Teaching the PHC Approach | Primary Health Care Directorate

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.

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.

The PHC Principles Portfolio module allows students to apply primary health care principals that have been learnt in preceding years to clinical practice. They are required to develop a portfolio of these cases for submission focused on doing the interview and observations of positionality; building patient-centred practice; stable eco-systems as a prerequisite for health; and applying Primary Health Care Principles. The module additionally promotes an understanding of the bio-psychosocial and cultural context of the patient; the patient care team approach; health promotion by means of information, education, communication, advocacy, mediation and enabling; inter-sectoral collaboration in healthcare; involving communities in asserting their rights and interests; and equity in healthcare & services for the poor and underserved.

The 6^th-year Primary Health Care Electives provide the student with an opportunity to enhance their competence in clinical skills, public health practice, and / or research and to deepen their understanding of health systems, the social context of disease and health, and the application of the Primary Health Care Approach in a variety of health care settings both locally and abroad - which is an equity-driven lead theme in the health sciences curricula. Students are able to do a clinical, research, public health or other elective in a country, province or health care setting of their choice and are responsible for planning, undertaking, reporting and finding an on-site clinical supervisor for their electives placement. Two electives are held annually including a long elective (4 weeks) which is graded on the basis of a report as well as a short elective (2 weeks clinical work only) which is assessed by means of a non-graded formatted report for DP purposes.

A 6^th-year Longitudinal Integrated Model of clinical learning has been established in the Eden District aimed at producing well-rounded, compassionate and skilled doctors who are committed to service. Students become versed in teamwork, communication, patient advocacy and empathy, and are encouraged to make rural career choices. They follow a panel of patients in each speciality throughout the year, with the emphasis on follow-up and tracking of patients and their illnesses over time. The model allows for continuity of students with their teachers and mentors, as well as continuity of students with a particular community. The academic programme for those students who are selected for the programme is equivalent to that in Cape Town and the same learning objectives, rotations, formal teaching and assessments are provided in a slightly different format.

