Thesis (MPhil)-- Stellenbosch University, 2013. / ENGLISH ABSTRACT: At the core of clinical education, within the allied health professions, is the teaching-learning relationship between the clinical educator and the student which is reinforced by and grounded in the explanatory theories of socio-constructivism, experiential learning and positioning. A good teaching-learning relationship is fundamental to the success of the students’ learning in the clinical environment. Clinical educators fulfil a dual role as mentors and assessors to students. The purpose of this study is to explore the students’ and clinical educators’ perceptions of the dual role of a clinical educator of students in the physiotherapy clinical environment, and how the perceptions of both parties influence the teaching-learning relationship. By following a phenomenological qualitative research approach with an interpretivist paradigm the researcher obtained data from focus groups and individual interviews. Data analysis involved a contextualised interpretive content analysis paradigm. The perceptions of the participants in the teaching-learning relationship, their particular expectations, challenges and preferences, reflect their experiences and are presented in the findings of the study. The findings of this study are comprehensively discussed and recommendations are made to transform the teaching-learning relationship by repositioning the participants (both students and clinical educators) in order to enhance the quality of the clinical learning experience within the physiotherapy clinical environment. / AFRIKAANSE OPSOMMING: Die onderrig-leerproses-verhouding tussen die kliniese dosent en die student vorm die kern van kliniese onderrig, ondersteun deur en op grond van die verduidelikende teorieë van sosiale konstruktivisme, leerervaring en posisionering, vir verwante gesondheidsberoepe. Die onderrigleerproses- verhouding word daarom beskou as die grondslag vir die sukses van leergeleenthede, aangesien die kwalitiet van die verhouding deurslagggewend is om studente se leerproses in die kliniese omgewing te ondersteun. Kliniese dosente speel ‘n dubbele rol as mentors en assessore vir studente. Die doel van die studie is om studente en kliniese dosente se sienings van die dubbele rol van ‘n kliniese dosent van studente binne die kliniese onderrigveld van fisioterapie in die kliniese omgewing te ondersoek, asook hoe die persepsies van albei partye die onderigleerproses- verhouding beinvloed. Die data word verkry van fokusgroepe en individuele onderhoude deur ‘n fenomenologiese kwalitatiewe navorsingsbenadering met ‘n interpreterende paradigma te volg. Die data is ontleed volgens ‘n kontekstuele interpreterende inhoudsontledingsproses. Die persepsies van die deelnemers aan die onderrig-leerprosesverhouding, hul spesifieke verwagtinge, uitdagings en voorkeure as drie breë temas van hierdie tesis, weerspieël hul ervarings en word weergegee in die bevindings van die studie. Die navorsing bespreek hierdie bevindings en doen regstellende aanbevelings oor die bevindings. Hierdeur kan die onderrig-leerproses-verhouding, deur herposisionering van albei partye (studente sowel as kliniese dosente), getransformeer word en die gehalte van die kliniese leerervaring in die fisioterapeutiese kliniese omgewing verbeter word.

Thesis (MA)--Stellenbosch University, 2000.

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2007. / Research regarding caregivers in institutions for people with intellectual impairment has traditionally focussed on aspects of pathology, such as stress and burnout. In the past three decades there has been a shift towards a stronger focus on individuals' competencies and strengths. This paradigm shift has contributed to the development of the term ‘Quality of Life’. This study focuses on the perceptions of formal caregivers in an institution for the intellectually impaired about their Quality of Life. The aim was to understand the selfperceived quality of life of staff caring for adults with intellectual disabilities using Positive Psychology theories. Based on fortigenic assumptions regarding human functioning, the influence of stress on formal caregivers and also positive experiences and the factors that enable these caregivers to rise above hardships of their occupation, were investigated. This qualitative interpretive study was conducted in an institution for adults with intellectually impairment and twelve caregivers at the institution willingly participated. Data were generated through structured open-ended, informal and a focus group interview and later analysed thematically. The themes discussed in the study evolve around the caregivers’ perception of 1) their definition of quality of life, 2) their current quality of life, 3) the negative factors, stressors, positive experiences and psychofortological factors impacting on their quality of life, and 4) possibilities for improving their quality of life. Based on the relation between the above mentioned themes, the quality of life of the caregivers appears to be a product of their relationship with the adults with intellectual disabilities. Therefore, the findings indicate a paradox of care-giving where the participants not only report on care-giving, but also on care-receiving within their relationship with the adults with intellectual disabilities. In this relationship care-giving seems to be a fortigenic factor for the most of the participants and also a means for interpersonal flourishing. On the basis of these findings several recommendations are made for further research, with a view to striving towards improving the quality of life of staff caring for adults with intellectual disabilities.

