The Students’ Health and Welfare Centres Organisation (SHAWCO) was developed in the 1940s at the University of Cape Town in response to the growth of informal settlements. Today, SHAWCO serves 4,000 patients annually. The aim of this study is to understand what parameters of care (language/cultural concordance, accessibility of clinic, medical student clinical skills, outcomes of visit) at SHAWCO improve or hinder patient satisfaction.
A study team member observed each patient visit and recorded medical student clinical practices. After the visit, patients completed a survey based on the Health Systems Trust Client Satisfaction Survey Questionnaire, used previously to evaluate patient satisfaction in South Africa. Medical students completed surveys regarding their clinical training, confidence, and motivations. A community health worker or co-investigator interviewed patients about their experience at SHAWCO. Medical student and patient responses were linked in REDCap.
39 clinical encounters were observed, 34 patients completed surveys, 58 medical students completed surveys, and 12 patients were interviewed. Satisfaction ratings were compiled into categories based on the WHO Building Blocks for Health Systems. Patients rated SHAWCO 4.54/5 for medical essentials, 4.41/5 for health workforce, and 4.38/5 for health information. Health services was evaluated by the percentage of patients who reported receiving some form of treatment at clinic, which was 93.8%. Language concordance was low between medical students and patients (25.0%). A majority of patients at SHAWCO received point-of-care testing and treatment at clinic (88.2% and 76.5%).
Patient feedback is a critical tool to improve health systems. Statistical analyses are pending completion of data collection. Results will be used to identify aspects of care at SHAWCO that could be improved and aspects that could be implemented at other student-run-free clinics to enhance patient experience. Study limitations include the lack of a control sampling of patients at a non-student-run clinic in the Western Cape