Thesis (Ed.D.)--University of Illinois at Urbana-Champaign, 2006. / Source: Dissertation Abstracts International, Volume: 67-11, Section: A, page: 4113. Adviser: Jane W. Loeb. Includes bibliographical references (leaves 151-155) Available on microfilm from Pro Quest Information and Learning.

Within the profession of nursing, reflective journal writing is enthusiastically endorsed as an essential pedagogical strategy for producing reflective practitioners. Despite a lack of empirical evidence to substantiate the claims associated with reflective journaling, the prevailing belief in contemporary nursing education reflects an assumption that this practice is essential in the production of critically engaged nurses. This has resulted in a totalizing discourse that presents the adoption of reflective journaling within nursing curricula as unproblematic. This study combines the methodological principles of grounded theory, along with a poststructuralist approach, to explore the experience of reflective journaling from the perspective of university nursing students. Application of a Foucauldian analysis demonstrates how assumptions related to the utility of reflective journal writing are embedded within a variety of powerful discourses that shape how we think and speak about this practice. Of particular relevance is Foucault's exploration of the impact of surveillance, observation and disciplinary power. Reflective journaling is identified as a ritual of confession that produces self-regulating and compliant students. This study reveals that journal writing is largely viewed as a prescribed activity and assumptions are made by nurse educators regarding the ability of journals to facilitate critical reflection. The discourses that emerged from this analysis reflect different aspects of the socialization process that ultimately results in the construction of an "authentic" nurse. In closing, students and nurse educators are encouraged to develop alternative discourses that challenge the uncritical acceptance of reflective journal writing within contemporary nursing education.

Performance assessments of professionals are commonly scored with rating scales but checklists are used with the Objective Structured Clinical Examination (OSCE). Theory suggests checklists are too detailed (Norman, 2005a) and studies show that generic rating scales (e.g., Hodges, Regehr, McNaughton, Tiberius, & Hanson, 1999) are more discriminating and reliable. However, generic scales may represent clinical expertise too narrowly, resulting in less valid scores. Study One asked how case-specific rating scale scores and decisions compared to checklist scores and decisions at representing professional competency. Study Two asked the same question about a skill-specific rating scale. Data were from a medical licensure OSCE. Participants were 1,587 test takers and 190 physician raters. Two patient cases (Depression and Delirium) were used. In each case, two physicians scored. One scored a checklist and the other a rating scale; both scored a patient interaction rating scale (PIRS). Results from both studies showed internal consistency was higher for rating scales (e.g., for Study One alpha=.87 and alpha=.79 for rating scales; alpha=.55 and alpha=.64 for checklists). Item-total score correlations (ITC) for each rating scale as an item within the OSCE were also higher than the ITC for the checklists in both studies. Logistic regression analyses predicting pass/fail decisions from a 3-variable expertise model explained more variance for the rating scales decisions than it did for the checklists in both studies (e.g., RL2=16.4% and RL2=16.4% for rating scales; RL2=12.7% and RL2=5.7% for checklists in Study One). The highest Pearson correlations (corrected for attenuation) were between the rating scale scores and the respective PIRS scores. In conclusion, these rating scale scores are more discriminating and reliable than checklist scores but correlations with PIRS scores indicate they may not measure the intended dimension of the clinical expertise construct. Evidence for a validity argument was strongest for the case-specific rating scale for Depression, raising the question of whether rating scale methodology is appropriate for all OSCE cases.

Background The University of Cape Town Faculty of Health Sciences (UCT FHS) adopted the Primary Health Care (PHC) approach as its lead theme for teaching, research, and clinical service in1994 Aim To develop indicators to monitor and evaluate the implementation of the PHC approach in Health Sciences Education . Method A Delphi study, conducted over two rounds, presented indicators of Social Accountability from the Training for Health Equity Network (THEnet), as well as indicators derived from the principles of the PHC approach in the UCT FHS, to a national multidisciplinary panel. An electronic questionnaire was used to score each indicator according to relevance, feasibility/measurability, and its application to undergraduate and postgraduate curricula. Qualitative feedback on the proposed indicators was also elicited. Results Round 1: Of the 59 Social Accountability indicators presented to the panel, the 20 highest ranked indicators were selected for Round 2. Qualitative feedback challenged the link between social accountability and PHC, resulting in an additional 19 PHC-specific indicators being presented in Round 2. Round 2: The indicators which scored >85% and made the final list were: PHC: Continuity of care (94%); Holistic understanding of health care (88%); Respecting human rights (88%); Providing accessible care to all (88%); and Promoting health through health education (88%). THEnet: Safety of learners (88%); Education reflects communities' needs (86%); Teaching embodies social accountability (86%); Teaching is appropriate to learners' needs (86%) Conclusion These PHC and THEnet indicators can be used to assess the implementation of PHC in Health Sciences Education. The specific indicators identified reflect priorities relevant to the local context. One limitation is that some key priority indicators did not make the final list.

