Perspectives on decoloniality of health professions education among final year students in the WiSDOM II cohort study in South Africa
Year: 2026
Type: article
Abstract: Background This study contributes to the global discourse on the transformation of health professions education. It compares the perspectives on decoloniality of final-year health professional students from the 2023 WiSDOM II cohort in South Africa and examines the factors associated with these perceptions. Methods WiSDOM, a prospective longitudinal cohort study, consists of clinical associates, dentists, doctors, nurses, occupational therapists, oral hygienists, pharmacists, and physiotherapists. The second cohort was established in 2023. Following informed consent, all final year health professional students were invited to participate in the baseline study. Each student completed an electronic self-administered questionnaire (SAQ) that included inter alia socio-demographic information, opinions about transformation, reasons for choosing their profession, and future career and job intentions. We used STATA® 17 to compare differences among the professional groups. We used principal component analysis (PCA) to construct a composite index of decoloniality of health professions education from 12 questions on transformation, and multiple linear regression to investigate factors associated with the decoloniality scores. Results In 2023, we recruited 459 final year health professional students and obtained an overall response rate of 71.7%. The mean age of the study participants was 24.0 years (SD ±3.3); the majority female (76.9%); and 53.9% self-identified as Black African. Notwithstanding variations across the professions, the majority of cohort members agreed that there is open support of people regardless of their sexual orientation (72.1%), that the curriculum equips them to work in resource-poor environments (66.4%), and encourages community accountability (66.2%). However, 32.2% agreed that the institutional culture does not promote racial diversity, and 25.3% agreed that the selection criteria do not sufficiently address historical disparities. Students of colour reported lower scores on decoloniality than white students ( p < 0.001). Female students reported lower scores than males ( p < 0.01). Medical ( p < 0.001) and occupational therapy ( p < 0.001) students reported significantly lower scores than the overall mean of the different professions. Students who agreed that they were motivated by money reported higher decoloniality scores ( p < 0.01). Conclusion An inclusive institutional culture and addressing historical inequities remain priorities to ensure that health professions education contribute to workforce development and social transformation in South Africa.
Source: Frontiers in Medicine
Institution: University of the Witwatersrand
Language: English
Topic: Health and Medical Education
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7225787183