Faculty of Health Sciences
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Item The clinical experience of registered master's chiropractic students in the management of elderly patients during their practicum(2021-05-27) Naidoo, Kimone; Varatharajullu, Desiree; Sibiya, M.N.Background The elderly population is increasing rapidly worldwide. As elderly individuals age, their physiological process changes, which means that elderly patients present differently, as a result of associated comorbidities and challenges in their physical and cognitive function, and thus the management of an elderly patient could present as a challenge. Registered master’s degree chiropractic students complete a theoretical elderly module during the fifth year of their studies, while entering their clinical practicum. The registered master’s degree chiropractic students need to acquire and refine their clinical skills, as well as apply their theoretical knowledge during their clinical practicum. The healthcare system in South Africa has limited knowledge on the management of elderly patients. Therefore, the aim of this study has been to determine the clinical experiences of registered master’s degree chiropractic students during their clinical practicum with respect to the management of elderly patients. Aim of the study The aim of the research study was to explore and discuss the experiences of registered chiropractic master degree students in the management of elderly patients presenting at the Chiropractic Day Clinic at the Durban University of Technology. Method A qualitative, exploratory, descriptive study was conducted, using an interpretivist paradigm. The master’s degree chiropractic students, who had been clinically active for four months during their clinical practicum, were interviewed to establish their experiences in the management of elderly patients during their clinical practicum. The interviews were semi-structured and conducted in English, and later transcribed verbatim into a Microsoft® Word document. The transcripts were then analysed using Tesch’s eight steps of thematic analysis to establish the themes, categories and codes. Results Of the twenty-four registered master degree chiropractic students, twelve (50%) participated in the study. There were five overarching themes that emerged from the data: attitudes and opinions towards the management of an elderly patient; important aspects of the management towards an elderly patient; positive aspects of managing an elderly patient; challenges faced during the management of an elderly patient and suggestions to improve a chiropractic clinical practicum. The participants discussed the importance of having practical experience in managing an elderly patient and the significance of elderly patients being interactive with their own management protocols. The participants elaborated that they did have a sufficient basis to manage elderly patients. Many participants mentioned that they needed to be more involved in the management of elderly patients. Most of the participants felt that managing elderly patients was beneficial and they suggested that learning about elderly patients earlier in their studies would be beneficial to their clinical experience of managing elderly patients. Conclusion This is the first South African study that has been conducted on registered master’s degree chiropractic students’ clinical experiences in managing elderly patients during their clinical practical. This study will add to the existing body of literature and enable other registered master’s degree chiropractic students and new graduate chiropractors to have a better understanding of the management of elderly patients.Item Clinical experiences of first-time registered Master's chiropractic students during their clinical practicum(2017) Ganesh, Nivida; Varatharajullu, Desiree; Sibiya, Maureen NokuthulaBackground The imperative of clinical education in chiropractic is to endow students with the clinical competencies and professional attributes necessary for independent practice. The clinical practicum exposes chiropractic students to the realities, demands and expectations of patient care through immersion into the clinical learning environment. Various authors emphasise the importance of obtaining a student’s perspective of their experiences within this environment as it is essential to curriculum development and improvement, delivery of quality clinical education, and student satisfaction with their standard of education. Interestingly, unlike in other health professions’ disciplines, the clinical experiences of chiropractic students who have commenced their clinical practicum have scarcely been described in international literature. This study is the first of its kind to record the clinical experiences of chiropractic students during their clinical practicum in South Africa. Aim The aim of this study was to explore and describe the clinical experiences of first-time registered Master’s chiropractic students during their clinical practicum component at the Durban University of Technology Chiropractic Day Clinic in 2016. Method A qualitative, exploratory, descriptive approach was utilised. A purposive sample of 15 first-time registered Master’s chiropractic students was interviewed. Their clinical experiences during the clinical practicum were obtained through semi-structured interviews. Seven key questions, each relating to a specific aspect of the clinical practicum, were used to stimulate discussion. The data were recorded electronically and thereafter transcribed. Thematic analysis was used to interpret the data. Results Four main themes were identified, viz. undergraduate education and pre-clinical preparation; experiences within the clinical learning environment; inter-personal relationships in a clinical learning environment, and appraisal of the clinical practicum. Participants reported that the undergraduate and pre-clinical preparatory phase needed to be more practically orientated in order to provide relevance and cohesion to clinical learning. Significant experiences in the clinical learning environment included personal and professional growth and development, perceptions of preparedness for independent practice, perceptions of patient responses to chiropractic care, administrative duties and clinic infrastructure. The interpersonal relationships that contributed to the overall clinical experience were between students and their clinical supervisors, and students and the administrative staff. The appraisal of the clinical practicum included highlights and positive aspects that shaped the attitudes, values and philosophies of students, as well as the challenges and obstacles they encountered within the clinical learning environment. Conclusion This is the first South African study to document the clinical experiences of first-time registered Master’s chiropractic students. These clinical experiences were based on a variety of organisational and curriculum-orientated factors, as well as interpersonal dynamics. While students acknowledged and appreciated the critical importance of clinical education, and valued the learning opportunities within the clinical setting, they also provided constructive feedback on matters needing improvement to enhance the overall clinical experience. The lack of exposure to patient care prior to the commencement of the clinical practicum negatively impacted the clinical experiences. It is recommended that the findings of this study be utilised by the key stakeholders within chiropractic education to enhance chiropractic clinical education in South Africa.