Maria Elizabeth Cochrane

Background. Virtual reality (VR) offers a novel solution to overcoming traditional barriers in procedural skills training among medical students. Correct ECG lead placement is a critical yet undertrained skill owing to resource limitations. The design process underpinning VR-based training platforms, especially in low- and middle-income countries, is not yet fully described in the literature. Objectives. To describe and reflect on the process of developing a VR-based training platform aimed at improving ECG lead placement skills among medical students. Methods. A design-based thinking approach was employed, involving needs analysis, ideation, development, implementation and reflection. Critical reflection was performed at each step to guide the development of VR-based training platforms for health science education. Results. Critical elements of VR design were identified, including enhancing student engagement, providing monitoring and feedback, managing side- effects and deployment considerations of VR systems. Conclusion. The VR-based training platform shows promise in addressing resource constraints, enhancing procedural skill acquisition and offering broader implications for medical education in low-resource settings. However, careful consideration of VR platform design is critical to ensure the successful application of such a system.

Background: Health professions education is undergoing a paradigm shift from a predominantly curative focus towards prevention and health promotion, in line with global health priorities such as Sustainable Development Goal 3 (SDG3). Physiotherapy curricula, however, often still devote limited attention to preventative competencies. Objectives: The objectives of this study are to identify risk factors for shoulder pain in amateur fast bowlers and illustrate how such evidence can inform the integration of preventative competencies into undergraduate physiotherapy curricula. Method: A prospective, longitudinal cohort study was conducted during the 2018–2019 amateur cricket season. Thirty-nine male fast bowlers completed baseline musculoskeletal screening and weekly online questionnaires documenting injury incidence. Physical assessments included shoulder range of motion, scapular control, muscle strength, endurance and stability tests. Data were analysed using t-tests, Mann–Whitney U tests, chi-square and/or Fisher’s exact tests. Results: Nine participants (23%) sustained shoulder pain during the season. Risk factors associated with injury included scapular dyskinesia, decreased internal rotation, increased external rotation, glenohumeral internal rotation deficit, poor endurance and reduced isometric muscle strength. These factors demonstrated moderate-to-large effect sizes. Conclusion: The identification of modifiable risk factors for shoulder pain demonstrates the value of embedding screening skills into undergraduate physiotherapy curricula. Teaching students to assess and address risk factors fosters a preventative orientation that extends beyond sports injuries to broader health contexts. Clinical implications: Incorporating risk factor screening into training equips physiotherapy graduates with practical skills for early detection and prevention, thereby reducing the burden of preventable conditions and aligning education with the objectives of SDG3.

Teaching child developmental milestones in undergraduate physiotherapy can be challenging due to the high volume of factual content, which students often find difficult to master. Furthermore, higher education institutions are expected to promote self-directed learning among students. This dual challenge requires innovative methods of teaching and learning to ensure student success. A narrative-based digital game, called 'Kidnapped', was developed using a design-thinking approach. This game was developed in response to the need for interactive, accessible content delivery and to foster self-directed learning among students. The game was intentionally designed to incorporate the principles of learning scaffolding and reinforced learning through repetition, ensuring its educational relevance and alignment with student learning needs. The game was piloted with academic staff to ensure implementation feasibility. A cross-sectional, cross-over study will be conducted towards the end of 2025, combining quantitative and qualitative methods to evaluate the game's effectiveness. Findings will inform iterative improvements and guide broader implementation across health sciences programmes. Key lessons learned include the value of early stakeholder engagement, the importance of adaptable technology, and the potential of gamification to enhance active learning and learning autonomy in health professions education.

Peer tutoring is an essential service in higher education, requiring comprehensive training that transcends academic content to include leadership development. This study assessed the impact of a tutoring and mentoring intervention on the leadership skills of tutors. Seven medical students participated in a year‐long program involving leadership workshops, peer tutor training, and mentoring. Pre‐ and post‐test results showed a large effect on 12 of 30 leadership questions and a medium effect on 6, demonstrating significant leadership growth in peer tutors. This study highlights how mentoring and tutoring can significantly enhance tutors' leadership abilities, supporting their holistic growth and preparing them for future leadership roles.

Background: Comprehensive and formalized digital health care ecosystems in health sciences tertiary education in South Africa do not currently exist, but they have the potential to influence teaching and learning, research, and community engagement. Objective: A total of 3 key objectives underpin the study, that is, determining the health care curriculum needs and required content for the development of a formalized digital health ecosystem, determining the level of readiness of staff and students to participate in a digital health care ecosystem, and determining whether community engagement and strategic partnerships can contribute to the sustainability of a digital health care ecosystem. Methods: A multipronged approach will be used to address the objectives, with a mixed methods design being undertaken. The qualitative phases will be phenomenological in nature, and triangulation of information along with thematic analysis will be conducted on the collected data. Quantitative data will be collected prospectively and cross-sectionally and analyzed using descriptive analysis. Sampling will include subject experts for the Delphi technique, staff and students at the University, clinical training and education partners, and community leaders. This study has received ethical approval from the Sefako Makgatho Health Sciences University Research and Ethics Committee (SMUREC/H/260/2023:PG). Results: Data collection for the first phase will begin in January 2024 and conclude in December 2024. Phase 2 and 3 of the study will be conducted concurrently, with data collection starting in January 2025 and concluding in December 2026. Conclusions: The establishment of a digital health care ecosystem has the potential to benefit staff, students, and communities through stakeholder collaboration, educational opportunities, research projects, and improved service delivery. International Registered Report Identifier (IRRID): DERR1-10.2196/57821

