Medical schools have been reviewing their curricula to prepare caring and competent health professionals in the midst of a knowledge and technology explosion. The implementation of problem-based learning curricula signalled attempts to make learning more significant, based on constructivist perspectives that emphasise social interaction for meaning making and understanding. Available literature suggests that learning in PBL should be assessed by authentic, contextual real-life tasks that support and encourage students’ learning. To this end, the Nelson R. Mandela School of Medicine implemented the progress examination (PE) to complement the aims of Curriculum 2001 (C2001). The potential formative function of the PE was specifically appealing in terms of allowing for the development of reflective, self-directed and deep learning. Early explorations revealed an apparent mismatch between the aims of C2001, the expectations of stakeholders and their experiences with the PE at the site and these resulted in a number of adaptations to the examination. Cognisant of the influence of assessment on students’ learning, this study sought to examine whether the educational principles governing the implementation of C2001 also informed the implementation and adaptations of the PE. Using a qualitative case study methodology, the study investigated stakeholders’ understandings of the PE and its goals and the lived experiences of its implementation as a suitable tool to assess students’ cognitive learning. In addition, the study also investigated the possible factors that influenced the reform. Findings suggest that the PE was not suitable to assess students’ learning in C2001. Despite the perceptions of a strong educational need for curriculum reform and the apparent suitability of the PE, some members of staff lacked understanding, skill and confidence to apply and implement its aims. Staff failed to apply transformative practices of teaching and learning, while the principles of the PE and C2001 were not well diffused through the organisation. Members of staff expected the PE to differentiate between high and low performing students, while students came to regard the examination as just another hurdle in an already hostile learning environment. Factors such as the unstable and poor leadership, the restructuring of the health and education sectors, impacted on the implementation of the reform. Curriculum and assessment reform is challenging for students and lecturers, requiring the transforming institution to actively prepare and support stakeholders in a conducive educational climate. This case study highlights the need for comprehensive planning for effective and sustained curriculum reform. Collaborative strategies and educational systems should be sought and implemented to sustain conceptual and practical reform. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2009.

This study explores problem-based learning (PBL) as a form of pedagogy, and its interrelationships with the students, staff members and institution of the Medical Faculty at the University of KwaZulu-Natal. Little has been written previously about the interaction of student diversity and resource-constrained circumstances with PBL. I investigate perceptions and experiences of PBL as a pedagogic strategy, using Bernstein's theories of classification and framing as an organising framework. I draw also on his writings on discourses and knowledge structures and the pedagogic device. Within an interpretive methodology, I use three methods to generate data. I analyse numerically the test marks of a cohort of 202 students over three years for demographic influences on pedagogic engagement. I explore in semi-structured interviews the perceptions and experiences of PBL of 19 students and 6 staff members, and relate these to Faculty documents; I analyse these sources thematically in order to describe the roles of student, teacher and institution. These perceptions and experiences I then examine according to the eight elements of Bernstein's classification and framing. A number of contradictions emerge: between PBL theory, echoed by Faculty documents on one hand, and staff/student perceptions and experiences on the other; between staff members and students at some points but not at others; between high-achieving and low-achieving students; between different respondents' under-standings of "integration". Some demographic characteristics prove on analysis to be highly significant influences while others, counter-intuitively, are not. Bernstein's theories about knowledge structures are pertinent to the tensions revealed. Medicine has thought of itself as akin to the pure sciences – implying a hierarchical structure in which all knowledge aggregates towards a point of abstraction. However, the structure and function revealed by respondents suggests a horizontal knowledge structure, in which disciplinary knowledge is kept distinct. Students and teachers thus struggle to integrate areas of knowledge that are inherently discrete. In terms of Bernstein's "pedagogic device", some students are able to discern PBL's implicit rules of engagement, while others are not. Consensus on medicine‟s knowledge structure might settle ambiguities and help PBL achieve its potential as a complex pedagogy in a complex field. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2012.

