Building Clinical Clerkships Capacity in a Resource-limited Setting: The Case of the Kilimanjaro Christian Medical University College in Tanzania

Ann Glob Health. 2018 Apr 30;84(1):129-138. doi: 10.29024/aogh.15.

Abstract

Background: The shortage of medical doctors in sub-Saharan Africa (SSA) has resulted in increased enrolment in medical schools, which has not been matched with increased faculty size or physical infrastructure. This process has led to overcrowding and possibly reduced quality of training. To reduce overcrowding at its teaching hospital, the Kilimanjaro Christian Medical University College introduced eight-week peripheral clerkship rotations in 2012. We explore students' perceptions and attitudes towards peripheral hospital placements.

Method: The clerkship rotations were conducted in eight hospitals operating in the northern Tanzania, after evaluating each hospitals' capabilities and establishing the optimum number of students per hospital. Paper-based surveys were conducted after student rotations from 2014 to 2016.

Results: Overall student satisfaction was moderate (strength of consensus measure (sCns), 77%). The three cohorts exhibited improving trends over three years with respect to satisfaction with clinical skills and attitude towards placements. student-preceptor interaction was rated highly (sCns 81-84%). The first cohort students expressed concerns about limited laboratory support, and poor access to Internet and learning resources. Specific interventions were undertaken to address these concerns.

Conclusions: Student experiences in peripheral rotations were positive with adequate satisfaction levels. Opportunities exist for medical schools in SSA to enhance clinical training and relieve overcrowding through peripheral clerkship rotations.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Attitude
  • Clinical Clerkship*
  • Clinical Competence
  • Education, Medical, Undergraduate* / methods
  • Education, Medical, Undergraduate* / organization & administration
  • Female
  • Hospitals, Teaching* / organization & administration
  • Hospitals, Teaching* / standards
  • Humans
  • Male
  • Medically Underserved Area
  • Program Evaluation
  • Quality Improvement
  • Schools, Medical / organization & administration
  • Schools, Medical / standards
  • Socioeconomic Factors
  • Students, Medical / psychology
  • Students, Medical / statistics & numerical data
  • Surveys and Questionnaires
  • Tanzania
  • Teaching / organization & administration

Grants and funding

University College for participating in this survey. We also thank the preceptors/mentors and staff at the peripheral hospitals together with supervisors from Kilimanjaro Christian Medical Centre and Kilimanjaro Christian Medical University College for facilitating the peripheral hospital placement program. Lastly, the KCMC-Duke Medical Education Partnership Initiative (MEPI) administered by Health resource and Service Administration (HRSA), Grant number T84HA21123 for the support.