Mémoire (M.P.M.O.)--Université du Québec en Abitibi-Témiscamingue, 1989. / Ce mémoire à été réalisé à l'Université du Québec en Abitibi-Témiscamingue dans le cadre du programme de la Maîtrise en gestion des petites et moyennes organisation, extensionne de l'Université du Québec à Chicoutimi. CaQCU Document électronique également accessible en format PDF. CaQCU

The shortage of healthcare workers and doctors in the developing world compared to the developed world is a problem, and will continue to be so, due to the continual migration of qualified professionals and the inability of the state to remedy these shortfalls. A shortage of healthcare workers and specialist doctors will seriously hamper the Government’s National Health Insurance (NHI) plan, as well as the sustainability of the private health care sector. In addition, the duration of medical training in South Africa is exceptionally long. The three major hospital groups and other private corporates have over the last number of years taken limited initiative to fund education projects in conjunction with the academic institutions. However, these projects have been poorly focused and have been managed in an unstructured and detached manner. There is a desire from the private sector to get involved in these projects on a much larger scale through more formalised structures. Given this background, the primary objective of this research is to develop a business model for medical subspecialty training to complement the current academic subspecialty training in South Africa. A trial model for training subspecialists in reproductive medicine was developed as a first attempt to address the threatening shortages and training duration. This trial programme is the basis of this research. A two-phased process was used in collecting data. In Phase 1 data was collected from stakeholder groups. The results of this survey assisted in generating variables to include in the measuring instrument for the survey in Phase 2. In Phase 2 the perceptions and expectations of sub-specialists (reproductive subspecialists and cardiologists) regarding sub-specialty training was collected. The results of the demographic variables confirm the aging profile of subspecialist and the need to ensure succession. The results further showed that cardiologists and reproductive subspecialist expectations of the training of subspecialists are very similar except for their expectations on the training duration. Reproductive subspecialist respondents agreed more than cardiology subspecialist respondents that the training duration is too long. The biggest gap between perceptions and expectations is also with the factor training. The results showed that the expectations of subspecialists are not met for training. From these results a business model for the training of medical subspecialists is proposed. This proposed business model can play a complementary role to the existing state controlled system and form the bases of Public Private Partnerships (PPP) in medical training. This proposed business model will fit a developing country were the focus is on primary healthcare, with financial and capacity constraints. The proposed model would require role players to bring about change to accommodate a larger scale Public Private Partnership (PPP) to ensure the implementation of the model. The proposed decentralised business model for training subspecialists would allow the trainee subspecialist to practise as a specialist thus maintaining an acceptable income, and enable an expedited completion and lead to a wider dissemination of medical expertise that can be delivered in a wider national foot print. It further will provide for a structured Public Private Partnership.

All schools must have access to a pupil health care team where dilemmas that arise in pedagogical practice must be treated with the aim of preventing students from getting into school difficulties. Pupil health care teams must have access to multiple professions who, based on their professional perspective, must nuance the perceived problem and find a consensus on how this should be handled in the best way. Based on guidelines from the School Act, this work must now take place from a salutogenic (health-promoting) and preventive perspective. This entails a work of change within the pupil health team that affects the school as an organization. The study has investigated how the salutogenic and preventive work of change imposed on schools affects pupil health's work in dealing with school difficulties. This qualitative study has used semi-structured interviews and observations as a method, in order to gain knowledge about the work of the pupil health teams. Six interviews were conducted with professions that belongs to pupil health team (principal, special education need teacher, school psychologist). In addition, six observations of student health meetings were carried out at three different schools. Collected data were then analyzed based on concepts related to organizational learning to create an understanding of how change of work develops. The results of the study show that there is an awareness among the pupil health professions that they are expected to work salutogenically and preventively, but they express difficulties in how this should be carried out in practice. There are questions about who should do it, how it should be structured, whether it is already being done and if they already work in this way, there is a risk of not taking care of the children who are already in school difficulties. The pupil health teams that are investigated have access to several different professions and strive for cooperation and that the different professional perspectives are taken into account. However, the interviews show that this cooperation does not always work fully and that the different professional languages can make cooperation difficult. The principal's role as the one who contributes with visions, structure and the release of resources is noticed in the study as essential for the change work to be able to lead to organizational learning and competence development for the entire organization and not just individual employees. Ways of adding competence within the college are noticed in the study such as tutoring time with a special education needs teacher or the presence of the pupil health team's professions at ”årskurslags”-meetings. The responsibility for students who have found themselves in school difficulties should not be left to the individual teacher, but should be handled in consensus with the pupil health professions.

