A need for professional development in the training of registrars was identified by the School of Medicine, University of the Free State, in 2007. The module on Health Care Practice (GPV703) was developed to address these shortcomings.

    A    quantitative   stu dy, enhanced by qualitative data, was conducted. A self-administered questionnaire, that included a rating scale and open-ended questions, was used. The quantitative responses were analysed using Microsoft Excel, and the qualitative data were edited, categorised and summarised.

Knowledge of ethics, patient communication and practice management are essential to clinical medicine from the skills or needed by all, especially those in private practice (the majority of doctors in South Africa). The findings showed that the module on Health Care Practice, offered by the UFS, address these in the training of registrars.

The majority of registrars were happy with the presentations and content of the modules. Communication skills (lecture by the presenter needs attention). More information is needed to better understand the problems with this lecture. The presenter was not pitching the lecture correctly and or was not as professional as expected. E-learning challenges need to be addressed.

This is often a problem with developing world settings or requires careful consideration of its utility in poor circumstances. Ethics frequently discussed in interviews epitomising the clinical role thereof in clinical practice. Registrars have made a huge contribution to improve the quality of the module. Registrars contributed significantly to assist the School of Medicine in as far as presentation times, multiple presentations, quality of presenters and aspects related to module content.

Other aspects directly related to the training of registrars were also referred to Heads of Departments as identified. Registrar feedback also provided a platform to identify shortcomings in their training and was shared with HOD's in a feedback session. Improvements suggested by registrars would be fairly simple to address (Table 3). The HOD comments showed that they are very busy and that their inputs would not be sustainable.

The results showed that Heads of Department observed a general improvement in registrars' insight, comprehension and application related to Ethics, Patient Communication and Practice Management in the module. This was based on their previous observations (superficial) and evaluations of registrars. Of the 31 questionnaires completed by Heads of Department, 17 registrars were given an above-average, and 14, an average score on the selected, criteria.

No registrars received an under-average score. Heads of Departments indicated that they were under pressure as a result of staff shortages and service delivery needs and requested that they are not asked to participate in the completion of the questionnaire in future. Heads of Departments indicated that they observed progress and scored the registrars, but were reluctant to make comments or to motivate their answers.

The opinions of Heads of Department in the various disciplines on the registrars' on the insight into ethics, patient communication and practice management will be used to adapt the module and select appropriate presenters for future presentations.

 The  questionnaire was completed by 38 (95%) of 40 registrars.  The quantitative questions, regarding the orientation session, content and applicability of the content of the module, showed satisfactory to very good responses.

Of the 40 surveys collected from registrars, 31 (77, 5% response rate) were completed by Heads of Department. They showed a significant improvement in registrar competence; 17 were given an above average rating and 14 were given an average rating. No one received a below-average rating.

T he  module on Health Care Practice, part of the MMed programme, was found to add value and addressed aspects required by registrars to develop and/or enhance their skills, knowledge and professional behaviour with regard to Ethics, Practice Management and Patient Communication.

Registrars were generally satisfied with the content and presentation of the module. The open-ended questions raised concerns about aspects and patient communication and electronic learning. These, need to be addressed to improve the quality of the module.

Ethics, Practice Management and Patient Communication are essential skills needed by registrars and must be included in their training.

Visit to the AMEE conference was made possible with funds from the Dean's Office, Faculty of Health Sciences and the International Office, University of the Free State.

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