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Transformative learning theory has been recommended as a pedagogy of uncertainty for accommodating new beliefs that enable humans to thrive amid the challenges and complexity of our world. As higher education institutions embrace new roles and responsibilities, few studies have focused on how the disruptions caused by COVID-19 may facilitate formative learning experiences. This study explored how registrars responded to the challenges facing clinical training during the first wave of COVID-19, and how the impact of these disruptions prompted personal and professional development. Registrars completed an online qualitative SWOT (strengths, weaknesses, opportunities, and threats) analysis of their training experiences during the COVID-19 pandemic. Data were thematically analysed. Four hundred and five responses were received from 54 registrars. Themes related to challenges included mental distress, resource constraints, and compromised and inadequate training. Themes related to strengths and opportunities included new learning experiences, resilience, coping strategies, and enhanced graduate competencies related to leadership, collaboration, communication, and health advocacy. The disruptive and disorienting elements of COVID-19, although situated in chaos, aggravating the constraints of training in under-resourced settings, also provided unexpected learning opportunities. These findings highlight the transformative potential of disrupted learning contexts and the need for responsive curricular to enhance graduate competencies, adaptability, and resilience.

High levels of stress and burnout, low help-seeking behaviour and unhealthy coping in healthcare professionals (HCPs), are a critical concern globally. Mindfulness-based interventions (MBIs) reduce stress, are a healthy coping mechanism and have become increasingly popular among HCPs, especially during the Covid-19 pandemic. Nevertheless, HCPs' busy schedules require the intervention to be accessible, pragmatic, and context specific. Key to this goal is approaching mindfulness from a multicultural perspective, especially in diverse settings such as Africa. This paper aims to provide practical tips to ensure that the MBI offered is effective with multicultural HCPs during intense stress. Four tips each discuss the curriculum, implementation, and sustainability, respectively. The tips are elucidated by practical examples of regulating stress in healthcare settings and to offer a guideline to help structure future MBIs to be culturally and context appropriate. [ABSTRACT FROM AUTHOR]

Little is known about the influence of language background in problem-based learning (PBL) tutorial groups on group processes and students' academic achievement. This study investigated the relationship between language background, secondary school score, tutorial group processes, and students' academic achievement in PBL. A validated tutorial group effectiveness questionnaire was administered to undergraduate medical students in a PBL curriculum at the Nelson R. Mandela School of Medicine (NRMSM) in South Africa. Although 58 percent of the students did not speak English as their first language, the tutorials were in English. Furthermore, secondary school scores differed strongly due to inadequate resources between secondary schools. A path analysis was conducted to test a causal model in which the two independent variables were English as the First Language (EFL) and secondary school scores. These variables were assumed to influence the process variables (cognitive, motivational, and demotivational group processes). Input and process variables were assumed to influence the two output variables, being overall group productivity and students' academic achievement. All data were analyzed at the individual student level (N = 387). A very good model fit was found (CMIN/DF = 0.68, GFI = 1.00, TLI = 1.02, CFI = 1.00, RMSEA = 0.00). EFL and secondary school scores positively affected students' academic achievement (respectively beta = 0.24 and beta = 0.16). EFL negatively affected motivational group processes (beta = -0.22). Cognitive group processes positively influenced overall group productivity (beta = 0.31) and so did motivational group processes (beta = 0.27). Demotivational group processes negatively predicted academic achievement and overall group productivity (beta = -0.15, and beta = -0.25). The model resulted in an R-square of 0.15 and 0.45 for academic achievement and overall group productivity, respectively. EFL and secondary school scores had a positive effect on academic achievement. Cognitive and motivational group processes had a positive effect on overall group productivity, while EFL negatively impacted motivational group processes. We recommend English language development courses to be formally included into curricula to enhance student learning.