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Thesis (MPhil (Centre for Health Sciences Education)--University of Stellenbosch, 2010. / Aim: The aim of this study was to investigate the approaches, conceptions and perceptions toward learning of undergraduate Physiotherapy students in a PBL module in order to inform curriculum development and enhance facilitation of learning at the Stellenbosch University Division of Physiotherapy. Methodology: A mixed-method, descriptive study was conducted during 2010. Physiotherapy students currently in their 3rd year of the course, completed the Revised Two-factor Study Process Questionnaire (R-SPQ-2F) at the commencement of the academic year and again at the end of the first semester. The aim of this questionnaire is to determine the deep and surface approach toward learning of participants. Students also completed a perception of learning questionnaire and participated in focus group discussions to evaluate their perceptions and conceptions of learning in the module. Results of the three data instruments were analysed statistically, descriptively and phenomenographically, respectively. Results: There was a 100% response rate to the R-SPQ-2F and perception questionnaires, with only 6 out of 16 participants responding to invitations for focus group interviews. There were a statistically significant greater number of students who adopted a deep approach toward learning at the commencement of the academic year. An increase in those with a deep approach and a decrease in those with a surface approach toward learning were seen at the end of the first semester. This shift was however not significant. Students showed a trend toward an increase in their intrinsic interest in the learning material as the module progressed. Clinical reasoning and internalizing information were seen as two of the advantages of the instructional approach. Conversely, the disadvantages of the module included the perception that the instructional approach used is time consuming and concerns regarding quality and accuracy of learning material. The presence of dysfunctional group dynamics also plays a role in students perceptions of disadvantages in APT. Students conceived the module to have an effect on their approach toward learning and both personal and professional skills. Conclusion: The Applied Physiotherapy 373 module had no significant effect on students‟ approach toward learning. The results of this study however are not conclusive on why and how this lack of significant effect is present. Further research is needed to determine the long-term changes in approach toward learning and the possible determinants of these changes. This should be done in conjunction with implementation of quality assurance mechanisms for learning material, introduction of multi-media into PBL sessions and earlier preparation of students for the change in learning environment.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: A portfolio assessment system was designed to meet the needs of a Rural Clinical School education platform, hosting final year MB ChB students for the duration of their final year. A study entitled “What can be learned from the implementation of a portfolio assessment system, to be used in the assessment of clinical reasoning of final MB ChB students placed in a Rural Clinical School in South Africa? “ was conducted. The experience of educators and students during this process was explored. The findings are in keeping with the literature. Van Tartwijk & Driessen 2009, Eley et Al 2002, Lake & Ryan 2004, Burch & Seggie 2008 claim that portfolios drive deep student learning and develop clinical reasoning. Burch & Seggie (2008) offer an assessment tool which has proved feasible within the South African setting on which this portfolio assessment system was modelled. The assessment tool design faced a number of challenges within the RCS setting which were addressed during a review process. The portfolio assessment system is viewed as a work in progress requiring further development. Despite the constraints and challenges, both staff and students unanimously supported the development of patient case studies within the design as a valuable learning tool. / AFRIKAANSE OPSOMMING: ‘n Portefeulje assesserings sisteem is ontwerp om die behoeftes van ‘n UKWANDA Landelike Kliniese Skool opvoedings program wat die gasheer van die MB ChB student tydens hul finale jaar is, na te kom. ‘n Studie genaamd “ Wat kan geleer word uit die implementering van ‘n portefeulje assesserings sisteem, wat gebruik gaan word om die kliniese redenering te bepaal van finale jaar MB ChB student wat geplaas is in ‘n Landelike Klinieke Skool in Suid Afrika? ” is uitgeoefen. Die ervaring van die dosent, so wel as die studente, is ondersoek. Die bevinding is in lyn met die literatuur. Van Tartwijk & Driessen 2009, Eley et Al 2002, Lake & Ryan 2004, Burch & Seggie 2008 beweer dat portfeuljes dryf student tot diep studie en ontwikkel kliniese redenasie. Burch & Seggie (2008) bied ‘n assesserings (hulp)middel aan wat toepaslik en uitvoerbaar is in die SA konteks , waarop die portfeulje assessering sisteem gebaseer is. Die ontwerp van die assesserings (hulp)middel het vele uitdagings binne die RCS opset in die oog gestaar. Dit is aangespreek tydens ‘n proses van hersiening. (Lather, 2006).Die portefeulje assesserings sisteem word gesien as ‘n werk onder hande en vereis verdere ontwikkeling. Ten spyte van die beperkinge en uitdagings het beide die staf en die student onomwonde die ontwikkeling van pasiente gevalle studies, binne die ontwerp, as ‘n waardevolle leermiddel gesien.