Instructors’ feedback on Kenya Medical Training College students’ clinical attachment

Abstract

Kenya Medical Training College (KMTC) is the largest health training institution nationally that produces most mid-level health professionals. Clinical attachments are a primary focus of educational practice for health professions that allow students to link theory with practice. KMTC has institutionalized mentorship and feedback in their training framework; however, empirical studies show inconsistent feedback delivery, poor mentor preparation, and no models for standardization. This gap is critical as the quality of feedback directly determines the competencies of KMTC graduates and, hence, the backbone of Kenya's health workforce. The study used a descriptive cross-sectional design for KMTC students on attachments. The study was conducted in various KMTC-associated hospitals and practicing sites. Data were collected from 458 instructors using questionnaires, and a purposive sampling technique was used. The Statistical Package for the Social Sciences was used in the analysis, where descriptive statistics (frequencies, percentages) and inferential statistics (Chi-Square, Cramer’s V test, Odds Ratio) were utilized. Data presentation was in tables and charts. Institutional review for ethical approval was done prior to commencement of the study. Feedback obtained from clinical instructors (n=458) showed that there were regional differences in terms of responses, including Nairobi having the highest (14.4%). Courses in nursing prevailed (31.2%), followed by clinical medicine and surgery (14.4%). Lecturers frequently followed up with students on attachment (35.2% always, 28.8% often), which is also moderately related to student satisfaction (46.9% satisfied). Most of the facilities were county referral hospitals (41.7%), followed by orthopedic departments (14.0%). The instructor-student ratios were sufficient in 50.4% of the facilities, and resources in 48.9% had a significant association. Students showed good behavior, with more than 80% having positive attitudes, respect, professionalism, and punctuality, while teamwork was rated 45.9%. High skills were seen by instructors: 92.1% had theoretical knowledge, 89.8% communicated, 90.6% empathized, and chi-square supported positive biases (all p<0.001). The study concludes that KMTC students are well-informed in terms of their theoretical background, communication, and empathy. They are willing to get educated and be professionals. However, the instructors reported deficiencies in clinical mastery and the connection of theory with practice. The study recommends KMTC enhance the mentorship through regular, task-oriented, and objective feedback from instructors and bridging between theory and practice. There is also a need to develop attachment guidelines for faculty, students, and clinical instructors in order to standardize the attachment process.