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 known as the body-mind-unity, does not contradict the biological model; it aims to expand health professionals understanding by integrating psychological and eco-social elements as influential factors in health and disease. We investigated the knowledge, attitude, and practice (KAP) of University of Botswana faculty of medicine (UB-FOM) clerkship supervisors on BPSM. Methods This was a quantitative cross-sectional survey. We distributed online (using Microsoft Forms) and self-administered paper-based questionnaires to clerkship departments. We gathered KAP information using a five-point Likert scale and an open-ended question section that asked respondents to elaborate on the factors they believed could limit their application of the BPSM. Results Forty-eight clerkship supervisors completed the questionnaire. Most participants (n = 38, 79.2%) reported that they received training on the BPSM throughout their undergraduate or postgraduate education. UB-FOM clerkship supervisors appreciated the importance of considering all four dimensions of health in any healthcare activity (mean score = 4.14 > weighted mean score of 4.04). They also noted the intricate nature of the interaction between psychological and physical health elements (mean score = 4.18 > weighted mean score of 4.04). However, they did not feel comfortable instructing medical students on the model during clinical rotation (mean score = 3.98 < weighted mean score = 4.04), and they expressed scepticism over the ability of psychosocial processes and treatments to alter medical illnesses. Additionally, they did not feel the importance of incorporating the spiritual evaluation into medical practice (mean score = 3.82 < weighted mean score of 4.04). Obstacles to the implementation of a BPSM included time constraints during consultations and burden, a negative "attitude" towards the BPSM, a lack of updated training, and a defined guideline for the BSPM. Conclusion UB-FOM Clerkship supervisors appreciated the importance of considering all four dimensions of health in any healthcare activity. However, they did not feel comfortable instructing medical students on the model during clinical rotation, and they expressed scepticism over the ability of psychosocial processes and treatments to alter medical illnesses. We recommend implementation research that specifically targets the beliefs and attitudes of clerkship supervisors.