{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:15:28Z","timestamp":1772550928769,"version":"3.50.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["57035"],"award-info":[{"award-number":["57035"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["57035"],"award-info":[{"award-number":["57035"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["57035"],"award-info":[{"award-number":["57035"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["57035"],"award-info":[{"award-number":["57035"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["57035"],"award-info":[{"award-number":["57035"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["57035"],"award-info":[{"award-number":["57035"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["57035"],"award-info":[{"award-number":["57035"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Educ"],"DOI":"10.1186\/s12909-026-08735-5","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T06:23:45Z","timestamp":1770099825000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Towards medical pedagogical pragmatism: transforming medical students\u2019 Understanding of community health needs through the integrated longitudinal community clerkship in rural South Africa"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7704-6834","authenticated-orcid":false,"given":"Siyonela","family":"Mlonyeni","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6070-2176","authenticated-orcid":false,"given":"Laston","family":"Gonah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9444-9737","authenticated-orcid":false,"given":"Wilson Wezile","family":"Chitha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9458-3742","authenticated-orcid":false,"given":"Sikhumbuzo Advisor","family":"Mabunda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3857-8225","authenticated-orcid":false,"given":"Ntiyiso Vinny","family":"Khosa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4749-4258","authenticated-orcid":false,"given":"Mirabel","family":"Nanjoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4130-0707","authenticated-orcid":false,"given":"Sibusiso Cyprian","family":"Nomatshila","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"issue":"1","key":"8735_CR1","first-page":"4401","volume":"16","author":"J Blitz","year":"2024","unstructured":"Blitz J, et al. Longitudinal integrated clerkships from start to finish: A medical curriculum innovation. Afr J Prim Health Care Family Med. 2024;16(1):4401.","journal-title":"Afr J Prim Health Care Family Med"},{"issue":"8","key":"8735_CR2","doi-asserted-by":"publisher","first-page":"e1416","DOI":"10.3109\/0142159X.2013.778392","volume":"35","author":"D Playford","year":"2013","unstructured":"Playford D, et al. Longitudinal assessment in an undergraduate longitudinal integrated clerkship: the mini clinical evaluation exercise (mCEX) profile. Med Teach. 2013;35(8):e1416\u201321.","journal-title":"Med Teach"},{"issue":"3","key":"8735_CR3","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1080\/14739879.2020.1816859","volume":"32","author":"ME Brown","year":"2021","unstructured":"Brown ME, et al. Not all who wander are lost: evaluation of the hull York medical school longitudinal integrated clerkship. Educ Prim Care. 2021;32(3):140\u20138.","journal-title":"Educ Prim Care"},{"key":"8735_CR4","doi-asserted-by":"publisher","unstructured":"O\u2019Brien BC et al. Introducing pragmatic approaches in health professions education research. Foundations of health professions education research: Principles, perspectives and practices, 2023: pp. 164\u2013188. https:\/\/doi.org\/10.1002\/9781394322213.ch9","DOI":"10.1002\/9781394322213.ch9"},{"key":"8735_CR5","unstructured":"SmithLM. Beyond Truth: A Pragmatist Approach to Narrative Pedagogy in Professional Learning for Healthcare Practitioners. Discourses, Dialogue and Diversity in Biographical Research. 2021: p. 107. https:\/\/scholar.google.com\/scholar?hl=en&as_sdt=0%2C5&q=Smith%2C+L.M.%2C+Beyond+Truth%3A+A+Pragmatist+Approach+to+Narrative+Pedagogy+in+Professional+Learning+for+Healthcare+Practitioners.+Discourses%2C+Dialogue+and+Diversity+in+Biographical+Research%2C+2021%3A+p.+107&btnG="},{"issue":"5","key":"8735_CR6","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1111\/tct.13388","volume":"18","author":"H Dixon","year":"2021","unstructured":"Dixon H, et al. Medical students\u2019 experiences of health inequalities and inclusion health education. Clin Teach. 2021;18(5):529\u201334.","journal-title":"Clin Teach"},{"issue":"1","key":"8735_CR7","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1186\/s12909-025-06910-8","volume":"25","author":"D Sims","year":"2025","unstructured":"Sims D, et al. Medical education, reflections and perspectives from South africa: a review. BMC Med Educ. 2025;25(1):370.","journal-title":"BMC Med Educ"},{"key":"8735_CR8","unstructured":"Africa SS. Population statistics: census 2022. Republic of South Africa; 2023. https:\/\/www.statssa.gov.za\/?p=16716"},{"issue":"1","key":"8735_CR9","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1080\/21665095.2022.2032236","volume":"9","author":"C Moyo","year":"2022","unstructured":"Moyo C, Mishi S, Ncwadi R. Human capital development, poverty and income inequality in the Eastern cape Province. Dev Stud Res. 2022;9(1):36\u201347.","journal-title":"Dev Stud Res"},{"key":"8735_CR10","volume-title":"Poverty and inequality","author":"SS Africa","year":"2025","unstructured":"Africa SS. Poverty and inequality. Statistics South Africa: Pretoria; 2025. S.S. Africa, Editor."},{"issue":"1","key":"8735_CR11","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.hpe.2019.09.003","volume":"6","author":"A Amalba","year":"2020","unstructured":"Amalba A, et al. The role of Community-Based education and service (COBES) in undergraduate medical education in reducing the mal-distribution of medical Doctors in rural areas in africa: a systematic review. Health Professions Educ. 2020;6(1):9\u201318.","journal-title":"Health Professions Educ"},{"issue":"1","key":"8735_CR12","doi-asserted-by":"publisher","first-page":"74","DOI":"10.5334\/aogh.4560","volume":"90","author":"S Mlonyeni","year":"2024","unstructured":"Mlonyeni S, et al. Personal and social transformative learning through Community\u2013Based education: insights from training socially accountable medical Doctors at a historically disadvantaged university in the Eastern Cape, South Africa. Annals Global Health. 