How do medical students experience autopsy demonstrations that form part of the undergraduate curriculum? This was the primary question guiding this phenomenological study within the interpretive paradigm. Both explicit cognitive outcomes and elements of the “hidden curriculum” associated with autopsies were evaluated. Most previous studies on this topic employed survey questionnaires and were conducted prior to the radical curriculum reformations in medical undergraduate training. Some of these pedagogical changes have threatened the use of autopsies for teaching. More recently some other studies concentrated on aspects that were not directly related to educational outcomes. Burton (2003) conducted a phenomenological study interviewing medical educators about the uses of autopsy in the modern undergraduate curriculum, essentially detailing the “delivered curriculum”. Therefore this study focused on the “received curriculum”. Interviews were conducted with 10 medical students in their 4th year of study, having attended medico-legal autopsy demonstrations forming a central part of a course in Forensic Medicine. The underlying assumption of the study is that ‘student voices’ need to be heard in determining what is taught and how (Brooker & MacDonald, 1999), something typically determined by academic staff. This need is especially highlighted in a climate of “self-directed learning” promoted by modern medical curricula. The data are analysed qualitatively using a theoretical framework of three dimensions of learning (Illeris, 2004): (1) cognitive content dimension, (2) emotional psychodynamic, attitudinal and motivational dimension, (3) social-societal dimension. Findings of the study show that medical students perceive autopsy demonstrations to be of considerable benefit to their learning; both cognitive and affective outcomes are discussed detailing individual contextual factors that influenced the outcomes. Some suggestions regarding curriculum and autopsy-based teaching are made in the light of various factors found to influence students’ attitudes towards autopsies. / Thesis (M.Ed.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

Doctor of Philosophy / Similar to their colleagues throughout the world, nurses and midwives in New South Wales (NSW), Australia, welcome evidencebased practice (EBP) as a means to improve patient or client outcomes. This thesis explores the way nurses and midwives understand evidence for EBP and aims to determine whether members of these professions currently have the knowledge and skills necessary to implement evidence‐based care. Three separate studies were conducted to explore NSW nurses’ readiness for EBP. Attitudes, knowledge and skill were investigated using an EBP questionnaire returned by 383 nurses. The views of 23 nursing opinion leaders were elicited during qualitative in‐depth interviews, and their ideas on maximising the potential for future nurses to confidently engage in EBP were explored. Current approaches to teaching EBP in undergraduate nursing programs were investigated by examining documents issued by NSW nursing education providers. The results demonstrate many differences between the ways NSW nurses currently understand evidence for EBP, and a range of approaches to teaching EBP in undergraduate nursing programs. Under current conditions, nurses graduating from universities in NSW commence practice with varying levels of preparation for EBP and enter into a professional arena that is itself struggling to cope with the concepts and language of this approach to improving healthcare. v Evidence for the effectiveness of EBP is slowly accumulating and despite some small positive signs, the collective results of this thesis suggest that current educational approaches are not capable of producing the kind of results that are both necessary and desirable for the promotion of evidence‐based nursing practice in NSW. Articulating a commitment to EBP, using a common language and a consistent approach are among the recommendations made for the future promotion of EBP in nursing education.