Mapping the PHC Lead Theme

UNDERGRADUATE DEGREES
Name of Degree & Course	Degree	Course Code	Lecturers / Convenors
1^st Year (Semester 1 & 2)
Bachelor of Medicine and Bachelor of Surgery Becoming a Health Professional (BHP) 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 Dr Ishaaq Datay
2^nd 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	Dr Ishaaq Datay Prof Steve Reid
Bachelor of Medicine and Bachelor of Surgery Integrated Health Systems (IHS): Critical Health Humanities (CHH) Course Critical Health Humanities is a thread that draws on the emerging field of Medical and Health Humanities to facilitate dialogue between humanities and science disciplines and pedagogies. Semester 3 explores Power, Privilege, and Intersecting Identities that shape current socio-political contexts. Semester 4 explores Contextualizing Health and Illness and how intersecting identities influence health, health care provision, access to health care, and the complex impact of the SA context on health and illness.	MBChB	HUB2017H	Dr Carla Tsampiras Sarah Crawford-Browne
3^rd Year (Semester 5 & 6)
Bachelor of Medicine and Bachelor of Surgery Integrated Health Systems (IHS): Semester 5a and Semester 5 b/Neuroblock: Critical Health Humanities (CHH) Course Critical Health Humanities is a thread that draws on the emerging field of Medical and Health Humanities to facilitate dialogue between humanities and science disciplines and pedagogies. Semester 5a explores experiencing health & illness including subjective experiences, psychological & mental health factors, and intersecting social & cultural identities influencing health and illness. Semester 5b/Neuroblock explores understanding mental health and illness by examining the complex health practice choices in plural health systems and the impact of the SA context on health and illness.	MBChB	LAB3009F	Sarah Crawford-Browne Dr Carla Tsampiras
Bachelor of Science Physiotherapy Physiotherapy: Critical Health Humanities (CHH) Course: Intersecting Identities ‘Power, Privilege & Violence’ Race and sciences; histories of health in SA; gender and health; climate change; globalization and health; victim empowerment; structural & cycles of violence; embodiment of identities.	BSc (Phys)	AHS3070H	Dr Carla Tsampiras Sarah Crawford-Browne
Bachelor of Medicine and Bachelor of Surgery Introduction to Evidence Based Medicine Introduction to Evidence Based Practice.	MBChB	MDN3001H	James Irlam
4^th Year (Semester 7 & 8)
Bachelor of Medicine and Bachelor of Surgery MBChB 4^th 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; 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 practice; PHC approach; district health systems; Alma Ata Declaration; millennium development goals; environmental health and climate change; location and movement of people and effect on health; development of action plans and HP interventions; community diagnosis reflection; home visits.	MBChB	PPH4056W	Dr Ishaaq Datay (co-convenor) Prof Steve Reid James Irlam Dr Ben Gaunt Dr Karl le Roux
Bachelor of Medicine and Bachelor of Surgery MBChB 4^th Year Medicine: Evidence Based Medicine Critical appraisal of systematic reviews.	MBChB	MDN4011W	James Irlam
Bachelor of Medicine and Bachelor of Surgery MBChB 4^th Year Medicine: PHC Principles (at the Bedside) Teaching PHC at the patient’s bedside at Groote Schuur Hospital; integrating the PHC approach into clinical rotations in medicine; applying PHC principals that have been learnt in preceding years to clinical practice. Promoting understanding of the bio-psychosocial and cultural context of the patient; patient care team approach; health promotion by means of information, education, communication, advocacy, mediation and enabling; promoting inter-sectoral collaboration in healthcare; involving communities in asserting their rights and interests; promoting equity in healthcare, services for the poor and underserved.	MBChB	MDN4011W	Dr Carla Tsampiras (convenor) James Irlam Prof Steve Reid Sarah Crawford-Browne Dr Ishaaq Datay
5^th Year
Bachelor of Science Occupational Therapy Occupational Therapy in Primary Health Care Review PHC: basic concepts, policies and current debates.	BSc (OT)	AHS5044S	Prof Steve Reid
6^th Year
Bachelor of Medicine and Bachelor of Surgery Primary Health Care Elective - 6^th Year The MBChB curriculum makes provision for a 4-week plus 2-week elective based at any placement of choice. 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 assessed by an on-site clinical supervisor.	MBChB	PPH6005W (2 weeks) PPH6001W (4 weeks)	James Irlam (convenor) Dr Hermann Reuter
Bachelor of Medicine and Bachelor of Surgery MBChB 6^th Year Medicine: Evidence Based Medicine Emphasizes the clinical application of evidence from a valid and up-to-date study to a specific patient who is familiar to the student. It builds on the teaching of EBM in earlier years and will require students to understand and use EBM resources for searching the literature and critically appraising a study.	MBChB	MDN6000W	James Irlam
Bachelor of Medicine and Bachelor of Surgery MBChB 6^th Year Longitudinal Placements Eden District Community-based educational component and Longitudinal Integrated Model in the Eden District.	MBChB		Dr Hermann Reuter Dr Francois Marais
Bachelor of Medicine and Bachelor of Surgery MBChB 6^th Year: Family Medicine Family medicine.	MBChB		Dr Hermann Reuter Dr Francois Marais
Bachelor of Medicine and Bachelor of Surgery MBChB 6^th Year Internal Medicine: Ambulatory Care Ambulatory care.	MBChB	CHM6030S	Dr Francois Marais
Bachelor of Medicine and Bachelor of Surgery MBChB 6^th Year Internal Medicine: Acute Care Acute care skills training.	MBChB		Dr Francois Marais
Bachelor of Medicine and Bachelor of Surgery MBChB 6^th Year Paediatrics: PALS Training Course PALS training course.	MBChB		Dr Francois Marais
POSTGRADUATE DEGREES (HONOURS & MASTERS)
Medicine and the Arts Humanities: Social Anthropology & Health Sciences Interdisciplinary course examining the production of knowledge of and about the body from multiple perspectives; the ways in which the arts can constructively engage with medical pedagogy and practice; and engaging in key debates relating medicine, the arts and medical anthropology.	Humanities (Soc Anthro & Health Sciences)	AXL5412F	Prof Steve Reid (Co-Convenor) (Ass Prof Susan Levine)
POSTGRADUATE DEGREES (MASTERS)
Masters Public Health Evidence Based Health Care Evidence based health care.	MPH	PPH7022S	James Irlam
Masters Public Health Public Health & Society Introduction to primary health care.	MPH	PPH7016F	Prof Steve Reid Dr Ishaaq Datay
Masters Public Health Climate Change, Pollution and Health Climate change, pollution and health.	MPH	PPH7097S	James Irlam (Co-convenor)
Masters Family Medicine (Part 1) Community Oriented Primary Care (COPC), Health and Culture & Evidence Based Medicine Community oriented primary care; health and culture; Evidence based medicine.	MMed FamMed	PPH7072W &PPH4005S	Prof Steve Reid James Irlam (Co-convenor)
Masters Occupational Therapy Evidence Based Health Care & Health Promotion Evidence based health care; health promotion.	MSc (OT)	AHS5018F	James Irlam Dr Ishaaq Datay
Masters Occupational Therapy Primary Health Care Review of PHC: basic concepts, policies and current debates; politics of advocacy and strategic leadership.	MSc (OT)	AHS5044S	Prof Steve Reid Dr Ishaaq Datay
Masters Nutrition Management Community Nutrition 1: Primary Health Care Primary health care and the NHI.	MSc (Dietetics)	HUB4049H	Prof Steve Reid
Masters Development Paediatrics Health and Development Health Promotion.	MPhil (Dev Paeds)	PED7029W	Dr Ishaaq Datay
POSTGRADUATE DIPLOMAS
Diploma Family Medicine Evidence Based Health Care Evidence based health care.	FamMed	PPH4005S	James Irlam (Co-convenor)
Diploma Community Eye Health Health systems strengthening and eye care.	Community Eye Health	CHM4001F	Prof Steve Reid
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)
Diploma Disability Studies Critical Priorities in Disability and Development Neoliberalism, globalization and health; development theories - modernization and underdevelopment.	Disability Studies	AHS4117S	Dr Carla Tsampiras Sarah Crawford-Browne
MOOC (MASSIVE ONLINE OPEN LEARNING COURSE)
Medicine and the Arts: Humanizing Health Care Humanities: Social Anthropology & Health Sciences This course is offered to the general public, undergrad & postgrad students, medical doctors, health practitioners, and academics in Humanities, Social Sciences and Health Sciences. The educators aim to expand interest in the emerging field of medical humanities, particularly with content and perspectives from the developing world. The intention is to expose participants to the different perspectives of the various disciplines and build an appreciation for different disciplinary perspectives on topics within medical humanities.	Humanities (Soc Anthro & Health Sciences)		Prof Steve Reid (Co-Convenor) (Ass Prof Susan Levine)