Informed by constructivist and social constructionist theory, a qualitative research study was conducted applying Andersen’s (1991) reflecting team model to explore use of self themes in the supervision process. A male and female Supervisor were paired with a male and female therapist to form two person supervision and reflecting teams. Four RTS sessions were conducted. Each RTS session involved three phases: 1) supervision of a case with the reflecting team observing, 2) reflecting team discussion of their observations with the supervision team observing, and 3) supervision follow-up by the supervision team with the reflecting team observing. The three phases of the RTS process led to three derivations of the original therapist story. The RTS process was discussed after each session in the post-session discussion. Utilizing the reflections of the reflecting team from Phase 2, a difference that makes a difference was introduced into the supervision story. In Phase 3, the supervision follow-up, the supervisor helped the therapist explore previously non-conscious use of self themes in the supervision narrative and construct a different narrative about him/herself and the case brought for supervision. The nature of the points of connection established in the socially constructed conversation between the therapist and client(s) was pertinent to the establishment of a "relational distance" between the client and the therapist that was too close or too distant. The supervisor not only helped the therapist become aware of the points of connection but also helped introduce a difference that allowed the therapist to be more maneuverable. All three phases of RTS are important to a supervision process. The role of the reflecting team in uncovering the "unsaid," and the supervisor in creating a difference possibly become less critical as supervisors develop reflexivity and incorporate these two phases into their typical supervision process. / Ph. D.

Thesis (PhD (Education))--University of Stellenbosch, 2006. / During the past twelve years of democracy health care services in South Africa have been influenced by political, social and economic change. As a result of the transformation of health care services and the change of political policy, the focus on primary health care increased. During the early stages of the transformation of health care services stakeholders realized that in order to provide an extensive health care service specialized training is required. Various educational institutions provided formal and informal programmes in order to meet the new challenges of the nursing profession. Although minimum requirements of the content and clinical practice have been established by the nursing council, the mode of presentation, costs, duration and type of qualification awarded to clinical nursing practitioners differed substantially. Uniformity in terms of programme content was lacking, neither were any scientifically founded attempts made to establish whether these programmes fulfilled the needs of the student in the rural community. Although a variety of training programmes exist the number of trained clinical nursing practitioners is still inadequate. In addition training is focused on the urban community. The objective of the research was to determine the opinion of the rural nurse on clinical nursing education, and to develop a training framework based on their input which would meet their needs. This research was conducted from an explanatory-descriptive paradigm. The case study was used as research design. A literature study on the development of primary health care both internationally and nationally was done. The literature study revealed the development of training programmes for clinical nurses. Chapter three of the literature study is dedicated to the theoretical aspects of the design of a student centered training framework for the adult student. A student centered training framework has created from data gathered via questionnaires completed by clinical nurses and semi-structured interviews with semi-qualified nurses. Semistructured interviews have also been conducted with the supervisors of nurses working in clinics and community health centres in the Northern Cape. The conclusion that respondents showed a positive attitude towards training in clinical nursing was encouraging. The majority of respondents indicated that they would welcome an additional qualification which will improve their knowledge and would result in better patient care. The respondents highlighted staff shortages, financial constraints and family responsibility as the main obstacles towards these qualifications. During the research it became clear that no formal training is currently available in Kimberley. This is as a result of the absence of mentors. Although the respondents have limited access to computers they indicated that they would prefer computer supported training in conjunction with physical contact sessions. The research indicated that no formal policy on the training of clinical nurses exists in the rural Northern Cape. In the absence of a training framework the research further contributed towards the development of a student centered training framework for clinical nurses in rural Northern Cape. The research succeeded in highlighting the necessity for formal policy on the training of clinical nurses in rural Northern Cape.

