa. METHODS: This study used a qualitative exploratory design using in-depth interviews to obtain rich data about the personal and professional challenges that CHWs experience on a daily basis. RESULTS: Five themes emerged with regard to professional challenges (social conditions, mental health of patients, work environment, patient adherence and communication). This cadre identified ineffective self-management as a personal challenge and two themes emerged as motivation for participating in a self-management programme: empowerment and widening perspective. CONCLUSION: The challenges raised by the CHWs have a direct impact on their role in communities. This study therefore highlights an urgent need for policymakers and leaders who plan training programmes to take intentional strategic action to address their health challenges and to consider utilising a self-management intervention model to improve their overall health status.

Perceptions, attitudes and understanding of health professionals of interprofessional practice at a selected community health centre.

BACKGROUND: Despite being identified as a solution to the challenges related to healthcare service delivery, the incorporation of interprofessional practice (IPP) into clinical practice has been limited. To implement an interprofessional model of healthcare, successfully, health professionals need to have an understanding of IPP and its related content. AIM: The aim of this study was to explore and describe the health professionals' perceptions, attitudes and understanding of IPP at a selected community health centre. SETTING: This study was conducted at a primary healthcare facility in the Western Cape, South Africa. METHODS: Ethical clearance and permission to conduct the study was obtained from all relevant stakeholders. Four focus group discussions were conducted with health professionals at the facility. Themes, codes and categories were highlighted from the transcripts of the audiotape-recorded data. FINDINGS: The findings suggest that health professionals do not have an understanding of IPP, and are thus unable to apply it practically. The health professionals perceived certain healthcare processes in the facility as barriers to the integration of practices. In addition, the health professionals expressed the need for interprofessional relationships, creation of opportunities for IPP, and communication to transform the current practice. CONCLUSION: To implement IPP into this facility, effectively, the authors of this study recommend that facility management implement campaigns for and training on, the transition to IPP, staff induction programmes and regular meetings.

Non-cognitive Support for Postgraduate Studies: A Systematic Review.

Retention of postgraduate students is a complex problem at higher education institutions. To address this concern, various forms of academic support are offered by higher education institutions to nurture and develop the pipeline of postgraduate students. The support provided to postgraduate students tends to emphasize academic support at times at the expense of psychosocial or non-academic support. Non-cognitive skills were underscored as integral to determining academic and employment outcomes and thus, may need to be investigated more. This manuscript reports on an attempt to filter and consolidate the literature reporting on interventions for postgraduate students that include the development of non-cognitive skills. A systematic review was conducted, because it enabled rigorous and replicable process of consolidating literature. Covidence software was used as a digital platform for the systematic review. The review was conducted at four levels as per the PRISMA guideline namely, identification, screening, eligibility and final summation. The filtration process attempted to answer the following research questions: (1) How are non-cognitive factors or skills defined? (2) Which non-cognitive skills were included in support for postgraduate (Masters and Doctoral) students in the higher education setting?, and (3) How have non-cognitive skills been included in support interventions provided to retain postgraduate students? Descriptive and theory explicative metasynthesis was used for the summation and data extraction. The primary finding was that the term non-cognitive was not used explicitly in the included studies to describe skills or factors supporting student retention. The discourse centered around support and social support as non-academic factors and skills. This suggested that non-cognitive skills were constructed as co-curricular and not integrated into the postgraduate academic project or core learning outcomes. The findings highlighted the distinction between non-cognitive skills and factors and illustrated how skills and factors operate at different levels with different spheres of influence. The formats of support provide an intersectional space where skills and factors are combined.

Emerging from the Shadows: Intrinsic and Extrinsic Factors Facing Community Health Workers in Western Cape, South Africa.

