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PHC Approach

Teaching the PHC Approach

Integrating principles into the MBChB & Allied Health Sciences curriculum

The key principles of the PHC Approach are integrated into various courses that make up the MBChB as well as Allied Health Sciences curriculum within the Communication Sciences, Physiotherapy and Occupational Therapy modalities, as indicated in the table below.

Plenaries and lectures, tutorials and seminars, case studies, service learning, and community surveys are used as methods of teaching and learning. In addition textbooks, readings, lecture notes, exercises, worksheets and survey forms are used as learning resources. Students are assessed by means of examinations, assignments, portfolios, research projects, oral presentations, and reflective journals.

The key PHC principles of equity and patient rights also feature prominently in lectures, multimedia, and class exercises on the District Health System, on PHC and equity in health, and on advocating for the rights of patients.

PHC ward rounds in the 4th Year General Medicine rotation at Groote Schuur Hospital are facilitated by Dr Carla Tsampiras, Sarah Crawford-Browne and Prof Reid who join the consulting physician and leads students in a tutorial to explore their insights into the bio-psychosocial history and cultural context of selected patients on the round. An annual multi-disciplinary portfolio-based exam is used to assess student understanding of how the PHC principles apply to their clinical learning.

A four-week Primary Health Care Elective in the 5th year has allowed students to reflect on the validity and applicability of all PHC principles in a variety of clinical settings. The Faculty has incentivized rural electives by assisting students with their elective expenses to any rural site within South Africa. A new model for integrating the electives into the 6th Year of study is being formulated to extend service learning in rural hospitals. The revised MBChB curriculum makes provision for a 6-week elective period in sixth year from 2016, which students will need to organize, undertake and report on as part of their academic requirements. All elective students write reflective reports on their clinical activities and their observations and are assessed by an on-site clinical supervisor.

The 2nd year Special Study Module blocks provide opportunities for students to conduct small research projects, literature reviews or researched digital stories within the auspices of the Primary Health Care, Health Promotion and Culture, Psyche & Illness and Medical Humanities streams.

Postgraduate degree PHC teaching filters into the Masters in Medicine (research); Masters in Public Health (evidence-based health care, public health & society); MPhil in Maternal & Child Health (epidemiology, research ethics); MSc Occupational Therapy; MSc in Genetic Counselling; Masters in Family Medicine (health & culture, community oriented primary care); MPhil Social Justice, Law and Poverty; and the MEd ICTs in Education. Postgraduate diploma teaching includes the Diploma in Family Medicine; Diploma Clinical Educators Course; Diploma Community Eye Health (Vision 2020); Opthalmic Nursing; and Nephrology Nursing in Primary Care Settings.

A postgraduate certificate course in Community Eye Health for Vision 2020 aims to introduce health promotion as an important strategy for promoting eye  health. The module covers definitions of health promotion and milestones; Ottawa Charter strategies and actions; health promotion approaches; behaviour change theories; ethics; health rights; community participation; and empowerment of individuals and communities at all levels of care including models for planning health promotion programmes, tools for analyzing health problems, and advocacy for eye health promotion.

A 3-hour Postgraduate Diploma on Opthalmic & Nephrology Nursing seminar is held every year to promote the importance of health promotion among Opthalmic and Nephrology Nursing practitioners. The seminar covers definitions of health promotion; approaches and theories for helping clients to be aware of barriers to health promotion and strategies for enabling clients; and principles of health communication and strategies to address barriers thereof. Participants are also introduced to health rights and health promotion ethics.

