Health students unsupervised in practicals register low grades

The Uganda Allied Health Examinations Board (UAHEB) is concerned that some students are not adequately supervised during their practical part of studying.

As YUDAYA NANGONZI writes, the government recently approved an allowance for medical personnel to guide the trainees but some supervisors ignore their roles, leading to low performance outcomes.

The six-month practical experiences, distributed throughout the semesters from year one to year three, are meant to provide students with real-world exposure to their fields of study. UAHEB examiners found that some students complete their studies with minimal exposure while others go unsupervised, which inadvertently compromises the safety of patients and the trainees.

Speaking at the release of the 15th series of the November/December final semester examination 2023 results, the UAHEB executive secretary, Joseph Agondua, said supervisors play a crucial role in providing feedback and guidance for skills development.

However, during the board’s interaction with candidates who had presented fraudulent logbooks, it was discovered that a lot was left to be desired in some practicum areas. Candidates’ logbooks as part of school-based assessments were not well managed because supervisors did not have enough time for supervision.

“When we invited students about their poor performance and information filled in the logbooks, we realized several gaps. The wrong information was not only from students but also from supervisors in the hospitals,” Agondua said.

Whenever a student carries out a procedure such as taking a patient’s temperature or blood pressure, the information is supposed to be filled in the logbook. The supervisor goes ahead to comment and confirm the student’s work.

“All this does not happen. Some students fill out those procedures without the knowledge of the supervisor. Supervisors are supposed to append their signatures on the student’s work; and this is not done. They sign the entire logbook and students continue to do practical work as they wish,” he said.

Agondua added: “There’s a high level of dishonesty between the students and some supervisors. Some students indicated that they did 15 procedures in a single day. Surely, this cannot happen in the health sector because on average, a student is supposed to conduct at least five procedures that are supervised effectively.”

Some supervisors also counter-signed on wrong information presented by students while others allowed students to do the practicals and only signed their logbooks at the end of the six-month practicum placements.

The inadequate supervision didn’t only impact individual students but also affected the overall performance last year. At least 27,262 candidates registered for the examinations in 30 Allied Health training programmes under the categories of; higher diploma, diploma, and certificate programmes. Of these, 7,376 were final-semester candidates, and 19,866 continuing students. Out of the registered candidates, 20 candidates missed the examinations.

DECREASE IN PERFORMANCE

Out of the 7,376 finalists assessed in the November/December 2023 final semester examinations, 4,222 were male and 3,154 female. At least 6,016 (82.8%) passed the examinations while 1,360 (17.2%) had retakes. They have an opportunity to repeat the papers when next offered.

Candidates performed at 82.8% compared to 82.9% last academic year 2022/23, indicating a decrease in performance of 0.1%. This is attributed to candidates having inadequate supervision in the practicum areas.

“We are producing a health worker who is going to attend to humans in our hospitals. If you pass out a half-baked student, how do you feel as a supervisor? It is dishonesty, unfair, and unprofessional with huge implications on people’s lives,” Agondua said.

There was a decrease in examination malpractice from seven to five candidates this year. The most common form of malpractice was plagiarism of the research reports due to inadequate teaching and supervision of research. Candidates kept presenting similar research reports to the board.

Two students from Chemequip Laboratory Training School in Wakiso and Lira Institute of Health Sciences entered the examination room with summarised notes, and their results were cancelled.

Three candidates from Fort Portal College of Health Sciences, Mayanja Memorial Medical Training Institute, and Mbale School of Hygiene plagiarized research reports and their results canceled, and were asked to repeat the research.

FEMALE NUMBERS STILL LOW

In the spirit of equitable access to education, the state minister for Higher Education, Dr John Muyingo, who released the results last week said more efforts are still required to attract female students in the allied health field.

Despite being fewer, female candidates performed better at 84% compared to their male counterparts at 80%. He noted also that a few students enrolled for higher diploma programmes last year in ENT (10), Audiology (3), Clinical Psychiatry, and Clinical Ophthalmology with two candidates each.

“This is regrettable yet the said programmes are very critical in contributing to effective health service delivery,” Muyingo said.

He added that the ministry will continue to monitor the quality of health workers and will not hesitate to bring to order all those who fail to comply with the set standards.

On her part, the commissioner in charge of Health Education and Training, Dr Safinah Kisu Museene, pledged to take up the problem of inadequate supervision of students for discussion to the Inter-Ministerial Sectoral Coordination Committee and the principals will soon be guided to improve on the activity.

PROPOSALS TO THE MINISTRY

To improve the performance of the board and training of allied health professionals, the UAHEB chairperson, Rose Nassali Mugumisiriza, shared various proposals with the Education ministry officials.

“The issue of delayed release and cut on the amount of subvention released to the board should be addressed. These cuts have been experienced in the quarterly releases and paralyzed critical examination activities,” Nassali said.

She urged the ministry to support training in terms of health tutor recruitment, provision of equipment and other learning materials, and enhanced supervision of institutions to manage clinical practice and mentoring of students.

This is in addition to reviewing all Allied Health Curricula to align them to the Competence Based Education and Training (CBET) to guarantee skilled professionals.

Nassali also requested that the ban on the recruitment of staff pending the merger of the board be selectively considered so as not to paralyze the work between now and July 2024.

Currently, the board secretariat is operating at half capacity of its required human resources while critical positions such as human resource and administration and examination officers are vacant.

In the ongoing discussions to implement the cabinet resolution on the Rationalization of Agencies and Public Expenditure (RAPEX) this year, all health sciences assessment bodies will be merged into one body; the Uganda Health Professionals Assessment Board (UHPAB).

According to the Education ministry’s permanent secretary, Ketty Lamaro, whereas there are restrictions on staff recruitment for the institutions affected by the proposed merger, the board may in special circumstances request for staff by writing through her office to the permanent secretary of the ministry of Public Service.

nangonzi@observer.ug