Community health workers (CHWs) have been identified as a key component of the health workforce in South Africa. However, the efficacy of CHW programs continues to be limited by a poor understanding of facilitators and barriers to CHW engagement. This study explores intrinsic and extrinsic factors that CHWs face. We conducted in-depth interviews with 20 CHWs in order to understand the challenges they may face as they implement their duties linked to the primary health care strategy in the Western Cape, South Africa. All interviews were audiotaped, transcribed verbatim, coded and analyzed using NVivo 12. Drawing on narratives of CHWs, we illustrate the complex issues surrounding CHW outreach in poor rural communities. The CHWs identified five key areas of challenges with respect to personal health, gender issues, poor community understanding of CHWs roles, environmental challenges and lack of patient adherence. These all hinder the ability of CHWs to meet their personal and familial needs, as well as those of the community members they support. There is a need to address the intrinsic needs of CHWs in order to ensure their emotional and physical well-being, as well as a need to create an awareness of the roles of CHWs.

A Self-Management Training Intervention: Perceptions and Practices of Community Health Workers in South Africa.

Background. While community health workers (CHWs) are increasingly being used as a strategy for increasing health care access, particularly in rural communities, interventions are needed to improve their skill sets in inspiring health behavior change, both for themselves and among their community clients. Self-management (SM) education interventions have shown to improve health behaviors and well-being. Purpose. This article reports on systematic, in-depth interviews conducted with rural CHWs in South Africa to understand (1) their motivation for participating in SM training, (2) skills gained from training and (3) perceived impact of training on CHW health behavior, both personally and as health professionals. Method. Nineteen rural CHWs who completed an SM training participated in face-to-face semistructured interviews. Transcripts were independently coded by two researchers using the thematic framework approach. Findings. CHWs felt empowered to change their health behavior by skills such as goal setting and action planning, and by growth in self-awareness and confidence. They expressed that their desire to help others motivated them to participate in SM training. Conclusion. SM training programs that address practice skill gaps hold promise in producing health behavior changes for rural CHWs and their clients.

Clarifying the role of clinical supervisors according to physiotherapists at a higher education institution.

BACKGROUND: The roles of doctors and nurses in clinical supervision and clinical education are well defined. The role of the physiotherapist in clinical education has not been clearly defined. OBJECTIVES: The aim of this study was to define and clarify the views and experiences of physiotherapy clinical supervisors regarding clinical education and their role in contributing to student learning. METHODS: This qualitative exploratory study targeted 17 physiotherapy clinical supervisors, employed in a physiotherapy department, at a local university in the Western Cape. Twelve of the 17 participants agreed to participate in the study. Data were collected by means of in-depth audio-taped interviews, at a time convenient for the participants. Each transcript was read individually by the first author and notes made in the margins to highlight interesting concepts that emerged. The different types of concepts were listed and categorised, while common categories were grouped into themes. RESULTS: Based on the results, the clinicians' role is viewed as a valuable asset in clinical education, embodying the role of an educator, mentor, role model and communicator. Clinical supervisors discussed their roles in terms of understanding the importance of clinical supervision, providing guidance within a clinical setting, role modelling and professionalism. Although clinical supervisors play a significant role, they experienced a few challenges including role clarification and students' lack of knowledge. CONCLUSION: This study highlights that clinical supervisors and clinicians fulfil significant roles in assisting students to integrate theoretical and clinical knowledge. CLINICAL IMPLICATIONS: Understanding the expectations of clinical supervisors in supporting clinical education is important for higher education institutions and the clinical sector.

Knowledge about modifiable risk factors for non-communicable diseases adults living with HIV in Rwanda.

BACKGROUND: Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes. Research has revealed that there is a relationship between knowledge of NCD risk factors and risk perceptions in the general population. Therefore, an assessment of PLHIV's NCD risk factors knowledge is quite critical, to design effective NCD prevention programmes. OBJECTIVE: To assess the level of knowledge of modifiable risk factors for NCDs and its associated factors among adults living with HIV in Rwanda. METHODS: A cross-sectional quantitative design was used to collect the data. The study targeted PLHIV who visited the out-patients' public health centres in three purposively selected provinces of Rwanda. The knowledge assessment questionnaire relating to risk factors for chronic diseases of lifestyle was used to collect the data. Data were analysed using SPSS version 23. RESULTS: Of the 794 respondents, 64.6% were women, and the mean age was 37.9 (±10.8) years. The results revealed that the majority of the respondents (65.0%) had low levels of knowledge about NCD risk factors, while some (35.6%) were of the opinion that they had a low risk of contracting NCDs. Good knowledge was significantly associated with high educational status, a low CD4+ cell count (< 350 cells/mm3) and normotension. CONCLUSION: The current study findings highlight the need for comprehensive health education, to raise awareness of non-communicable diseases' risk factors for adults living with HIV in Rwanda.

