Breaking barriers in rural healthcare: new ‘Onboarding Pack’ empowers doctors and improves patient care.

Rural doctors are excited about a new “onboarding pack” developed by Dr Madeleine Muller and the Rural Doctors Association of Southern Africa (RuDASA), providing a much-needed positive boost to the struggling healthcare sector. As detailed in this article by health journalist Chris Bateman, this program, with tailored webinars and resource packs, is addressing the dire lack of support and hands-on clinical supervision in underserved areas. Having grown significantly over the past three years, the program is set to expand to include nurses, rehabilitation professionals, and pharmacists. The overwhelmingly positive feedback and improved clinical care reported by participants highlight its impact. By expanding its reach and addressing the challenges faced by rural clinicians, this initiative offers hope and improvement for healthcare in South Africa. This article is republished courtesy of Axess Health and Medbrief Africa. – Nadya Swart

Rural doctors rave about new ‘onboarding pack.’

Nearly three hundred interns, clinical associates, community service doctors and medical officers in rural hospitals country-wide have responded enthusiastically to a “rural onboarding” cyber pack supporting their practical learning.

The project is the brainchild of Dr Madeleine Muller and the Rural Doctors Association of Southern Africa (RuDASA). Dr Muller, a Family Physician at Cecilia Makiwane Hospital in Mdantsane and Senior Lecturer at Walter Sisulu University, created an eight-week onboarding/orientation program for all new rural clinicians. Each week is dedicated to different disciplines and offers specially tailored webinars hosted by experts while referring participants to appropriate U-tube channels to support diverse topics.

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The participants are e-mailed high-quality resource packs covering disciplines ranging from anaesthetics, surgery and orthopaedics to child health and emergency medicine, with all resources available on the RuDASA Learning portal. A recent feedback survey from participants shows that it’s catching on like wildfire, especially in far-flung hospitals where power outages and Wi-Fi dysfunction often aggravate a dire lack of hands-on clinical supervision.

Muller, a stalwart of RuDASA who oversees the mentoring portfolio, is coordinating this year’s Rural Health Conference in Chintsa, East London, from 14-16 September 2023, where the theme will be “Celebrating Rural Service,” – a sorely-needed bid to lend moral support to juniors, particularly interns and community service officers. 

The survey affirms value.

An evaluation survey with feedback from forty-three doctors and five clinical associates among the three hundred resource pack users so far shows 92% of them believe the webinars improved their clinical knowledge and their patient management. Some 87% said the webinars were of high quality (slides and facilitation), while 75% said the resource packs were well-structured and easy to use. Nearly 69% said it had improved their clinical care, while just over 83% said the rural onboarding content was “comprehensive”.

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Among the quotes from the rural doctors were, “It’s incredibly informative and very practical. I really enjoyed how user-friendly the resources were and how up-to-date they were. The webinars and resources were also very practical and allowed us to implement the knowledge gained clinically,” and “wonderful resources and up-to-date. Also assists in registrar training in family medicine. Thank you.”

Muller says the program’s reach has grown dramatically over the past three years, with scope remaining to improve reach in different provinces. They want to expand it to nurses, rehabilitation professionals and pharmacists.

A graph of resource pack engagement shows infectious diseases and child health to be the most sought-after topics, followed by adult medicine (NCDs), maternal health and emergency medicine. 

Webinars on diagnosing TB are proving the most popular, followed by fluid management in children, early pregnancy sepsis and cardiac arrhythmias. The survey also shows the Eastern Cape had the most doctors enrolled (173), followed by Gauteng (26), the Western Cape (21) and KwaZulu Natal (20). The Northern Cape had the least participation, with five doctors. 

“This may reflect the reach of the marketing, with myself and many of the facilitators hailing from the Eastern Cape. There is no doubt that more clinicians would join if given the opportunity,” says Muller. 

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The vast majority of participants this year were medical officers (157), followed by community service doctors and clinical associates (76), with twenty-one clinical associates, eighteen interns and fourteen seniors (registrars, consultants, and academics). Just two nurses took part, one pharmacist and one rehabilitation worker.

Adds Muller, “The rural onboarding program is running annually during February and March, but doctors joining facilities later in the year need not be concerned. The RuDASA Learning Portal contains all the resource links, and the webinars are available on the RuDASA YouTube channel. RuDASA membership is free and gives access to a large network of inspired rural doctors. Join at www.rudasa.org.za.

Dr Muller and the Rural Health Conference committee invited rural clinicians from across the country to join them for the RHC conference in September for an opportunity to learn some useful skills, meet other rural colleagues and get inspired by rural health. Abstract submission closes on 12 June.

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