Ian Guyton Munabi

2 Publications in AERD

Author Publications

Experiences of medical students and faculty regarding the use of long case as a formative assessment method at a tertiary care teaching hospital in a low resource setting: a qualitative study

By Jacob Kumakech

Introduction: The long case is used to assess medical students’ proficiency in performing clinical tasks. As a formative assessment, the purpose is to offer feedback on performance, aiming to enhance and expedite clinical learning. The long case stands out as one of the primary formative assessment methods for clinical clerkship in low-resource settings but has received little attention in the literature. Objective: To explore the experiences of medical students and faculty regarding the use of the Long Case Study as a formative assessment method at a tertiary care teaching hospital in a low-resource setting. Methodology: A qualitative study design was used. The study was conducted at Makerere University, a low-resource setting. The study participants were third- and fifth-year medical students as well as lecturers. Purposive sampling was utilized to recruit participants. Data collection comprised six Focus Group Discussions with students and five Key Informant Interviews with lecturers. The qualitative data were analyzed by inductive thematic analysis. Results: Three themes emerged from the study: ward placement, case presentation, and case assessment and feedback. The findings revealed that students conduct their long cases at patients’ bedside within specific wards/units assigned for the entire clerkship. Effective supervision, feedback, and marks were highlighted as crucial practices that positively impact the learning process. However, challenges such as insufficient orientation to the long case, the super-specialization of the hospital wards, pressure to hunt for marks, and inadequate feedback practices were identified. Conclusion: The long case offers students exposure to real patients in a clinical setting. However, in tertiary care teaching hospitals, it’s crucial to ensure proper design and implementation of this practice to enable students’ exposure to a variety of cases. Adequate and effective supervision and feedback create valuable opportunities for each learner to present cases and receive corrections. © The Author(s) 2024.

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Implementation of Social Accountability in Undergraduate Medical Training at a SubSaharan African Medical School: Stakeholders' Perspectives

By Lorraine Oriokot

Background: Social accountability for medical schools is the obligation of the medical school to direct its core activities toward meeting the priority needs of the community. The core activities of medical schools are education, research, and service. Social accountability is a global concept that requires local contextualisation. Stakeholder partnerships are central to the implementation of social accountability, and stakeholders need to work together in planning, implementing, and evaluating social accountability in undergraduate medical education. We aimed to explore stakeholders' perspectives on the implementation of social accountability in undergraduate medical training at Makerere University School of Medicine. Methods: This was an exploratory qualitative study. Data was collected between September 2022 and December 2022. Ethical clearance was obtained from the Makerere University School of Medicine Research Ethics Committee. Fourteen stakeholders in undergraduate medical training at Makerere University School of Medicine were interviewed, including three policymakers, one health administrator, three health professionals, three community representatives, two medical students, and two representatives from the medical school. Transcripts were analysed to generate themes using the six-phase approach to thematic analysis described by Braun and Clarke. Results: Diverse expressions of the implementation of social accountability were present in all three core activities of the medical school. The curriculum and community-based education research and service were key expressions of social accountability in education activities. Research to understand community needs was described within community-based education research and service. The opportunities to improve the implementation of social accountability include involving civil society partners and improving equity in undergraduate medical training. Conclusion: Our study found evidence of the implementation of social accountability in undergraduate medical education. The opportunities to improve the implementation of social accountability in undergraduate medical education include: involving civil society partners in training medical students about the community; working with the community living in the nearby slum; and providing financial support for students.

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