Perceptions and satisfaction of caregivers regarding rehabilitation services from selected rehabilitation centres in the Western Cape.

BACKGROUND: Understanding caregivers' views on rehabilitation services is important as it may assist in informing healthcare services and patient management. OBJECTIVES: The aim of this study was to explore caregivers' perceptions and satisfaction regarding rehabilitation services in the Western Cape, South Africa, and to inform clinical practice and policy in this emerging field. METHOD: This study used a descriptive, qualitative design using in-depth interviews with conveniently selected participants. Interviews were conducted with 13 caregivers of patients with: amputations (3), cerebrovascular accidents (5) and neuromuscular disorders (5). Thematic content analysis was conducted with the transcripts. RESULTS: Four key themes emerged, which were (1) financial difficulties, (2) caregiver and therapist relationships, (3) facility management and (4) caregiver experience with service delivery. CONCLUSION: Based on the participants' feedback, the rehabilitation services seem to be meeting the basic rehabilitation needs of the patients; however, the needs of the caregivers require attention.

Health-related quality of life and associated factors in adults living with HIV in Rwanda.

In Rwanda, as in other sub-Saharan African (SSA) countries, life expectancy of people living with HIV (PLWH) has increased dramatically as a result of combined antiretroviral therapy (cART). People living with HIV can now live longer but with increasing rates of non-communicable diseases (NCDs). Thus, prevention of NCD comorbidities in PWLHI is crucial to maintain and gain health-related benefits and to maximise the health-related quality of life (HRQOL) in the long-term management of PLWH. This study determines the association between physical and mental health-related dimensions of quality of life (QOL) with behavioural and biological risk factors, after controlling socio-demographic and HIV-related factors in adults living with HIV in Rwanda. A cross-sectional study using the WHO STEPwise approach and Kinyarwanda version of the MOS-HIV Health Survey, risk factors for NCDs and HRQOL were analysed for 794 PLWH, both HIV+ on ART and ART-naïve. Multiple regression analysis was used to examine the relationship between CMD risk factors and physical health and mental health summary scores. A total of 794 participants were interviewed. The mean age of the sample was 37.9 (±10.8) years and the majority of the participants were women (n = 513; 64.6%). About 16.2% reported daily smoking, 31.4% reported harmful alcohol use and 95% reported insufficient consumption of vegetables and fruits while 26.1% reported being physically inactive. 18.4% were overweight 43.4% had abdominal obesity, i.e. waist-hip-ratio (WHR) ≥0.95 in males and 0.85 in females. High blood pressure (HBP), i.e. systolic blood pressure (SBP) of ≥140 mmHg, or diastolic blood pressure (DBP) ≥90 mmHg was 24.4%. The results reveal that mean physical health summary and mental health summary score values were 63.96 ± 11.68 and 53.43 ± 10.89, respectively. While participants indicated that tobacco users and those who had abdominal obesity reported poor mental HRQOL, physical inactivity and hypertension have a negative impact on physical HRQOL. In addition, certain socio-demographic and HIV-related variables - specifically being unmarried, lack of HIV disclosure and low CD4 count (less 350 cell counts /mm3) - were associated with significantly lower mental and physical dimensions of quality of life. The results of this study reveal that behavioural and biological risk factors for NCDs were significantly associated with a lower HRQOL. These research findings also suggest that the assessment of the association between behavioural and biological risk factors for NCDs and a HRQOL provides opportunities for targeted counselling and secondary prevention efforts, so that health care providers can implement strategies that have a significant impact on the HRQOL.

Promoting Physical Activity and Exercise in Daily Practice: Current Practices, Barriers, and Training Needs of Physiotherapists in Eastern Nigeria.