Mapping the PHC Lead Theme

UNDERGRADUATE DEGREES
Name of Degree & Course Degree Course Code Lecturer
1st Year (Semester 1 & 2)      
Bachelor of Medicine and Bachelor of Surgery
Becoming a Health Professional
Overview of primary health care; key principles of the PHC approach; different levels of the PHC system; PHC and comprehensive care; the NHI health systems framework; transformative education & social accountability
MBChB PPH1002S Prof Steve Reid
2nd Year (Semester 3 & 4)      
Bachelor of Medicine and Bachelor of Surgery
Becoming a doctor Part IA
Orientation for becoming a doctor; intro to health promotion and approaches; principles of health communication and development of mass media; intro to behaviour change theories to address cultural beliefs and practices; health promotion ethics; health rights; principles of PHC
MBChB PPH2000W Johannah Keikelame
Prof Steve Reid
Bachelor of Science Speech and Audiology
Becoming a Communication Therapist: Disability in Primary Health Care
Integration of primary health care approach into Allied Health Science curriculum; intro to health promotion; behaviour change theories and approaches; planning a health promotion project
BSc (Sp&Aud) AHS2045F Johannah Keikelame
James Irlam
Sarah Crawford-Browne
Dr Carla Tsampiras
Prof Steve Reid
Bachelor of Science Occupational Therapy
Occupational Therapy 2: Disability in Primary Health Care
Integration of primary health care approach into Allied Health Science curriculum; intro to health promotion; behavior change theories and approaches; planning a health promotion project
BSc (OccTher) AHS2043W Prof Steve REid
Johannah Keikelame
James Irlam
Sarah Crawford-Browne
Bachelor of Science Physiotherapy
Applied Physiotherapy 1: Disability in Primary Health Care
Integration of primary health care approach into Allied Health Science curriculum; intro to health promotion; behavior change theories and approaches; planning a health promotion project
BSc (Phys) AHS2053H Prof Steve Reid
Johannah Keikelame
James Irlam
Sarah Crawford-Browne
Dr Carla Tsampiras
Bachelor of Medicine and Bachelor of Surgery
Integrated Health Systems Part 1A
RCT evidence for TB (case 7)
MBChB HUB2017H James Irlam
Bachelor of Medicine and Bachelor of Surgery
Integrated Health Systems
Alternative medicine perspectives; ethical issues; belief systems; bio-psychosocial and cultural issues; relevant PHC principles
MBChB HUB2017H Dr Carla Tsampiras
Sarah Crawford-Browne
Prof Steve Reid
Special Study Module (SSM)
Music and Medicine
This project explores the links and integration of music and medicine in the South African context. Where and how does music happen in a medical context? How do medical professionals who are also musicians integrate their lives in their careers? What are the underlying paradigms of these two disparate fields, and what are the issues and areas where they converge? Is there benefit in working across disciplinary boundaries in this way, and what could those benefits be?
MBChB PPH2002S Prof Steve Reid
Special Study Module (SSM)
Stories of Illness: Writing about health and medicine
Health care professionals use language to describe and document findings in ill and injured patients as objectively as possible according to strict protocols. This language is distancing and reductive, and leaves out most of the patient’s story – including context. Writers of poetry and literature use language to describe and document observations and findings as subjectively as possible so as to convey insights about the human condition. Students will explore these different uses of language and investigate the strengths and weaknesses of both approaches.
MBChB PPH2002S Prof Steve Reid
Dr Dawn Garisch
Special Study Module
Theatres of the Psyche
MBChB PPH2002S Prof Steve Reid
Marlize Swanepoel
Special Study Module
A qualitative pilot study exploring the attitudes and perceptions of medical students about Epilepsy in a health sciences faculty in Cape Town
MBChB PPH2002S Johannah Keikelame
3rd Year (Semester 5 & 6)      
Bachelor of Medicine and Bachelor of Surgery
Integrated Health Systems
Culture, psyche and illness: bio-psychosocial and cultural issues; relevant PHC principles
MBChB LAB3009F Dr Carla Tsampiras
Sarah Crawford-Browne
Bachelor of Medicine and Bachelor of Surgery
Integrated Health Systems Part 2
Causation and evidence for leukaemia (case 14)
MBChB LAB3009F James Irlam
4th Year (Semester 7 & 8)      
Bachelor of Medicine and Bachelor of Surgery
MBChB 4th Year Medicine
Teaching PHC at the patient's bedside at Groote Schuur Hospital; integrating the PHC approach into clinical rotations in medicine
MBChB MDN4011W Dr Carla Tsampiras
Prof Steve Reid
Bachelor of Medicine and Bachelor of Surgery
MBChB 4th Year Public Health/Family Medicine/ Primary Care Paediatrics
Intro to PHC approach; equity and health; evidence-based practice; rural health; climate change
MBChB PPH4013W Prof Steve Reid
James Irlam
Dr Ben Gaunt
Dr Karl le Roux
Bachelor of Medicine and Bachelor of Surgery
MBChB 4th Year 'Health in Context'
Health promotion ethics and health rights; community participation and partnerships; behaviour change theories and health promotion approaches; Ottawa Charter actions; planning cycle process and health communication for behaviour change; rural health; poverty and inequality; access to services; nutrition; maternal and child health challenges facing rural doctors; equity in health; health for all; principled health care; PHC lead theme; patient rights; role of doctors; advocacy; communities; right to health; putting PHC principles into practices; PHC approach; district health system; Alma Ata Declaration; millennium development goals
MBChB PPH4056W Johannah Keikelame
Prof Steve Reid
James Irlam
6th Year (to take effect from 2016)      
Bachelor of Medicine and Bachelor of Surgery
Primary Health Care Elective - 6th Year
The revised MBChB curriculum makes provision for a 6-week elective period in the 6th year from 2016, which students will need to organize, undertake and report on as part of their academic requirements. A grant to subsidise the extra costs of travel and board and lodging has been made available in the past to students for electives in rural hospitals. All elective students write reflective reports on their clinical activities and their observations of the application of the principles of the PHC Approach, which is an equity-driven lead theme in the health sciences curricula. They are also assessed by an on-site clinical supervisor.
MBChB PPH6000H James Irlam
POSTGRADUATE DEGREES (MASTERS)
Masters Public Health
Public Health & Society
MPH PPH70016F Prof Steve Reid
Masters Family Medicine
Community Oriented Primary Care (COPC) & Health and Culture
MMed FamMed PPH6003S Prof Steve Reid
Masters Public Health
Evidence-Based Health Care
MPH PPH7O22S James Irlam
Masters Occupational Therapy
Evidence-Based Health Care & Health Promotion
MSc (OT) AHS5018F James Irlam
Johannah Keikelame
POSTGRADUATE DIPLOMAS
Diploma Family Medicine MG015   James Irlam
Diploma Clinical Educators Course     Johannah Keikelame
Prof Steve Reid
Sarah Crawford-Browne
Dr Carla Tsampiras
Diploma Community Eye Health (Vision 2020) MG019 CHM4001F Johannah Keikelame
Dr Carla Tsampiras
Opthalmic Nursing Opthalmic Nursing AHS 4052H Johannah Keikelame
Nephrology Nursing in Primary Care Settings Nephrology Nursing AHS 4094F Johannah Keikelame
Diploma Health Professions Education
Teaching and Learning Theory in Health Prof Ed
Learning and Teaching Practice
Assessment in Health Profession Education
Curriculum Development & Course Design
Integrated Assessment
Health Prof Ed PPH4044F
PPH4045F
PPH4046F
PPH4047S
PPH4055S
Prof Steve Reid
(convenor)