EVALUATION OF THE IMPLEMENTATION AND ASSESSMENT OF AFRIMEDS PHYSICIAN COMPETENCY FRAMEWORK IN AN UNDERGRADUATE MEDICAL PROGRAMME: A SOUTH AFRICAN MIXED- METHODS CASE STUDY

Abstract

Aim and background: The study evaluates the University of the Free State (UFS) MBChB programme in relation to its implementation and assessment of the AfriMEDS physician competency framework. The Health Professions Council of South Africa (HPCSA), in collaboration with the South African Committee of Medical Deans (SACoMD), adopted and adapted the CanMEDs physician framework in 2014 by incorporating community-based education and a community-oriented approach to healthcare training, and this became the AfriMEDS physician framework. This framework provides an evaluation of physician competencies for medical students in the eight competency roles: medical expert, communicator, scholar, collaborator, professional, leader and manager, health advocate, and community-based education.

Methodology: The study employed mixed-methods case study design using the UFS MBChB programme as a case study. The methods involved qualitative methods, namely, document analysis and virtual interviews with educators, and quantitative methods by using a cross-sectional survey conducted among medical interns who graduated from UFS and were doing first- and second-year internships in 2020.

Results: The findings of the study revealed that AfriMEDS graduate competencies are superficially implemented at the UFS and that some competencies are more challenging to teach and assess than others. The results from document analysis reveal that the core competencies of health advocate, leader and manager, and scholar feature less prominently across all phases, while professional and health advocate role assessment tools are not mentioned in the phase guides of the UFS undergraduate medical programme. The tools of assessment mentioned in the MBChB phase guide booklets are not in line with the recommended tools used to assess the CanMEDS (AfriMEDS) competency framework.

A total of 71 medical interns took part in the online survey, and 15 educators participated in virtual interviews. More than 80% of the medical interns felt that they were sufficiently trained and prepared for internship (80%). Most of the medical interns rated the sufficiency of competencies very high (over 80%), with the exception of leader and manager (63%), community-based education (71%), collaborator (72%), and communicator (79%). These results were closely similar to educators’ findings.

Conclusion and recommendations: The study identified challenges, barriers, and gaps affecting the effective implementation of the AfriMEDS competency framework. Lack of staff, increasing number of students, lack of sufficient time, COVID-19 impact, and limited clinical exposure are factors that need to be addressed to enhance internship experience and undergraduate training. The study concludes by showing that a framework, guidelines, and benchmarked assessment tools are needed to infuse the AfriMEDS framework to transform the UFS MBChB programme and curriculum.

Date of Award	26 Jul 2023
Original language	English
Awarding Institution	University of Bath
Sponsors	Nelson Mandela Metropolitan University
Supervisor	Gina Wisker (Supervisor) & Mpho Jama (Supervisor)