PURPOSE: To investigate current practices, barriers, and training needs for the promotion of physical activity (PA) in physiotherapy practices in eastern Nigeria. METHODS: A total of 141 fully licensed physiotherapists in southeast Nigeria were invited to participate in a cross-sectional survey consisting of 23 questions in five key sections, focusing mainly on risk-factor management practices of physiotherapists. RESULTS: A total of 103 questionnaires were returned. Respondents ranged in age from 25 to 54 years and reported a mean of 11 (SD 10) years of clinical experience. Respondents reported that they regularly assess and advise their clients on PA but rarely give written prescriptions. Although they are confident in assessing and advising their clients on PA and consider including PA intervention as a priority in daily practice, lack of time and lack of access to materials were reported as barriers to effective PA intervention. CONCLUSION: Findings showed the potential for physiotherapists to address physical inactivity and highlighted several barriers. Strategies are needed to improve contact time with clients and make material promoting PA available to practising physiotherapists.

Objet : Étudier les pratiques, les obstacles et les besoins en formation courants qui ont trait à la promotion de l'activité physique (AP) dans les cabinets de physiothérapie de l'est du Nigéria. Méthodes : Au total, 141 physiothérapeutes entièrement autorisés du sud-est du Nigéria ont été invités à participer à une étude transversale comportant 23 questions réparties en 5 sections clés et portant principalement sur les pratiques de gestion des facteurs de risque suivies par les physiothérapeutes. Résultats : Au total, 103 questionnaires ont été renvoyés. L'âge des répondants variait de 25 à 54 ans et ils ont déclaré une moyenne de 11 (ET 10) ans d'expérience clinique. Les répondants ont signalé qu'ils évaluent régulièrement leurs clients et leur conseillent de faire de l'AP, mais leur donnent rarement des ordonnances écrites. Même s'ils se sentent en confiance lorsqu'ils doivent évaluer leurs clients et leur donner des conseils en matière d'AP, et s'ils envisagent de faire de l'intervention sur l'AP une priorité dans la pratique quotidienne, les répondants ont signalé le manque de temps et d'accès au matériel comme obstacles à une intervention efficace sur l'AP. Conclusion : Les constatations ont révélé que les physiothérapeutes pourraient aborder l'inactivité physique et ont dégagé certains obstacles. Des stratégies s'imposent pour améliorer le temps de contact avec les clients et mettre à la disposition des physiothérapeutes en activité du matériel de promotion de l'AP.

Promotion of healthy nutrition in clinical practice: A cross-sectional survey of practices and barriers among physiotherapists in southeast Nigeria.

BACKGROUND: Healthy diet counselling is an important concept in health promotion. Physiotherapists are well positioned to initiate or support healthy nutrition in addition to physical activity counselling, in routine patient consultation. OBJECTIVE: To determine the practices about and barriers to diet counselling practices among physiotherapists in Southeast Nigeria. METHODS: In this cross-sectional survey, a total of 140 questionnaires were distributed among physiotherapists. RESULTS: Overall, 103 physiotherapists responded. Physiotherapists are confident and consider the incorporation of dietary counselling very important and of high priority in their daily clinical work. They, however, assessed and counselled on dietary status opportunistically in patients. Notwithstanding, physiotherapists believed that the diet counselling they give could be effective in helping patients change their unhealthy dieting practices. Patients were also amenable to physiotherapists advocating on diet issues as part of their consultation. Several barriers to incorporating diet counselling into physiotherapy practice were identified, including lack of access to a dietician/health promotion staff/counsellors, lack of proper patient education materials, lack of expertise in relation to dietary risk factors' assessment and management, and uncertainty about what dietary services to provide. CONCLUSION: Although physiotherapists consider it important to incorporate diet counselling in their daily clinical practice, development and implementation of strategies to improve physiotherapists' diet counselling knowledge, competence, skills, and practice are warranted.

The effect of a knowledge-based ergonomic intervention amongst administrators at Aga Khan University Hospital, Nairobi.

