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Background. It is uncertain how descriptions of learner experiences and expectations can influence learner engagement in prehospital emergency care education in South Africa (SA). Improved access to higher education may imply a greater diversity of life experiences and academic needs. However, neither this diversity nor the consequent disengagement-engagement differential has been documented for the emergency care student body in SA. Objectives. To explore the expectations of, impediments to and enablers for success in undergraduate emergency care education. Methods. A concurrent (embedded) mixed-methods design was employed. Through a prospective online survey, 115 of 249 emergency care learners who were registered in 2014 - 2018 were sampled. Qualitative responses were thematically analysed from a process of mind mapping and dyadic contrasting of codes. Results. Three propositions emerged: ( i ) the paradox of programme motivation and subject hindrance suggests that participants were intrinsically and extrinsically motivated for programme completion, but experienced hindrances at the subject level; ( ii ) there was a perception of insufficient academic interaction and engagement; and ( iii ) while there were divergent experiences and expectations, coercive contexts for premature attrition in emergency care education prevail. Conclusions. Sacrifices made by respondents to overcome challenges were identified as a profound loss of time, money and relationships. Extrinsic factors affecting learner success included competing demands, institutional structure/processes, teaching quality and online teaching and learning. A learner-centred approach is therefore posited, given expression through learner engagement. If engagement is to become a meaningful social justice practice, then monoculture ideation in emergency care education must be challenged.

african journal of health professions education

Learner engagement as social justice practice in undergraduate emergency care education: An exploration of expectations, impediments and enablers for academic success