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Background. Internationally, the development of partnerships between institutions of higher learning and the communities they serve is stressed as a priority. The Umthombo Youth Development Foundation (UYDF) is an educational model developed in rural KwaZulu-Natal, South Africa as a response to the scarcity of medical personnel in hospitals. Community involvement in health professional education has become a key strategy in the model, and review of the model may provide lessons for other educators towards implementing community involvement in health professional education.Objective. To review the UYDF, with emphasis on aspects of community involvement.Methods. This qualitative study used a social accountability theoretical framework. Data were collected using the Appreciative Inquiry method and participants who were involved in the UYDF model were interviewed. Themes arising around community involvement were generated inductively.Results. Community involvement in health professional education grew from a funding requirement and has strengthened over time to become an integral component of the UYDF model. Community involvement occurred mainly at the student selection process, but continued during education and after graduation. Participants suggested means by which community involvement could be strengthened.Conclusion. The UYDF successfully presents a model that facilitates community involvement in health professional education. Lessons learnt could guide other models, and the UYDF model could be strengthened by further research.

Metadata only record The author of this article presents an overview of wildlife conservation efforts in Costa Rica and describes the different narratives regarding in wildlife conservation: the traditional narrative, which seeks to conserve wildlife species and their ecosystems by the establishment of parks and protected areas that exclude humans and restrict or prohibit access to these protected areas and their resources; and the more-recently developed counter-narrative, which recognizes the economic importance of access to wildlife and ecological resources and seeks to conserve these resources through sustainable use patterns and community-based conservation efforts. The traditional narrative has been implemented in Costa Rica since the early twentieth century; however, problems such as inadequate management and lack of enforcement of protected areas, along with the need to access resources in these areas for economic development, has shifted conservation efforts towards implementation of the counter-narrative. The author discusses conflicts between the two narratives as well as ways in which the different narratives co-exist with each other.

While it is essential that professional competence should be maintained, it is equally important that entry to the specialist ranks should be conditional on the demonstration of an acceptable level of competence. Multiple-choice papers and videotaped consultations are two parts of a multi-format approach to assessment which also includes a trainer's report and an audit report. The number of doctors identified as unsatisfactory at the recertification stage could be reduced by these methods, and the system could also provide a template for the introduction of recertification procedures.

There are many factors which influence general practitioners' behaviour with regard to attendance at education meetings. The demographic characteristics of general practitioners in the west of Scotland attending educational meetings were studied over a two year period. A total of 1672 doctors had attended sufficient sessions to claim their postgraduate education allowance and of these 1551 (93%) responded to the questionnaire. Overall attendance at meetings did not vary between age groups, but older doctors (those born before 1935) attended the highest mean number of education sessions on disease management and the lowest mean number on service management and health promotion. Doctors in rural areas attended fewer meetings than those in urban areas with the largest difference in the disease management category. Doctors from smaller practices attended significantly fewer sessions on service management than those from larger practices. There was no difference between sexes regarding the mean total number of education sessions attended but men attended significantly more sessions on service management and women attended more on health promotion. Full-time doctors attended more service management sessions than part-time doctors. Those who were widowed or divorced attended fewer sessions in total, the differences being greatest in service management and health promotion. Multiple regression analysis showed that location of practice, whether working full time or part time and marital status had a small but statistically significant bearing on overall attendance at meetings. Although the differences are small, these factors should be noted by education providers, negotiators and government.

In the autumn of 1991 the Committee in General Practice of the west of Scotland region appointed a working party to investigate the possibility of developing a credible, valid and reliable programme of summative assessment for general practitioner trainees. The working group formulated a four-part package consisting of a multiple true-false paper, a trainee audit project, the trainers' judgement, and analysis of videotaped consultations. The reasons for the use of this selection of methods are discussed. It is suggested that a summative assessment process for trainees should make use of the trainers' considerable knowledge of the trainee, have an external component, be criterion referenced, have an element of continuous assessment, and involve direct assessment of clinical competence. A pilot study of assessment of clinical competence using videotapes of routine trainee consultations by 25 volunteer general practitioner assessors is described. A rating instrument for use in differentiating the competent from the not yet competent trainee is discussed. The working group and the group of videotape assessors came to the provisional conclusion that the use of videotaped consultations may be a valid and feasible method of assessing the competence of general practitioner trainees as part of a balanced summative assessment programme.

The educational attainment of general practitioners in the west of Scotland region who subscribed to a centrally organized educational scheme for the postgraduate education allowance was compared with that of their colleagues who did not subscribe to the scheme. During the year studied (1990-91) 1712 of the 1830 principals in general practice in the region had sufficient sessions to claim their postgraduate education allowance. Of these 1712 doctors the 1353 who subscribed to the educational scheme attended a mean of 15.7 educational half day sessions during the study year in comparison with a mean of 12.5 half days attended by the 359 doctors who did not subscribe to the scheme. This difference was observed in all three categories of education--disease management, service management and health promotion--and was greatest in health promotion where subscribers attended a mean of 4.7 half days and non-subscribers 3.1. The doctors who were members of the scheme had achieved a better balance of education. A higher number had attended an educational day in each of the three categories, with the increase being 10.5% for subscribers versus non-subscribers for disease management, 20.0% for service management and 39.1% for health promotion. The differences between the two groups were greater for combinations of categories and 66.6% of subscribers had attended an educational day in each of the three categories compared with 40.9% of non-subscribers. A centrally organized educational scheme for a region can give a balanced spread of education and is likely to meet the educational requirements of the new contract for general practitioners.

A study was undertaken to investigate the number of doctors attending postgraduate education courses outwith their own region. During the one year study period general practitioners from the west of Scotland obtained 2262.0 half-day sessions accredited for the postgraduate education allowance from 335 different courses outwith their region and 10 different distance learning programmes. Four hundred and thirteen doctors from the west of Scotland region (22.6%) attended courses in other areas and 85 doctors (4.6%) participated in 258.6 half-days of distance learning. More than half of the education sessions (56.0%) were in the category of disease management. Sixty four doctors (3.5%) attended 10 or more half-day sessions outwith their region. Almost half the courses were in England and 32.5% of courses were in south east Scotland. Over the same period 122 doctors outwith the area attended 263 different courses in the west of Scotland region. Despite concern regarding the removal of travel and subsistence contributions for postgraduate education activities, general practitioners are attending education courses outwith their region.

A postal questionnaire was sent to all 140 trainers in the west of Scotland region and to the 102 trainees who had completed their training three months prior to the survey. The aim of the study was to identify the types of trainee assessment in use, the proportion of trainers using the various methods, the attitudes of trainers and trainees to the assessment methods employed, and their views on a regional assessment programme. Response rates of 89% for trainers and 71% for trainees were obtained. Almost all respondents reported the use of some from of assessment. The mean number of assessment types reported by trainees was 3.7 and by trainers 5.2. The most commonly used method was videotaping of trainee consultations, used by 76% of respondents, and the least common the use of hard data, for example prescribing statistics or referral rates. Videotaping was also rated the most useful method by both groups. Those with experience of the assessment methods gave them a higher score for usefulness than those without such experience. Approximately half of the respondents favoured a regional protocol for assessment. This study has shown that if trainers and trainees can be encouraged to use assessment methods they will find them helpful. However, universal assessment will only become a reality when it becomes a requirement for accreditation as a trainer.