South African–Cuban Medical Collaboration: students’ perceptions of training and perceived competence in clinical skills at a South African institution

Abstract

Background: The South African–Cuban Medical Collaboration programme aims to alleviate the critical shortage of practitioners in local South African rural settings. The students who return from Cuban-based facilities in their fourth year experience difficulty, especially in clinical settings, upon joining the MB ChB final-year student programme at the University of KwaZulu-Natal. Attempts to support their skills acquisition for local practice have led to an investigation of their prior clinical skills exposures, the curricular context and exposures in Cuba in which skills had been acquired, and students’ perceptions of their competence in clinical skills.

Methods: This descriptive, cross-sectional study explored the clinical experiences of the 2013 cohort of students. Qualitative and quantitative data were collected through questionnaires that explored the curricular approach and setting of clinical skills training in Cuba, the students’ exposure to clinical skills and their perceptions of their competence at performing these skills.

Results: Students experienced the Cuban curriculum as didactic and lecture intensive as opposed to the systematic, problem-based curriculum offered in South Africa. Clinical training in Cuba occurs in hospital wards while local students first train in a clinical skills laboratory prior to hospital exposures. The majority of students self-reported a lack of clinical exposure to 35 of an overall 75 core-skills list as identified by the undergraduate UKZN curriculum. In addition, they reported an inability to perform 71 of the 75 (95%) skills independently.

Conclusion: This study has highlighted a mismatch between the focus and scope of clinical training offered to students studying in Cuba and those at a South African institution.