Made available in DSpace on 2014-06-11T19:33:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-05-27Bitstream added on 2014-06-13T19:23:32Z : No. of bitstreams: 1 carvalhofilho_cj_dr_mar.pdf: 1708457 bytes, checksum: 6b04d1b8f52d6d246726c823643bd44a (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Unidade Ffc / A presente investigação discute o processo de implantação do novo Projeto Político Pedagógico do Curso de Medicina da Universidade Federal do Maranhão (UFMA). Apresenta uma pesquisa com os estudantes das quatro primeiras turmas que freqüentaram este novo currículo. A partir do trabalho de campo, objetiva: discutir as bases teóricas do novo projeto, incluindo a Pedagogia das Competências, as Metodologias Ativas de Aprendizagem e a Aprendizagem baseada em Problemas; analisar o percurso da implantação, englobando as suas redefinições e dificuldades; contextualizar as mudanças do ensino médico na UFMA com a história e as grandes questões colocadas no campo da Educação Médica. Numa investigação de cunho quali-quantitativo, utiliza-se da análise de conteúdo para investigar os discursos dos alunos captados em questionários, em perguntas abertas, fechadas, baseadas na escala de Likert e em comentários livres. A análise dos resultados produziu como conclusões: o processo de implantação do novo projeto pedagógico encontrou graves dificuldades, levando à redefinição das suas diretrizes metodológicas, em razão de condições estruturais do curso e da universidade deficientes, com precário apoio de laboratório e de suporte à pesquisa, imprescindíveis para a utilização das novas metodologias; dificuldades inerentes à implantação de um sistema baseado em diretrizes construtivistas, que determina mudanças nas teorias implícitas de ensino e aprendizagem de professores e alunos; fraco envolvimento de professores e alunos no processo; apoio pedagógico e programas de capacitação docente insuficientes; falhas na elaboração, discussão e do projeto curricular com a comunidade universitária... / This investigation approaches the process for the implantation of the new Political Pedagogic Project for the Medical Course at the Federal University of Maranhão (UFMA). It presents a research involving students from the first four classes that attended this new curriculum. From the starting point of field work it aims at: discussing the new project‟s theoretical bases, including Competence-based Pedagogy, Active Learning Methodologies and Problem-based Learning; evaluating the implantation path, encompassing its redefinitions and difficulties; and contextualizing changes within medical teaching in the UFMA by means of exploring history and major issues that were advanced in the field of Medical Education. In a quality-quantitative investigation, researchers resorted to the content analysis of questionnaires bearing data from students in open and closed questions based on Likert scale and free commentaries. Analysis of results provided the following conclusions: the implantation process of the new pedagogical project was hampered by serious issues, which led to the redefinition of its methodological guidelines due to the course‟s structural conditions and ill-functioning universities lacking laboratorial support to research, an item of invaluable importance to include new methodologies; detection of inherent difficulties to the implantation of a system based on constructivist guidelines which determine changes within implicit theories for teaching and learning directed to teachers and students; uninspired participation of teachers and students in the process; inadequate pedagogical support and faculty development programs in order to improve teachers' performance; failure in the elaboration… (Complete abstract click electronic access below)

Orientador: Hélia Sônia Raphael / Resumo: A presente investigação discute o processo de implantação do novo Projeto Político Pedagógico do Curso de Medicina da Universidade Federal do Maranhão (UFMA). Apresenta uma pesquisa com os estudantes das quatro primeiras turmas que freqüentaram este novo currículo. A partir do trabalho de campo, objetiva: discutir as bases teóricas do novo projeto, incluindo a Pedagogia das Competências, as Metodologias Ativas de Aprendizagem e a Aprendizagem baseada em Problemas; analisar o percurso da implantação, englobando as suas redefinições e dificuldades; contextualizar as mudanças do ensino médico na UFMA com a história e as grandes questões colocadas no campo da Educação Médica. Numa investigação de cunho quali-quantitativo, utiliza-se da análise de conteúdo para investigar os discursos dos alunos captados em questionários, em perguntas abertas, fechadas, baseadas na escala de Likert e em comentários livres. A análise dos resultados produziu como conclusões: o processo de implantação do novo projeto pedagógico encontrou graves dificuldades, levando à redefinição das suas diretrizes metodológicas, em razão de condições estruturais do curso e da universidade deficientes, com precário apoio de laboratório e de suporte à pesquisa, imprescindíveis para a utilização das novas metodologias; dificuldades inerentes à implantação de um sistema baseado em diretrizes construtivistas, que determina mudanças nas teorias implícitas de ensino e aprendizagem de professores e alunos; fraco envolvimento de professores e alunos no processo; apoio pedagógico e programas de capacitação docente insuficientes; falhas na elaboração, discussão e do projeto curricular com a comunidade universitária... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This investigation approaches the process for the implantation of the new Political Pedagogic Project for the Medical Course at the Federal University of Maranhão (UFMA). It presents a research involving students from the first four classes that attended this new curriculum. From the starting point of field work it aims at: discussing the new project‟s theoretical bases, including Competence-based Pedagogy, Active Learning Methodologies and Problem-based Learning; evaluating the implantation path, encompassing its redefinitions and difficulties; and contextualizing changes within medical teaching in the UFMA by means of exploring history and major issues that were advanced in the field of Medical Education. In a quality-quantitative investigation, researchers resorted to the content analysis of questionnaires bearing data from students in open and closed questions based on Likert scale and free commentaries. Analysis of results provided the following conclusions: the implantation process of the new pedagogical project was hampered by serious issues, which led to the redefinition of its methodological guidelines due to the course‟s structural conditions and ill-functioning universities lacking laboratorial support to research, an item of invaluable importance to include new methodologies; detection of inherent difficulties to the implantation of a system based on constructivist guidelines which determine changes within implicit theories for teaching and learning directed to teachers and students; uninspired participation of teachers and students in the process; inadequate pedagogical support and faculty development programs in order to improve teachers' performance; failure in the elaboration… (Complete abstract click electronic access below) / Doutor

