DEVELOPING LEADERSHIP AND HEALTH ADVOCACY SKILLS IN FINAL YEAR PHYSIOTHERAPY STUDENTS USING COMMUNITY ASSESSMENT PROJECTS

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Statham S1, Enright M1
1Stellenbosch University, Physiotherapy, Cape Town, South Africa

Background: The South African health care context includes a quadruple burden of disease and severe resource constraints. As healthcare workers grapple with providing a service that includes health care equity and social justice training students with the appropriate skills is essential. Physiotherapy students are expected to be responsive within these constraints as the consequences of these diseases result in high levels of disability and social isolation for health care consumers. The national disability prevalence rate is 7.5% many of whom are economically active living in low socio-economic communities. A six-week clinical block in the low socio-economic settings, a requirement during their undergraduate studies, developed competencies in both leadership and health advocacy.

Purpose: To develop the students' competencies in these areas it was decided to expand their clinical training to include community assessment skills. Using the Can Meds framework as a guideline, Stellenbosch University established Graduate Attributes for health care student training. An analysis of the curriculum identified the need to increase the students' competencies in leadership and advocacy.

Methods: A project structured around implementing a community assessment project was developed. Four rural communities and one peri-urban low socio economic community were used. The projects examined the contextual facilitators and barriers experienced by a specific target population. The students interacted with the communities through interviews with service providers and target populations. They completed an environmental assessment using community mapping and observations. Upon completion students presented a report advocating for appropriate interventions and systems changes. The students used reflective techniques facilitated by the DEAL model to consolidate their learning. The final written reports were submitted to the Department of Health and stakeholders for each setting.
A qualitative approach was used to evaluate the project. Semi-structured focus groups were conducted with volunteers from the students, members of the Department of Health, stakeholders and academic staff. Analysis of the focus groups was conducted inductively allowing for the emergence of unexpected themes. Retrospective analysis of anonymous students' reflections, to establish the alignment with the graduate attributes competencies, was done deductively.

Results: Improvement within the graduate attribute competencies were found. Students changed their approach from being impairments driven to focussing more on participation roles. This was achieved through addressing contextual barriers to improve social inclusion and quality of life. Growing self-confidence in the students' ability to view the community as a whole was expressed through their reports and reflections. Recommendations for improvements included increased time.

Conclusion(s): This unique project offered the students an opportunity to develop the competencies required to advocate at community level for groups of people with disabilities. The students' perceptions of the project was positive and encouraging. These new skills will enhance the wellbeing and inclusion of all in the communities they serve.

Implications: The successful development of these skills will help young professionals to be both competent and responsive to needs of marginalised groups. This will improve outcomes for the people and communities affected by these constraints within a developing country.

Keywords: health advocacy, community assessment, student training

Funding acknowledgements: None

Topic: Education; Education: methods of teaching & learning; Disability & rehabilitation

Ethics approval required: No
Institution: Stellenbosch University
Ethics committee: Committee C
Reason not required: Evaluation of an educational project


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