Table 1
Session format descriptions for structured learning activities.
| Session Type | Description |
|---|---|
| Current Structured Learning Activity Formats | |
| Lecture | any formal lecture given by a senior clinician or educator |
| Intern report | a case presentation and discussion led by an intern with or without facilitation from a senior clinician or educator |
| Journal club | a session devoted to critical appraisal of a study published in the scientific literature |
| Training workshop | one of several externally developed training sessions in which large cohorts of trainees participate, for example HIV provider training or Advanced Cardiac Life Support training |
| Morbidity and Mortality conference | a multi-disciplinary conference in which patient cases resulting in adverse outcomes are discussed for education and quality improvement purposes |
| Proposed Structured Learning Activity Formats | |
| Flipped classroom | interns receive materials beforehand, complete work at home, and then have a follow-up discussion in a group setting |
| Structured case discussion | a session focused on an approach to a symptom, physical finding, laboratory result, or imaging study, embedded within a patient case |
| Self-directed learning | a topic that is assigned for independent study |
| Unstructured | discussion with a senior clinician about a topic or topics that are not |
| session | preplanned, but brought up by the interns during that session |
Table 2
Demographic characteristics of survey respondents.
| Category | n (%) |
|---|---|
| Gender | |
| Male | 6 (43%) |
| Female | 8 (57%) |
| Age | |
| 20–25 | 9 (64%) |
| 26–30 | 5 (36%) |
| Medical School | |
| University of Botswana | 8 (57%) |
| Outside Botswana | 6 (43%) |
Table 3
Opinions on current educational formats and teachers.
| Manage Patients | Retain Information | Learn Effectively | Aggregate Score | No. ranking “most useful” | |
|---|---|---|---|---|---|
| Format | |||||
| Lectures | 4.07 (0.83) | 3.14 (0.66) | 4.00 (0.68) | 3.73 (0.83) | 5 (36%) |
| Intern report | 3.79 (0.89) | 3.79 (0.80) | 4.21 (0.80) | 3.93 (0.84) | 4 (29%) |
| Training workshops | 4.43 (0.79) | 4.29 (0.48) | 4.71 (0.49) | 4.47 (0.60) | 3 (21%) |
| Journal club | 3.14 (0.66) | 3.29 (0.83) | 3.43 (0.65) | 3.29 (0.71) | 1 (7%) |
| M&M | 3.86 (0.77) | 3.93 (0.83) | 4.07 (0.83) | 3.95 (0.79) | 1 (7%) |
| Teachers | |||||
| Interns | – | – | – | – | 1 (7%) |
| Medical Officers | – | – | – | – | 0 (0%) |
| Residents | – | – | – | – | 2 (14%) |
| Specialists | – | – | – | – | 11 (79%) |
Table 4
Opinion on the extent and importance of knowledge-based content in the current internship curriculum, October 2015.
| Content Topic | Too Much n (%) | Just Enough n (%) | Too Little n (%) | Perceived Importance Mean (SD) |
|---|---|---|---|---|
| Knowledge Domain | 3.99 (1.00) | |||
| HIV | 2 (14%) | 10 (71%) | 2 (14%) | 4.14 (0.86) |
| Tuberculosis | 1 (7%) | 12 (86%) | 1 (7%) | 4.14 (0.86) |
| Medical emergencies | 0 (0%) | 1 (7%) | 13 (93%) | 4.79 (0.43) |
| Non-communicable diseases | 0 (0%) | 3 (21%) | 11 (79%) | 4.07 (0.92) |
| Cancer | 0 (0%) | 0 (0%) | 14 (100%) | 3.5 (0.76) |
| Pain management | 0 (0%) | 4 (29%) | 10 (71%) | 4.07 (0.92) |
| Psychiatry | 0 (0%) | 0 (0%) | 14 (100%) | 3.5 (1.02) |
| End-of-life care | 0 (0%) | 0 (0%) | 14 (100%) | 3.14 (0.77) |
| Preventative medicine | 0 (0%) | 1 (7%) | 13 (93%) | 4.36 (1.2) |
| CPR | 0 (0%) | 3 (21%) | 11 (79%) | 4.86 (0.36) |
| Social determinants of health | 0 (0%) | 3 (21%) | 11 (79%) | 3.50 (1.22) |
| Outpatient medicine | 0 (0%) | 2 (14%) | 12 (86%) | 3.86 (1.1) |
