Knowledge, attitudes, and practices of clerkship supervisors regarding the biopsychosocial approach at the University of Botswana’s Faculty of Medicine

Abstract

Background

The biopsychosocial and spiritual model (BPSM), commonly referred to as body-mind unity, complements the biological model by expanding health professionals’ understanding through the integration of psychological and eco-social elements as influential factors in health and disease. Clerkships are a phase of medical education where students transition from theoretical learning to practical application under the supervision of experienced health practitioners. This study investigates the knowledge, attitudes, and practices (KAP) of clerkship supervisors at the University of Botswana’s Faculty of Medicine (UB-FOM) regarding the BPSM.

Methods

We conducted a quantitative cross-sectional survey, distributing online (via Microsoft 365 Forms) and self-administered paper-based questionnaires to clerkship supervisors. KAP information was gathered using a five-point Likert scale and an open-ended question section that asked respondents to elaborate on factors they perceived as limitations to applying the BPSM.

Results

Only 34.3% of approximately 140 clerkship supervisors invited to participate in the study responded. Forty-eight supervisors completed the questionnaire. Most participants (n = 38, 79.2%) reported receiving training on the BPSM during their undergraduate or postgraduate education. Most UB-FOM clerkship supervisors appreciated the importance of considering all four dimensions of health in healthcare activities (mean score = 4.14 > weighted mean score of 4.04). They felt less comfortable instructing medical students on the model during clinical rotations (mean score = 3.98 < weighted mean score of 4.04), and they expressed less agreement about the ability of psychosocial processes and treatments to alter medical illnesses. Additionally, they less recognised the importance of incorporating spiritual evaluation into medical practice (mean score = 3.82 < weighted mean score of 4.04). Obstacles to implementing the BPSM included time constraints during consultations, a negative attitude towards the BPSM, a lack of updated training, and an absence of defined guidelines for the BPSM.

Conclusion

While most UB-FOM clerkship supervisors who participated to the study acknowledged the importance of considering all four dimensions of health in healthcare activities, they felt less comfortable instructing medical students on the BPSM during clinical rotations and expressed less agreement about the efficacy of psychosocial processes in medical treatment. We recommend implementing research that specifically targets the beliefs and attitudes of clerkship supervisors.