Collaborative approaches such as Problem Based Learning (PBL) may provide the opportunity to bring together diverse students but their efficacy in practice and the complications that arise due to the mixed ethnicity needs further investigation. This study explores the key advantages and problems of heterogeneous PBL groups from the students' and teachers' opinions. Focus groups were conducted with a stratified sample of second year medical students and their PBL teachers. We found that students working in heterogeneous groupings interact with students with whom they don't normally interact with, learn a lot more from each other because of their differences in language and academic preparedness and become better prepared for their future professions in multicultural societies. On the other hand we found students segregating in the tutorials along racial lines and that status factors disempowered students and subsequently their productivity. Among the challenges was also that academic and language diversity hindered student learning. In light of these the recommendations were that teachers need special diversity training to deal with heterogeneous groups and the tensions that arise. Attention should be given to create "the right mix" for group learning in diverse student populations. The findings demonstrate that collaborative heterogeneous learning has two sides that need to be balanced. On the positive end we have the "ideology" behind mixing diverse students and on the negative the "practice" behind mixing students. More research is needed to explore these variations and their efficacy in more detail. (Contains 1 table.)

Background: Coronavirus disease 2019 (COVID-19) placed healthcare professionals (HCPs) at a higher risk for stress-related conditions. Implementing a brief online mindfulness-based intervention (MBI) was hypothesised to transform the HCPs' ability to cope with stress by enhancing their self-care. Aim: This study aimed to explore the impact of an online MBI on HCPs' self-care practices and determine if personality traits were a moderating variable. Setting: An online MBI was implemented for HCPs working in South Africa during the COVID-19 pandemic lockdowns. Methods: A quantitative study design included a pre-assessment and post-assessment component, which allowed paired comparison and regression analysis to confer correlations. Data were collected via two validated instruments: the Mindful Self-Care scale-2018 and the Big Five Personality test. Results: Forty-nine HCPs participated in the study. Significant improvements were found in all the major self-care subscales post-intervention (p < 0.05). No significant associations were found between the personality traits and self-care except for neuroticism, which appeared to be an essential moderating variable. Conclusion: An online MBI significantly impacted health professionals' ability to care for themselves, despite their personality styles. Contribution: The impact of an online MBI on HCPs' self-care during the most intense time of stress and with a cohort of people known to be the most vulnerable to stress, namely those with neuroticism to date, has not been commented on. [ABSTRACT FROM AUTHOR]

Thanatology is defined as the interdisciplinary study of death and dying. Religious beliefs, cultural patterns and insights into the spirit or the non-material aspects of our being form a component of thanatological studies and may be designated as 'cultural thanatology'. This ethnographic study explores the religious, spiritual and existential concerns of a group of elderly, terminally-ill South African Hindus. Using grounded theory, the in-depth interviews, which provided a rich tapestry of participants' religious and spiritual values and beliefs in the quest to find meaning in the midst of 'end-of-life' despair, were thematically analysed. Participants expressed both spiritual relief and spiritual pain based on their individual cultural constructs of religious beliefs and customs. We found that poorly interpreted or dysfunctional aspects of religious belief contributed to psychological disturbances, and that a frustrated existential quest for meaning manifested itself as spiritual distress. However, although they reflected varying levels of pain and suffering, mentally and physically, coping and acceptance were also prevalent among all the participants of this study. [ABSTRACT FROM AUTHOR]

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health professionals were pushed to the front line of a global health crisis unprepared and resource constrained, which affected their mental well-being., Aim: This study aimed to investigate the effectiveness of a brief online mindfulness-based intervention (MBI) on stress and burnout for health professionals training and working in South Africa during the COVID-19 crisis., Setting: The context of the study is the overburdened, under-resourced health care system in South Africa during a global pandemic., Methods: A mixed method framework was adopted for this study. The quantitative data was analysed using descriptive analysis and the participants' qualitative experiences were interpreted using interpretative phenomenological analysis., Results: Forty-seven participants took part in this study. The study found a statistically significant ( p < 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment after the intervention. The participants' shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness because of COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness., Conclusions: The study found that a brief online MBI can be associated with reduced levels of stress and burnout as well as an increased sense of control and empowerment, felt both personally and professionally, during a global crisis., Contribution: The impact of an online MBI for health care professionals amidst a pandemic has not been previously documented., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2021. The Authors.)