The purpose of this study was to determine and compare faculty perceptions of areas of concern that have been identified by osteopathic medical education administrators as having a relationship to institutional needs and goal setting. Specifically, a Delphi research technique was used to examine faculty perceptions of osteopathic perspective in relation to (a) the philosophical and functional orientation of the curriculum; (b) actual design, structure, and implementation of the curriculum; (c) location and design of the physical facilities and the campus environment; (d) faculty issues of tenure, promotion, salary, and merit; (e) teaching, and the evaluation of teaching; (f) student characteristics and admissions policies; and (g) administrative structure and communication networks.

The purpose of this project is to develop a curriculum, which will examine the ethical methods or practices used by nurses in resolving ethical dilemmas in clinical practice utilizing the Moral Decision-Making Model for staff nurses at St.Bernardine Medical Center, Five Tower North.

The science and technology of medicine is evolving and changing at a fast pace. With these rapid advances, it is paramount that physicians maintain a level of medical knowledge that is current and relevant to their practice in order to address the challenges of patient care and safety. One way physicians can maintain a level of medical knowledge that is current and relevant to their practice is through self-directed, lifelong learning, however little is known about how to develop these traits during clinical training. Schön (1983, 1987) theorized that one way learners can become self-directed, lifelong learners is through reflective practice. This study utilized an experimental design and employed quantitative methods to investigate the effects of a reflective practice exercise, based on Gibbs' (1988) model of reflection, on readiness for self-directed learning as measured by Guglielmino's (1977) Self-Directed Learning Readiness Scale/Learning Preference Assessment (SDLRS/LPA). A total of 51 anesthesiology residents training in three residency programs in the United States participated in this study. A follow-up survey was administered to all study participants to determine if participation in the reflective exercises affected future engagement in or attitudes about reflective practice. While the data analysis showed that participation in reflective practice did not affect readiness for self-directed learning in these study participants, this study has implications for medical education. Responses to the follow-up survey indicated that participants plan to engage in reflective practice in the future and that participating in reflective practice would have an impact on patient care. Chapter 5 includes ways to integrate the findings of this study into medical education and outlines next steps for future research utilizing both evidence from the literature and the qualitative responses from this study.

Indiana University-Purdue University Indianapolis (IUPUI) / The anatomical sciences are experiencing a notable decrease in the time and resources devoted to embryology in North American medical education. With more changes assured, it is necessary to investigate the current trends in curriculum, pedagogy, and related experiences of embryology teachers and learners. To address these concerns, the researcher developed two online mixed methods surveys: one for current anatomy and embryology faculty and another for first year medical students. The faculty survey was followed by interviews with volunteers from that cohort. The researcher used a grounded theory methodology to analyze the qualitative components of the surveys, and descriptive statistics to analyze the quantitative components of the surveys. Both the faculty and student surveys illuminated the vast differences between the explicit, implicit, and null curricular components found in the numerous medical education programs represented. A combined grounded theory methodology and phenomenological approach was used to analyze the interviews with faculty. This generated a lived experience narrative of the phenomenon of teaching embryological content to medical students in the modern world, which led to a better understanding of the needs and challenges that face this subject matter and those who teach it. In this fluid era of medical education reform and integration, the perceptions and experiences of anatomy and embryology faculty and first year medical students are invaluable to assessing the curriculum and pedagogy of this foundational anatomical science and formulating evidence-based recommendations for the future.