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Year : 2014  |  Volume : 27  |  Issue : 2  |  Page : 170-176

Kenyan medical student and consultant experiences in a pilot decentralized training program at the University of Nairobi

1 Department of Global Health, University of Washington, Seattle, Washington, USA
2 Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
3 Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya
4 Department of Global Health; Department of Epidemiology; Department of Medicine, University of Washington, Seattle, Washington, USA

Correspondence Address:
Dr. Minnie W Kibore
Department of Global Health, University of Washington, Seattle, Washington
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Source of Support: This work is supported by the United States Government [Office of the US Global AIDS Coordinator (OGAC), National Institutes of Health (NIH) funded Medical Education Partnership Initiative through grant number 1R24TW008889,, Conflict of Interest: None

DOI: 10.4103/1357-6283.143778

Background: Over the past decade, the University of Nairobi (UoN) has increased the number of enrolled medical students threefold in response to the growing need for more doctors. This has resulted in a congested clinical training environment and limited opportunities for students to practice clinical skills at the tertiary teaching facility. To enhance the clinical experience, the UoN Medical Education Partnership Initiative Program Undertook training of medical students in non-tertiary hospitals around the country under the mentorship of consultant preceptors at these hospitals. This study focused on the evaluation of the pilot decentralized training rotation. Methods: The decentralized training program was piloted in October 2011 with 29 fourth-year medical students at four public hospitals for a 7-week rotation. We evaluated student and consultant experiences using a series of focus group discussions. A three-person team developed the codes for the focus groups and then individually and anonymously coded the transcripts. The team's findings were triangulated to confirm major themes. Results: Before the rotation, the students expressed the motivation to gain more clinical experience as they felt they lacked adequate opportunity to exercise clinical skills at the tertiary referral hospital. By the end of the rotation, the students felt they had been actively involved in patient care, had gained clinical skills and had learned to navigate socio-cultural challenges in patient care. They further expressed their wish to return to those hospitals for future practice. The consultants expressed their motivation to teach and mentor students and acknowledged that the academic interaction had positively impacted on patient care. Discussion: The decentralized training enhanced students' learning by providing opportunities for clinical and community experiences and has demonstrated how practicing medical consultants can be engaged as preceptors in students learning. This training may also increase students' ability and willingness to work in rural and underserved areas.

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