A combined, multiple-methods action research strategy is constructed and used to assess teams of personnel working in and around group homes for mentally retarded adults and young offenders in the Canadian Province of Newfoundland and Labrador between August, 1983 and January, 1987. Grounded in the practise experiences and previous research of the author, the question "what works?" is developed both as a contextual framework for the examination of teamwork as a component of professional practise and as a contextual feature of group care. The question is used to guide categorization and organization of differences amongst 51 sample teams in order to isolate valid and reliable measures of team work functioning. Drawing from four distinct theoretical traditions comprising core knowledge of human behaviour in the social environment, multiple methodologies for differentiating within and amongst teams are combined to triangulate data around the central research question. A methodology for the collection and analysis of data which are thought to represent the "lived experiences" of sample subjects is developed and used to illuminate the phenomenological alignments of team members. Qualitative themes in the reports of on- and off-the-job satisfactions and frustrations for sample subjects are examined for teams and for occupational groupings. Separate measures of Level of Organizational Change and Prevalence of Stressful working Conditions are developed and used to examine the interplay between these variables and other preselected variables. The assessment procedures and the typology of team functioning developed by Fulcher (1983) are replicated. Specific flaws and limitations in Fulcher's methodology and design are overcome through the use of a different theoretical orientation, extensions and refinements of the methodology, changes in instrumentation and by replicating his findings with a more homogeneous sample. Four of the team styles of adaptation are empirically validated and their descriptions refined. Both linear and non-linear statistical analytic methods are used to test for correlation and association between and among preselected variables. The Heimler/Fulcher Work Orientation Schedule, which serves as the basis for Fulcher's interpretative categorization of teams, is subjected to tests of reliability and validity and found to meet predetermined expectations. Through the use of an international, comparative data base, norms for team satisfaction and ratio of frustration to satisfaction for this instrument are empirically validated. Further research using Fulcher's typology along with the Work Orientation Schedule is indicated. Field observation recordings, sample subjects' personal narratives, the social policy and corporate contexts in which the study takes place, and a mythical, yet ultimately necessary, experiment which takes place in the future are all used to illuminate and ground the findings in the action research process.

The purpose of this explanatory sequential mixed methods study was threefold. First, this study compared the effects of two different simulation-based instructional strategies on athletic trainers’ clinical competence in performing cardiovascular screening with cardiac auscultations. Second, this study identified the athletic trainers’ perceptions of learning through simulation-based instructional strategies. Third, this study attempted to identify and offer instructional recommendations based on the outcomes. The quantitative phase analyzed cognitive and diagnostic reasoning knowledge and history-taking and clinical skills specific to cardiovascular screenings with cardiac auscultations as it was taught to athletic trainers (ATs) at a continuing professional education (CPE) course. The quantitative results found that high-fidelity and low-fidelity simulation-based instructional strategies significantly increased cognitive and diagnostic reasoning knowledge and history-taking and clinical skill from pre-test to post-test assessment on all dependent variables. When comparing the two fidelity types to each other, the analysis found that the participants in the high-fidelity simulation group gained significantly more skill when compared to the low-fidelity group. In the qualitative analysis of this study, three themes emerged specific to the perceptions of the athletic trainers’ experiences as they learn through simulation-based instructional strategies. The first theme that emerged was a clear indication that participants’ exhibited positive perceptions of learning through simulation-based instructional strategies. The second theme that emerged was that the high-fidelity simulation experience during the pre-assessment and post-assessment raised an awareness of the deficit of knowledge and skills in performing a comprehensive cardiovascular screening with cardiac auscultations. Lastly, the third theme that emerged was specific to the perceived limitations in the effectiveness of low-fidelity simulation and the perceived strengths in the effectiveness of high-fidelity simulation. A few instructional recommendations emerged from this dissertation study. Simulation-based instructional strategies are an ideal teaching method to utilize during continuing professional education courses with athletic trainers. Specifically, this study identified that both, high-fidelity and low-fidelity simulation, are effective in teaching cardiovascular screening with cardiac auscultations. Additionally, the participants perceived influences of a pre-test on the identification of their knowledge and skills deficit suggests that there are benefits of utilizing an authentic simulation pre-test as part of CPE courses. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection