It has been an exciting six weeks for Professor Neil Prose, Fulbright Scholar and Paediatric Dermatologist from Duke University in the United States, who was hosted by the Discipline of Rural Health at UKZN to assist with integrating teaching around communication. 

Passionate and committed to teaching empathic communication between healthcare providers and patients, Prose helped educators in the College of Health Sciences (CHS) to develop sustainable curricula and to explore communication skills literature to determine what findings and suggestions were applicable in different cultures and countries.

Prose says the process of building a relationship with the patient and their family is half the work of being a doctor but often a very small focus in medical education.

Prose received the annual Leonard P Tow Humanism in Medicine Award at the Duke University Medical Center in 2008.

After marrying a Durban woman in 2001 and visiting the province annually after that, Prose developed an interest in interacting with diverse groups and individuals. ‘I started to wonder if the work I had done teaching empathic communication skills to medical students and registrars in the USA might have an application at the Medical School at UKZN.’

Prose said communication between doctor and patient in South Africa’s multicultural society was particularly challenging but presented wonderful opportunities for teaching and learning. This made UKZN his institution of choice for the Fulbright Scholarship.

At UKZN, Prose tutored communication skills, also lecturing fifth-year medical students during their Family Medicine elective. He visited the Hillcrest AIDS Centre as a potential site for medical school selectives and travelled to Murchison Hospital in the Ugu District where he met with a group of medical students during their rural health elective.

Prose said he was fortunate to have presented at CHS’s African Languages Colloquium, and a public lecture in August titled, “Curiosity and Compassion: Health Care Communication in a Multicultural Society.”

Prose led a group of 13 medical students on a half-day cultural experience at the Muthi market, food market and a mosque at Warwick Triangle in Durban.

The students had the opportunity to visit parts of Durban they had never seen, and to confront their own beliefs and prejudices.

‘The following week, we met as a group to discuss our own stereotypes and prejudices, and how they had been affected by the experience.

‘I chose this activity in the hope that the students might develop increased “curiosity”, and respect for South Africans who come from racial, cultural and economic backgrounds different to their own.’

Prose said he identified two particular challenges facing medical educators in South Africa.

‘The first is to develop a curriculum and a set of teaching skills that meet the needs of students who come from a very broad range of cultural and educational backgrounds. The second is to train a generation of healthcare providers whose skill set and career aspirations allow them to meet the enormous health needs in South Africa.’

Prose said KwaZulu-Natal had a particular history of racial and ethnic conflict during the apartheid years. ‘It is understandable that this legacy continues to impact on the way in which medical students interact with each other and approach the patients they are required to serve. Differences in spoken language add an additional level of complexity.’

Dr Paula Diab from the discipline of Rural Health said they welcomed a kind gesture from Professor Richard Hift, Dean and Head: School of Clinical Medicine, who is willing to fund Prose’s return next year to build on the work already begun.

Prose inspired an institutional collaboration between academics from UKZN, Rhodes University and Wits University who will be working on the production of educational videos in isiZulu, Xhosa and Tswana for teaching medical communication to students.

In addition to book chapters and articles to be written by UKZN academics for the South African Medical Journal on the students’ visit to the Muthi Market, further collaboration has been fostered with the discipline of Rural Health. This will adapt the current rural attachment in final year to focus more on teaching empathy to students and result in curriculum transformation in addition to further collaborative articles that will be published.

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