Workplace-based learning opportunities in a South African family medicine training programme

Abstract

Background: Workplace-based learning (WBL) provides authentic learning opportunities to develop fit-for-practice healthcare workers. Different types of WBL opportunities have been described in high-income countries, but the opportunities in the district health systems of sub-Saharan Africa have not been characterised. Aim: This study explored family physicians’ (FPs) and registrars’ perceptions of WBL opportunities in a decentralised postgraduate family medicine registrar training programme. Setting: The study was conducted at five decentralised training sites across two provinces affiliated with the University of the Witwatersrand in South Africa. Methods: This instrumental case study involved semi-structured qualitative interviews with 11 FPs and 11 registrars purposively sampled across the training sites. The verbatim transcripts were thematically analysed using Braun and Clark’s six-step approach. Results: Workplace-based learning opportunities were grouped into four themes: Learning from interpersonal interactions, learning from district activities, self-directed learning and contextual influences on learning opportunities. Registrars learnt from patients, peers, FPs and other professionals. Feedback, self-reflection, portfolio use, involvement in various district events, such as student and staff teaching, and continuous medical education augmented learning. Contextual influences originated from health facilities, resource availability, district management and university support, excessive workload and a need for standardised district learning opportunities. Conclusion: Registrars are exposed to several types of WBL opportunities in district health systems. Effective engagement with available opportunities and addressing contextual challenges could enhance registrar learning. Contribution: Maximising learning opportunities to promote registrars’ acquisition of required skills and competencies to efficiently address community needs in a middle-income country such as South Africa.

Keywords

• decentralised clinical training
• family medicine
• family physician
• postgraduate training
• postgraduate registrars
• workplace-based learning
• workplace learning opportunities.