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Re-imagining doctor-patient relationships in an African context: a transformative educational perspective
Clinician-patient relationships are central to health care, health systems and medical education. Current educational practice of doctor-patient relationships emerged from an episteme rooted in a biomedical understanding of disease, having epistemic and pedagogical roots in Global North contexts. Th...
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| Format: | Thesis |
| Language: | English |
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Department of Health Sciences Education
2023
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| _version_ | 1867613176904810496 |
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| access_status_str | Open Access |
| author | Ras, Tasleem |
| author2 | Reid, Stephen |
| author_browse | Ras, Tasleem Reid, Stephen |
| author_facet | Reid, Stephen Ras, Tasleem |
| author_sort | Ras, Tasleem |
| collection | Thesis |
| description | Clinician-patient relationships are central to health care, health systems and medical education. Current educational practice of doctor-patient relationships emerged from an episteme rooted in a biomedical understanding of disease, having epistemic and pedagogical roots in Global North contexts. The thesis offers an analysis of clinician-patient relationships that includes medical ethics, communication skills, and the development of the widely accepted (in Family Medicine) Biopsychosocial model of the clinical consultation. Using a South African clinical postgraduate Family Medicine training programme as a case study, this project answered two central research questions: (i) How do students learn to navigate relationships with patients in this training programme? And (ii) Can we develop an educational model of doctor patient relationships based on local experiences? Mezirow's transformative learning theory, Mbiti's conceptualisation of Ubuntu as an African philosophy, and Foucault's thoughts on structural power provided a conceptual framework. Aim The project aimed to understand the process of student learning about the doctor-patient encounter and to develop a model for teaching about the doctor-patient relationship. Methodology A qualitative longitudinal case study was conducted, drawing data from postgraduate students, educators, and patients. Data was collected from educational, clinical, and reflective activities, and analysed thematically using an inductive approach. Findings The key themes describe students' learning in relation to critical self-awareness, contextual awareness, the dialogic nature of learning, and the impact of transformed perspectives. Patients valued that their patient-hood and personhood were validated, and educators highlighted the theme that vulnerability has pedagogical implications. A new perspective of power dynamics in the clinical encounter is described and an Ubuntu-inspired episteme and pedagogy is synthesised from the findings. Conclusion This decolonial project provides evidence and proposes a model for incorporating an indigenous philosophy (Ubuntu) into mainstream health sciences education. Recommendations are made for educational and clinical practice, as well as future research. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/38536 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:31:58.458Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Department of Health Sciences Education |
| publisherStr | Department of Health Sciences Education |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/38536 Re-imagining doctor-patient relationships in an African context: a transformative educational perspective Ras, Tasleem Reid, Stephen Clinician-patient relationships Clinician-patient relationships are central to health care, health systems and medical education. Current educational practice of doctor-patient relationships emerged from an episteme rooted in a biomedical understanding of disease, having epistemic and pedagogical roots in Global North contexts. The thesis offers an analysis of clinician-patient relationships that includes medical ethics, communication skills, and the development of the widely accepted (in Family Medicine) Biopsychosocial model of the clinical consultation. Using a South African clinical postgraduate Family Medicine training programme as a case study, this project answered two central research questions: (i) How do students learn to navigate relationships with patients in this training programme? And (ii) Can we develop an educational model of doctor patient relationships based on local experiences? Mezirow's transformative learning theory, Mbiti's conceptualisation of Ubuntu as an African philosophy, and Foucault's thoughts on structural power provided a conceptual framework. Aim The project aimed to understand the process of student learning about the doctor-patient encounter and to develop a model for teaching about the doctor-patient relationship. Methodology A qualitative longitudinal case study was conducted, drawing data from postgraduate students, educators, and patients. Data was collected from educational, clinical, and reflective activities, and analysed thematically using an inductive approach. Findings The key themes describe students' learning in relation to critical self-awareness, contextual awareness, the dialogic nature of learning, and the impact of transformed perspectives. Patients valued that their patient-hood and personhood were validated, and educators highlighted the theme that vulnerability has pedagogical implications. A new perspective of power dynamics in the clinical encounter is described and an Ubuntu-inspired episteme and pedagogy is synthesised from the findings. Conclusion This decolonial project provides evidence and proposes a model for incorporating an indigenous philosophy (Ubuntu) into mainstream health sciences education. Recommendations are made for educational and clinical practice, as well as future research. 2023-09-12T07:57:08Z 2023-09-12T07:57:08Z 2023 2023-09-12T07:39:45Z Doctoral Thesis Doctoral PhD http://hdl.handle.net/11427/38536 eng application/pdf Department of Health Sciences Education Faculty of Health Sciences |
| spellingShingle | Clinician-patient relationships Ras, Tasleem Re-imagining doctor-patient relationships in an African context: a transformative educational perspective |
| thesis_degree_str | Doctoral |
| title | Re-imagining doctor-patient relationships in an African context: a transformative educational perspective |
| title_full | Re-imagining doctor-patient relationships in an African context: a transformative educational perspective |
| title_fullStr | Re-imagining doctor-patient relationships in an African context: a transformative educational perspective |
| title_full_unstemmed | Re-imagining doctor-patient relationships in an African context: a transformative educational perspective |
| title_short | Re-imagining doctor-patient relationships in an African context: a transformative educational perspective |
| title_sort | re imagining doctor patient relationships in an african context a transformative educational perspective |
| topic | Clinician-patient relationships |
| url | http://hdl.handle.net/11427/38536 |
| work_keys_str_mv | AT rastasleem reimaginingdoctorpatientrelationshipsinanafricancontextatransformativeeducationalperspective |