Utilizing skills laboratory resources to enhance clinical Clerkship competence among orthopaedic medicine students at the Ulams, Mulago, Kampala district

Abstract

The study sought to address the problem of declining clinical clerkship competence among Orthopaedic Medicine students at the Uganda Institute of Allied Health and Management sciences, Mulago.The main objective of the study was to utilize available skills laboratory resources to enhance clinical clerkship competence among the orthopaedic medicine students. A participatory qualitative action research design was employed guided by the future workshop model of action research. Participation in the study was voluntary involving sixty four stakeholders of the School of Orthopaedic Medicine. Forty two of these were year three students, two orthopaedic surgeons/lecturers, three administrators, two principal tutors, nine senior orthopaedic officers, one ward matron, two parents, and three information and communication technology specialists. Future workshops, document review, questionnaire, interviews, focus group discussions, observation, photography, pre-posttest evaluation were used as methods of data collection. Both descriptive and comparative approaches were used to analyze the data. In its preliminary phase, the study found out that there was lack of clinical clerkship curriculum, key essential curriculum materials for establishing a functional skills lab, clinical instructors, coordinators, technician and reliable evaluation and grading system for timely feedback. On evaluation of implemented interventions, it was found out that some skills lab resources such as a clerkship curriculum and 8 study guides were acquired 5/8(62.5%) of which were practiced). In post skills lab-based training evaluation, 24/42 (57.1 %) of the students got an outstanding overall average score of over 80 % during their four weeks-long practicum rotations while only I /42 (2.4%) of the same traditionally trained group got an outstanding score. The number of students rated incomplete in the traditionally trained group reduced from 13/42 (31 %) to 6/42 ( 14.3%). Of all the team players 11/ 12 (91.7%) believed that lack of funds was a key factor that stalled the action plan to be fully implemented. The key attributes for the success attained involved guiding students carry out the assigned procedural tasks and stakeholders' commitment to support training the students using the available resources at the practicum sites. It was concluded that utilisation of available skills lab resources considerably improved clerkship competence among students at the school of Orthopaedic Medicine- Mulago. Adopting the use of skills labs in the institute, establishment of a fully-fledged and well equipped skills lab, recruitment of skilled manpower to run the skills lab were among the recommendations made. Another Future Workshop should be held to facilitate the stakeholders to re-plan new strategies for solving the pending issues related to equipping the current skills lab and improving on the available resources.