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction: Literature shows that the transition from high school to university is fraught with challenges and that there is need to appreciate these challenges from the students’ perspectives and devise ways of assisting the students navigate them smoothly. - Aim: To explore the perspectives of first year students at the University of Zimbabwe, College of Health Sciences (UZCHS) regarding their transition from high school to the UZCHS and propose possible ways to manage the transition phase based on the students’ perspectives. - Objectives : The objectives of this study were to determine the students’ perspectives with regards to various factors that are known to affect the transition from high school to university. - Design: An evaluative research study design was adopted using a mixed method research approach sequentially applying a quantitative and qualitative method. - Method: Four hundred and eighty six (486) self-administered survey questionnaires with 23 closeended questions were distributed to all first year students in the UZCHS. Only 16 questions were analysed for purposes of this research project. A total of 49 interviews were conducted for the in-depth structured questions interview on a randomly selected group of students from each of the programmes. - Results : The response rate was 51% (246/486) ; 81.4% of students were in the 19 to 20 years age group; 52% males and 48% females; 44.4% of the students were enrolled in the MBChB programme. The major challenges faced by the students were the heavy workload; poor counselling services; sticking to timetables; using the library; poor teacher-student relationships; poor sense of belonging; living with a diverse population Frustrations at the UZCHS were identified as arising from academic issues: examinations marks; poor facilities; inadequate high school preparation for university grades and poor feedback. Students’ financing at university was also of concern to the students. The students found the orientation week most useful. The motivation for joining the UZCHS was for career prospects, personal desires and parental influence. Preparatory information given by the UZCHS was considered adequate but not sufficiently detailed. Factors that helped students settle in were the initial reception, orientation week, and the relationships between students, staff and lecturers. The role of parents, peers and friends in settling in was also highlighted as important. - Conclusions : The students’ perspectives on transition are similar to those reported in the literature:need for pre-university information, better accommodation, improved library facilities, improved counselling services, lengthening the orientation week, more detailed information about UZCHS before admission, improve pre-university contact with students ,reduced workload in order to accommodate extra-curricular social life. Students’ preparation for life and learning at university should start during high school. / AFRIKAANSE OPSOMMING: Inleiding: Uit die literatuur is ditbaieduidelikdat die oorgang van studentevanaf die skoolnauniversiteitbaieuitdagend is. Daar is derhalwe ‘n behoeftedathierdieuitdagingsvanuit die perspektiewe van die studentebeskou word in ‘n poging om hulle op die meeseffektiewemanierteondersteunentebegelei. - Doelstelling: Die doel van hierdie studie is om die perspektiewe van eerstejaarstudente aan die Universiteit van Zimbabwe se Fakulteit Gesondheidswetenskappe (UZCHS) te ondersoek wat betref die oorgang van hoërskool na die UZCHS, en wyses voor te stel om die oorgangsfase te bestuur, gebaseer op die studente se perspektiewe. - Doelwit: Die doelwitte van hierdie studie was om te bepaal wat die studente se perspektiewe was oor die verskeie welbekende problematiese faktore teenwoordig in die oorgang van skool na universiteit. - Ontwerp: ʼn Evaluerende navorsingsontwerp is onderneem deur ʼn gemengde navorsingsmetode te volg. Dit is opeenvolgend deur ʼn kwantitatiewe en kwalitatiewe metode toegepas. - Metode: ʼn Self-administrerende vraelysopname met 23 geslote vrae is ewekansig toegepas en versprei aan vierhonderd ses- en tagtig (486) studente van die UZCHS. Slegs 16 vrae is vir die doeleindes van hierdie studie geanaliseer. ʼn Onderhoud met in-diepte gestruktureerde vrae is ook gevoer met ʼn ewekansig geselekteerde groep studente (49) van elk van die programme wat aangebied word by die UZCHS. - Resultate: Die responskoers was 51% (246/486); 81.4% van die studente was in die ouderdomsgroep 19 tot 20 jaar; 52% was manlik en 48% vroulik; 44.4% van die studente was geregistreer vir die MBChB program. Die uitdagings deur die studente ervaar was onder andere die swaar werklading, swak studente-ondersteuningsdienste, om by te bly by die rooster, die gebruik van die biblioteek, swak dosent-student verhouding, ʼn swak gevoel van behoort aan, en om deel te wees van ʼn diverse samelewing. Frustrasies by die UZCHS het hul oorsprong gehad by akademiese kwessies: eksamenpunte; uitslae en swak terugvoering. Studente-finansiering aan die universiteit was ook ʼn bron van kommer by studente. Studente het die oriëntasieweek die nuttigste gevind. Die motivering om aan te sluit by die UZCHS het verband gehou met loopbaanvooruitsigte, persoonlike behoeftes en ouer-invloed. Voorbereidende inligting verskaf deur die UZCHS is beskou is voldoende maar sonder genoeg besonderhede. Faktore wat studente gehelp het om tuis te voel was die aanvanklike ontvangs, oriëntasieweek, en die verhoudings tussen studente, personeel en lektore. Die rol van ouers, portuurgroep en vriende om hulle te laat tuis voel, is aangedui as belangrik. - Gevolgtrekkings: Die studente se perspektiewe op oorgang is soortgelyk aan dié wat in die literatuur gerapporteer word. Daar is ʼn behoefte aan beter studentebehuising en biblioteekfasiliteite en studente-ondersteuningsdienste, en meer gedetailleerde informasie oor die UZCHS voor toelating. Studente glo ook dat die oriëntasie week verleng moet word en dat die werklading verminder moet word om hul buitemuurse sosiale lewe te akkommodeer. Studente se voorbereiding vir die studentelewe en universiteitstudies behoort reeds op hoërskool te begin.