BACKGROUND: Low back pain (LBP) and neck pain are part of the common work-related musculoskeletal disorders with a large impact on the affected person. Despite having a multifactorial aetiology, ergonomic factors play a major role thus necessitating workers' education. OBJECTIVE: To determine the prevalence of ergonomic-related LBP and neck pain, and describe the effect of a knowledge-based ergonomic intervention amongst administrators in Aga Khan University Hospital, Nairobi. METHODS: This study applied a mixed method design utilizing a survey and two focus group discussions (FGD). A self-administered questionnaire was distributed to 208 participants through systematic sampling. A one hour knowledge-based ergonomic session founded on the survey results was thereafter administered to interested participants, followed by two FGDs a month later with purposive selection of eight participants to explore their experience of the ergonomic intervention. Quantitative data was captured and analyzed using SPSS by means of descriptive and inferential statistics, whereas thematic content analysis was used for qualitative data. RESULTS: Most participants were knowledgeable about ergonomic-related LBP and neck pain with a twelve month prevalence of 75.5% and 67.8% respectively. CONCLUSION: Continual ergonomic education is necessary for adherence to health-related behaviours that will preventwork-related LBP and neck pain.

Cracking the nut of service-learning in nursing at a higher educational institution.

BACKGROUND: The readiness of academics to engage in the service-learning (SL) institutionalisation process is not accentuated in research on SL institutionalisation in South Africa. The argument has been advanced that SL scholarship and willingness of key stakeholders are crucial for SL institutionalisation at the academic programme level. AIM: The research focus of the study being reported here was on readiness of respondents to embed SL in the curricula of the nursing programme. METHOD: This study used a quantitative, exploratory and descriptive design. A self-administered structured questionnaire was used to collect data from a stratified sample comprising 34 respondents. The data were analysed for descriptive statistics using SPSS 19. RESULTS: The demographic profile of the respondents indicated that 31 (66%) were between 31 and 50 years old; 36 (75.16%) had a minimum of 10 years' nursing experience; 19 (39.6%) had a master's degree, two (4.2%) had a doctorate; and 29 (60.4%) had been employed by the school for a maximum of five years. The results indicated that the nurse educators were in need of SL capacity-building because 9 (18.8%) had limited or no knowledge of SL and 24 (50%) confused SL with other forms of community engagement activities. However, only 15 (33%) of the clinical supervisors and 13 (27%) of the lecturers indicated a willingness to participate in such a programme. CONCLUSION: The school was not ready to embed SL in the academic programme because of a lack of SL scholarship and willingness to remediate the identified theory-practice gaps.

The impact of a faculty development programme for health professions educators in sub-Saharan Africa: an archival study.

BACKGROUND: In 2008 the sub-Saharan FAIMER Regional Institute launched a faculty development programme aimed at enhancing the academic and research capacity of health professions educators working in sub-Saharan Africa. This two-year programme, a combination of residential and distance learning activities, focuses on developing the leadership, project management and programme evaluation skills of participants as well as teaching the key principles of health professions education-curriculum design, teaching and learning and assessment. Participants also gain first-hand research experience by designing and conducting an education innovation project in their home institutions. This study was conducted to determine the perceptions of participants regarding the personal and professional impact of the SAFRI programme. METHODS: A retrospective document review, which included data about fellows who completed the programme between 2008 and 2011, was performed. Data included fellows' descriptions of their expectations, reflections on achievements and information shared on an online discussion forum. Data were analysed using Kirkpatrick's evaluation framework. RESULTS: Participants (n=61) came from 10 African countries and included a wide range of health professions educators. Five key themes about the impact of the SAFRI programme were identified: (1) belonging to a community of practice, (2) personal development, (3) professional development, (4) capacity development, and (5) tools/strategies for project management and/or advancement. CONCLUSION: The SAFRI programme has a positive developmental impact on both participants and their respective institutions.

Prevalence and ergonomic risk factors of work-related musculoskeletal injuries amongst underground mine workers in Zambia.

