Navigating the troubled waters of higher education – a phenomenological study on the needs and challenges of first‐year clinical associate students in South Africa

Background. Clinical associates (ClinAs) are educated in decentralised learning platforms where they gain skills and a concrete understanding of the fundamental challenges of healthcare in remote and poverty-stricken districts of South Africa. Due to the decentralised nature of the programme, these students seldom have access to ‘on-campus’ academic and psychosocial support. A peer mentorship programme has proved useful in this regard in other settings. Objective. To explore the unique academic and psychosocial challenges and needs of first-year clinical associate (ClinA) students and describe the views of the research participants on the perceived enablers and constraints of a ClinA peer mentorship programme. Methods. A phenomenological research design was used. The population included ClinA students and academic members of staff. Five appreciative inquiry interviews and two focus group discussions were conducted. Results. Four themes were identified: (i) flailing like a fish out of water (challenges experienced by ClinA students); (ii) floating devices (benefits of peer support programmes); (iii) the life saver (perceived enablers of peer support programmes); and (iv) rip currents (perceived constraints of peer support programmes). Conclusion. Unique challenges identified were: (i) the teaching and learning strategy implemented by the facilitator of the programme; (ii) the decentralised learning platforms; and (iii) the absence of institutional support at clinical learning centres. All participants agreed that peer mentor support is beneficial and essential for ClinA students, but that the peer mentor programme needs to be bespoke to address the limited access to academic and psychosocial on-campus support and the profile of the students, who are of rural origin and first-generation students.