2024;90(1):74.","journal-title":"Annals Global Health"},{"issue":"1","key":"8735_CR13","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/S40037-019-00558-Z","volume":"9","author":"M Bartlett","year":"2020","unstructured":"Bartlett M, et al. The do\u2019s, don\u2019ts and don\u2019t knows of Establishing a sustainable longitudinal integrated clerkship. Perspect Med Educ. 2020;9(1):5\u201319.","journal-title":"Perspect Med Educ"},{"issue":"3","key":"8735_CR14","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1177\/1541344603001003006","volume":"1","author":"SM Scott","year":"2003","unstructured":"Scott SM. The social construction of transformation. J Transformative Educ. 2003;1(3):264\u201384.","journal-title":"J Transformative Educ"},{"issue":"9","key":"8735_CR15","doi-asserted-by":"publisher","first-page":"20621","DOI":"10.1007\/s10668-022-02444-x","volume":"27","author":"M Singer-Brodowski","year":"2025","unstructured":"Singer-Brodowski M. The potential of transformative learning for sustainability transitions: moving beyond formal learning environments. Environ Dev Sustain. 2025;27(9):20621\u201339.","journal-title":"Environ Dev Sustain"},{"key":"8735_CR16","doi-asserted-by":"crossref","unstructured":"Mezirow J. Transformative learning theory, in Contemporary theories of learning. Routledge; 2018. pp. 114\u201328. https:\/\/www.taylorfrancis.com\/chapters\/edit\/10.4324\/9781315147277-8\/transformative-learning-theory-jack-mezirow","DOI":"10.4324\/9781315147277-8"},{"issue":"1","key":"8735_CR17","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1177\/15413446211067285","volume":"21","author":"O Gunnlaugson","year":"2023","unstructured":"Gunnlaugson O, et al. Revisiting the nature of transformative learning experiences in contemplative higher education. J Transformative Educ. 2023;21(1):84\u2013101.","journal-title":"J Transformative Educ"},{"issue":"3","key":"8735_CR18","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1111\/medu.14380","volume":"55","author":"J Thompson Burdine","year":"2021","unstructured":"Thompson Burdine J, Thorne S, Sandhu G. Interpretive description: A flexible qualitative methodology for medical education research. Med Educ. 2021;55(3):336\u201343.","journal-title":"Med Educ"},{"key":"8735_CR19","doi-asserted-by":"publisher","unstructured":"Sally T. Interpretive description. Qualitative research for applied practive. Second edition ed. New York: Routledge, 2016. https:\/\/doi.org\/10.4324\/9781315545196","DOI":"10.4324\/9781315545196"},{"issue":"4","key":"8735_CR20","first-page":"91","volume":"6","author":"T Otani","year":"2020","unstructured":"Otani T. Functions of qualitative research and significance of the interpretivist paradigm in medical and medical education research. Fujita Med J. 2020;6(4):91\u20132.","journal-title":"Fujita Med J"},{"issue":"3","key":"8735_CR21","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1080\/0142159X.2022.2057287","volume":"45","author":"FM Olmos-Vega","year":"2023","unstructured":"Olmos-Vega FM, et al. A practical guide to reflexivity in qualitative research: AMEE guide 149. Med Teach. 2023;45(3):241\u201351.","journal-title":"Med Teach"},{"issue":"4","key":"8735_CR22","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1080\/2159676X.2019.1628806","volume":"11","author":"V Braun","year":"2019","unstructured":"Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qualitative Res Sport Exerc Health. 2019;11(4):589\u201397.","journal-title":"Qualitative Res Sport Exerc Health"},{"issue":"1","key":"8735_CR23","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1111\/medu.13124","volume":"51","author":"L Varpio","year":"2017","unstructured":"Varpio L, et al. Shedding the Cobra effect: problematising thematic emergence, triangulation, saturation and member checking. Med Educ. 2017;51(1):40\u201350.","journal-title":"Med Educ"},{"issue":"3","key":"8735_CR24","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1093\/poq\/nfad037","volume":"87","author":"J Jerit","year":"2023","unstructured":"Jerit J, Barabas J. Are nonprobability surveys fit for purpose? Pub Opin Q. 2023;87(3):816\u201340.","journal-title":"Pub Opin Q"},{"key":"8735_CR25","unstructured":"Hiller J. Epistemological foundations of objectivist and interpretivist research. 2016."},{"issue":"2","key":"8735_CR26","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Res Psychol. 2006;3(2):77\u2013101.","journal-title":"Qualitative Res Psychol"}],"container-title":["BMC Medical Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12909-026-08735-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-08735-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12909-026-08735-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T11:48:52Z","timestamp":1772538532000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12909-026-08735-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["8735"],"URL":"https:\/\/doi.org\/10.1186\/s12909-026-08735-5","relation":{},"ISSN":["1472-6920"],"issn-type":[{"value":"1472-6920","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,3]]},"assertion":[{"value":"14 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study received ethical clearance from the Walter Sisulu University Faculty of Health Sciences Postgraduate Education, Training, Research and Ethics Unit (Approval No. 109\/20). Participation was entirely voluntary, and all participants were fully informed about the study\u2019s purpose, procedures, potential risks, and anticipated benefits before enrolment. Written informed consent was obtained from all participants prior to data collection. All procedures were conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and relevant national research ethics guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"371"}}