UNLABELLED: Work-related musculoskeletal injuries (WMSIs) are common in both developed and third world countries. Most researchers agree that exposure to ergonomic risk factors is a major contributor to these injuries. OBJECTIVE: The aim of this study was to determine the prevalence of and ergonomic risk factors associated with WMSIs amongst underground mine workers in Kitwe, Zambia. METHODS: A cross-sectional quantitative study was conducted using a sample size of 500 workers. A stratified random sampling method according to mining work activity type was used to obtain the sample. Data was collected by means of a structured questionnaire, and the Statistical Package for Social Sciences (SPSS) was used to analyze data using descriptive and inferential statistical methods. Results were significant at 5%. RESULTS: A response rate of 40.4% (202) was obtained. The 12-month prevalence of WMSIs was 42.6%. The mean age of the workers was 40.31 years (SD +/- 8.57 years). Electricians and mechanics reported the highest injury frequencies. The back was the most affected body part. Ergonomic risk factors consistently reported by workers included poor postures and heavy lifting. There were significant (p=0.020) associations between working with the back bent and sustaining a back injury. Significant (p=0.049) associations were also found between injuries of the wrists/hands and grasping an unsupported object(s). CONCLUSIONS: This study revealed significant associations between WMSIs and ergonomic risk factors like working with the back bent and grasping objects.

Beyond knowledge and skills: the use of a Delphi study to develop a technology-mediated teaching strategy.

BACKGROUND: While there is evidence to suggest that teaching practices in clinical education should include activities that more accurately reflect the real world, many educators base their teaching on transmission models that encourage the rote learning of knowledge and technical skills. Technology-mediated instruction may facilitate the development of professional attributes that go beyond "having" knowledge and skills, but there is limited evidence for how to integrate technology into these innovative teaching approaches. METHODS: This study used a modified Delphi method to help identify the professional attributes of capable practitioners, the approaches to teaching that may facilitate the development of these attributes, and finally, how technology could be integrated with those teaching strategies in order to develop capable practitioners. Open-ended questions were used to gather data from three different expert panels, and results were thematically analysed. RESULTS: Clinical educators should not view knowledge, skills and attitudes as a set of products of learning, but rather as a set of attributes that are developed during a learning process. Participants highlighted the importance of continuing personal and professional development that emphasised the role of values and emotional response to the clinical context. To develop these attributes, clinical educators should use teaching activities that are learner-centred, interactive, integrated, reflective and that promote engagement. When technology-mediated teaching activities are considered, they should promote the discussion of clinical encounters, facilitate the sharing of resources and experiences, encourage reflection on the learning process and be used to access content outside the classroom. In addition, educational outcomes must drive the integration of technology into teaching practice, rather than the features of the technology. CONCLUSIONS: There is a need for a cultural change in clinical education, in which those involved with the professional training of healthcare professionals perceive teaching as more than the transmission of knowledge and technical skills. Process-oriented teaching practices that integrate technology as part of a carefully designed curriculum may have the potential to facilitate the development of capable healthcare graduates who are able to navigate the complexity of health systems and patient management in ways that go beyond the application of knowledge and skills.

The prevalence of intimate partner violence in the family: a systematic review of the implications for adolescents in Africa.

BACKGROUND: Intimate partner violence (IPV) and its multiple effects are well documented in Western research, but these are not adequately described in Africa. The effects of IPV on adolescent health and well-being are not conclusive. OBJECTIVE: The aim of this review was to systematically appraise prevalence studies conducted on the African continent to establish the prevalence of IPV and the implications of exposure on adolescents in Africa. METHODS: A comprehensive search was conducted in May 2012 for the previous 10 years, using databases such as Ebscohost (Medline, CINAHL, PsyArticles), Directory of Open Access Journals (DOAJ), Project Muse and BioMed Central and also specific journals Lancet, and JSTOR. Two reviewers independently evaluated the methodological quality of the studies reviewed. RESULTS: Seven eligible epidemiological studies were included in this review. Five of the studies were conducted in South Africa, one in Liberia, and another was a multi-country study that included Egypt, Kenya, Malawi, Rwanda and Zambia. The prevalence of IPV in African countries ranged from approximately 26.5% to 48%. All studies reported exposure to family violence during childhood. CONCLUSION: The findings support the global burden of IPV. There is also a need for standardized tools to determine IPV in Africa and a clear definition that can be used in research to allow comparison with future IPV studies. In addition, the studies point to a need for interventions focusing on adolescents exposed to family violence.