BACKGROUND Over the past decade, virtual reality (VR) has gained traction in healthcare skills training due to its ability to improve educational quality and efficiency. VR offers immersive simulations for practicing medical procedures safely, enabling repetition, immediate feedback and risk-free failure. However, despite its advantages, VR adoption in South Africa remains limited, with little information available on its implementation, benefits, and challenges in this context. OBJECTIVE Therefore, the aims of the study are to determine: the impact; relevance; perceived benefits; challenges; potential risks; perceived effectiveness; and lecturers’ perceptions and experiences of a novel VR simulator training system. METHODS A three-year longitudinal cohort study will recruit third-year medical students and staff involved in skills training. In the first year, the initial cohort (cohort 1) will be recruited. In the second year, a follow-up will be conducted with cohort 1, and a new group of third-year students (cohort 2) will be recruited as a comparator group. Both cohorts will be followed for two years. Data will be collected via questionnaires and focus group interviews. RESULTS To ensure a confidence level of 95% (5% margin of error), 222 students and 3 lecturers are required to participate in the study. To account for attrition and incomplete questionnaire submission, 312 students (i.e., 156 per cohort) and 4 staff members will be recruited for participation. Quantitative data will undergo descriptive analysis, while qualitative data will be analyzed thematically using a grounded theory approach, incorporating both inductive and deductive methods. Data collection will commence in January 2025 and will continue until December 2028. CONCLUSIONS This study will be the first in South Africa to investigate VR technology usage for electrocardiogram procedural skills training over a prolonged period of time. The results obtained from the data collected may be used in decision-making regarding the feasibility of VR for skills training both in a local- and global context. CLINICALTRIAL Not applicable

BACKGROUND Comprehensive and formalized digital health care ecosystems in health sciences tertiary education in South Africa do not currently exist, but they have the potential to influence teaching and learning, research, and community engagement. OBJECTIVE A total of 3 key objectives underpin the study, that is, determining the health care curriculum needs and required content for the development of a formalized digital health ecosystem, determining the level of readiness of staff and students to participate in a digital health care ecosystem, and determining whether community engagement and strategic partnerships can contribute to the sustainability of a digital health care ecosystem. METHODS A multipronged approach will be used to address the objectives, with a mixed methods design being undertaken. The qualitative phases will be phenomenological in nature, and triangulation of information along with thematic analysis will be conducted on the collected data. Quantitative data will be collected prospectively and cross-sectionally and analyzed using descriptive analysis. Sampling will include subject experts for the Delphi technique, staff and students at the University, clinical training and education partners, and community leaders. This study has received ethical approval from the Sefako Makgatho Health Sciences University Research and Ethics Committee (SMUREC/H/260/2023:PG). RESULTS Data collection for the first phase will begin in January 2024 and conclude in December 2024. Phase 2 and 3 of the study will be conducted concurrently, with data collection starting in January 2025 and concluding in December 2026. CONCLUSIONS The establishment of a digital health care ecosystem has the potential to benefit staff, students, and communities through stakeholder collaboration, educational opportunities, research projects, and improved service delivery. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/57821

The South African Journal of Physiotherapy is the official scholarly refereed journal of the South African Society of Physiotherapy. It aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions both nationally and internationally.

Background: Persistent low back pain (LBP) postpartum is a known phenomenon; however, the prevalence and characteristics thereof were unknown in South Africa. Objectives: This study determined the point prevalence and characteristics of women with persistent LBP postpartum. Methods: A cross-sectional quantitative design was used. Women over 18 years who gave birth more than six weeks prior to the study were included. Data were collected for both groups through physical measurements and questionnaires. Descriptive, correlational, and non-parametric statistical analysis was conducted. Results: 50 women participated in the study, and 22 (44%) presented with persistent LBP postpartum. The group with LBP experienced a higher level of disability (54.5% - moderate disability and 4.5% - severe disability) compared to the pain-free group. Postnatal depression was indicated in 40.9% of the LBP group and was statistically significantly and moderately positively associated with the presence of LBP (p=0.000; r=0.53). Regarding activity and participation levels, 59.1% of females with LBP postpartum had a moderate risk for chronicity, and 13.6% had a high risk. The LBP pain group differed significantly in terms of participation in physical activity (p=0.000) compared to the pain-free group. Conclusion: The results indicated a high point prevalence of LBP six or more weeks postpartum (44%). On impairment level, disability and postnatal depression experienced by women with LBP postpartum differed from the pain-free group. Participants who were pain-free were much more physically active than participants with LBP. The results from the study implied low levels of physical activity in the presence of LBP.