Practice Based Learning among Orthopaedic Medicine Students in Emergency Ward at Mulago National Referral Hospital

Abstract

Background: This study set out to establish the current practice and factors affecting practice-based learning among orthopedic medicine students attending emergency ward at Mulago National Referral Hospital. Methods: This was a mixed methods study. The quantitative arm was a descriptive cross-sectional study in which data were collected from orthopedic medicine students during their rotation on the emergency ward at Mulago hospital. Standardized observation checklist and the self-administered questionnaire were used to collect data. For the qualitative aspect, in-depth interviews were conducted on students and their supervisors. Qualitative data were analyzed by inductive methods using thematic analysis approach. Results: A total of 101 students and six supervisors were recruited for the study. From the observed learning practices, the overall state of practice-based learning was unsatisfactory 71.4% (five groups). The worst performed category being lack of supportive environment 100% (seven groups) implying that all the seven groups had an unsatisfactory supervisory environment (100%) while self-responsibility was the best performed category 85.7% (six groups) implying that six out of seven groups had satisfactory self-responsibility resulting into (85.7%). As for factors affecting learning, most students 86 (85.1%) reported that they enjoyed learning while 74 (73.3%) thought there was supportive learning environment with adequate opportunity for involvement in patient care and supervision. However, there was unanimous agreement that the training materials were insufficient and over 87 (86.1%) experienced stress and anxiety during the rotation. The issues from the in-depth interview that affected the quality of learning were having too many students on the wards during the rotation, frequent stock-outs of supplies for learning and supervisors being overwhelmed caring for the large number of patients. Conclusion: The overall state of practice-based learning was unsatisfactory. The major issues hindering satisfactory practice-based learning were overcrowding on the wards and insufficient training materials. In order to improve practice-based learning in Mulago Hospital adequate learning materials are required and the number of students enrolled need to be appropriate for the student – supervisors’ ratio as recommended by the ministry of education.