| Skills Domain | 4.04 (0.95) | |||
| Taking histories | 1 (7%) | 9 (64%) | 4 (29%) | 3.21 (1.1) |
| Doing physical examinations | 0 (0%) | 11 (79%) | 3 (21%) | 3.64 (1.0) |
| Patient management and clinical decision-making | 0 (0%) | 10 (71%) | 4 (29%) | 4.36 (0.75) |
| Doing procedures (e.g., thoracentesis, lumbar puncture) | 0 (0%) | 7 (50%) | 7 (50%) | 4.50 (0.76) |
| Evaluating laboratory data | 0 (0%) | 9 (64%) | 5 (36%) | 3.79 (0.80) |
| Interpreting X-rays | 1 (7%) | 5 (36%) | 8 (57%) | 4.14 (0.86) |
| Interpreting ECGs | 0 (0%) | 6 (43%) | 8 (57%) | 4.36 (0.84) |
| Performing and interpreting ultrasounds | 0 (0%) | 0 (0%) | 14 (100%) | 4.86 (0.36) |
| Dealing with emergencies | 0 (0%) | 5 (36%) | 9 (64%) | 4.79 (0.43) |
| Analyzing and interpreting scientific data (i.e., from a journal) | 0 (0%) | 8 (57%) | 6 (43%) | 4.07 (0.83) |
| Applying scientific data to patient care | 0 (0%) | 5 (36%) | 9 (64%) | 4.29 (0.83) |
| Managing stress | 0 (0%) | 1 (7%) | 13 (93%) | 3.93 (1.0) |
| Managing time | 0 (0%) | 3 (21%) | 11 (79%) | 3.64 (0.93) |
| Prioritizing tasks | 0 (0%) | 5 (36%) | 9 (64%) | 3.71 (0.91) |
| Recognizing cognitive biases in medicine | 0 (0%) | 2 (14%) | 12 (86%) | 4.21 (0.70) |
| Electrolyte management | 0 (0%) | 9 (64%) | 5 (36%) | 4.21 (0.89) |
| Fluid management | 0 (0%) | 11 (79%) | 3 (21%) | 4.21 (0.58) |
| DVT prophylaxis | 0 (0%) | 7 (50%) | 7 (50%) | 3.64 (1.22) |
| Bowel management | 0 (0%) | 9 (64%) | 5 (36%) | 3.07 (0.83) |
| Quality improvement skills | 0 (0%) | 4 (29%) | 10 (71%) | 3.64 (1.22) |
| Insulin management | 0 (0%) | 3 (21%) | 11 (79%) | 4.57 (0.65) |
| Communication Domain | 3.71 (1.18) | |||
| Listening to patients | 1 (7%) | 7 (50%) | 6 (43%) | 3.57 (1.2) |
| Communicating with patients | 0 (0%) | 8 (57%) | 6 (43%) | 3.86 (1.2) |
| Assessing patients’ knowledge of their disease and prognosis | 0 (0%) | 5 (36%) | 9 (64%) | 3.86 (1.5) |
| Disclosing medical information in a sensitive manner | 0 (0%) | 8 (57%) | 6 (43%) | 4.00 (1.2) |
| Eliciting and responding to patients’ worries or fears | 0 (0%) | 8 (57%) | 6 (43%) | 3.7 (1.3) |
| Communicating with patients’ relatives | 0 (0%) | 10 (71%) | 4 (29%) | 3.5 (0.86) |
| Communicating with professional colleagues | 1 (7%) | 11 (79%) | 2 (14%) | 3.5 (1.1) |
| Professionalism Domain | 3.92 (1.11) | |||
| Recognize your limitations and strengths | 0 (0%) | 5 (36%) | 9 (64%) | 4.14 (0.77) |
| Work in a team | 0 (0%) | 11 (79%) | 3 (21%) | 3.50 (1.16) |
| Adapt to different clinical environments | 0 (0%) | 12 (86%) | 2 (14%) | 3.36 (1.21) |
| Self-audit | 1 (7%) | 3 (21%) | 10 (71%) | 3.93 (1.21) |
| Admit to mistakes and talk about them to improve practice | 0 (0%) | 7 (50%) | 7 (50%) | 4.07 (1.27) |
| Identify career goals | 0 (0%) | 2 (14%) | 12 (86%) | 4.57 (0.65) |
Table 5
Opinions on potential new formats for curriculum sessions.
| Preference mean (SD) unless otherwise specified | |
|---|---|
| Potential new format | |
| Flipped classroom | 3.43 (1.3) |
| Self-education modules | 2.36 (1.2) |
| Structured case discussions/Case-based learning | 4.71 (0.47) |
| Unstructured sessions (topic determined same day) | 2.93 (1.4) |
| Ideal session characteristics | |
| Duration (minutes) | 47 (11.7) |
| Number per week | 4 (0.96) |
| Size of class (individuals) | 14.7 (5.3) |
| Time of day – Morning | 14 (100%) |
| System or symptom based curriculum | |
| Symptom-based | 13 (93%) |
| System-based | 1 (7%) |
| Preferred area of focus for new curriculum | |
| Knowledge | 4 (29%) |
| Skills | 9 (64%) |
| Communication | 0 (0%) |
| Professional development | 1 (7%) |