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No description available.

No description available.

Compared to other developed countries, the United States has healthcare spending that far outpaces other nations, but achieves below-average life expectancy. In urban cities, this disparity is most striking among predominantly black and Latino communities. There is increasing recognition that the reason for this is improper allocation of resources; we have a system that funds clinical services which contribute to only 20% of health outcomes, while providing inadequate support for social and environmental factors which account for 80% of the impact. When one considers the history of the United States, it becomes clear that such a system is not only inefficient, but also fundamentally unjust. African American patients have been used (often without consent) to obtain much of our current medical knowledge, but suffer most from healthcare disparities. Medical school is a fascinating lens from which to view this healthcare system, as students stand at the threshold between layperson and physician. Medical students, who predominantly come from backgrounds of privilege, benefit from access to institutions of medical knowledge. They often practice their fledgling skills on urban underserved patients who are disproportionately cared for in academic medical centers. Medical students also participate in service projects in the surrounding community, with common projects involving schools, churches, and free clinics. As a medical student, I spent nearly 100 hours with a class of ninth grade students at a Philadelphia public high school as I developed and implemented a health careers elective program. Through this experience, I gained a firsthand appreciation for the incredible barriers that prevent urban underserved students from equal representation in our medical schools and health care workforce. Here, I reflect on my experiences over the course of medical school, review relevant literature in the fields of ethics, medicine, education, and history, and present recommendations to move us closer to a just healthcare system by increasing investment in underserved communities and instilling in medical students a moral imperative to reduce health disparities, as well as the tools to do so effectively. / Urban Bioethics

In Practice Makes Practice: A Critical Study of Learning to Teach Deborah Britzman (2003) points out that teacher candidates enter their education programs with their own conceptions of teaching, “bring(ing) to teacher education their educational biography and some well-worn and commonsensical images of the teacher’s work” (p. 27). Similarly, teacher candidates bring their own preconceived ideas of literacy and community to their teaching as well. This study focuses on whether or not teacher candidates’ conceptions of literacy and community can change given a teacher education practicum focused on literacy and community, a community learning experience once a month, and two placements in local middle and high school classrooms. In doing so it inquires as to how each of these different classroom environments informs teacher candidates’ conceptions of literacy and community and how literacy and community is utilized in these different environments. Qualitatively and ethnographically based, the study took place at a state university in rural Pennsylvania. It focused on nine teacher candidates enrolled in a practicum course during their 16-week field experience. It utilized a card sort, surveys, e-mails, teacher candidate journals and assignments, audio taped transcripts of practicum classes and observations. All information was analyzed using constant comparison methods and journals and practicum classes were coded to identify changes over the semester and patterns in the data. The study found that teacher candidates’ conceptions of literacy and community changed over a sixteen week time period as a result of the three different environments that teacher candidates participated in during their field experience semester. Teacher candidates’ conceptions of literacy, once focused on more autonomous literacy practices, expanded to include more sociocultural, i.e. ideological literacy practices. Conceptions of community that were based on more homogeneous, relational conceptions of community grew to include more heterogeneous, geographic conceptions of community. Overall, given three environments focused on literacy and community teacher candidates’ expanded their ideas of literacy and overcame their fears of working with communities outside their own. Correlations were also uncovered relating to authority in each of the environments and the importance of teacher candidate/cooperating teacher relationship to placement success. / English

As medical students undergo their clinical years, they exhibit a well-documented loss of idealism, increasingly negative attitudes towards poor and underserved patients, and less interest in working with these patients. Here we describe the pilot year of a longitudinal service-learning requirement implemented as a part of the medical student pre-clinical curriculum. We hypothesized that increased non-clinical contact would decrease the formation of negative attitudes towards underserved patients. Students completed service hours at assigned community sites each semester along with written reflections. Surveys were administered to track attitudes towards the underserved. Written reflections were analyzed qualitatively for thematic content as well as feedback on the experience. The requirement was largely acceptable to medical students, and many found value and enjoyment in the experience. The most common critique was that the required hours were insufficient to develop continuity, and that students desired more thorough briefing beforehand to increase their effectiveness. Students reported practicing clinical skills and communication skills. They identified social determinants of health and learned about their patients. They reflected on their professional identity, motivations for entering medicine, and specialty choices. Students experienced moments of connection and belonging, as well as feelings of guilt, otherness, and awareness of privilege. We continue to explore how working collaboratively and learning reciprocally with community members outside of the hospital and clinic may teach students cultural humility and help insulate students from cynicism and negative views of poor and medically underserved patients. / Urban Bioethics

No description available.

The University of South Africa (Unisa) as comprehensive open distance learning institution (ODL institution) in South Africa is fulfilling a critical social mandate to serve people who would otherwise not have access to education, either for financial reasons, being employed, living in remote areas, or because they cannot access residential universities owing to disability (Unisa, 2008[a]: 15). In facilitating the entrée of the previously identified groups into tertiary education, Unisa has an open admission policy where students mostly have unlimited access to the system. The policy aims to cross the time, geographical, economic, social, educational, and communication distance between students, academics, courseware, and their peers and to accommodate these prospective students from diverse backgrounds (Unisa, 2008: 2). Unisa’s self-evaluation portfolio for the Commonwealth Audit during 2008 mentioned that this policy leads to the revolving door syndrome where students have unlimited access to the system but then often without success (Unisa, 2008[a]: 27). Open access poses a challenge for the training of student social workers within an ODL context. The Department of Social Work at Unisa, currently trains 70% of all social workers in South Africa (Department of Social Work - Unisa, 2008: 5). Coupled with the former, is the fact that Unisa is regarded in the tertiary landscape of South Africa as the most affordable university with the result that it attracts large number of students who have come straight from school (Kilfoil cited in Schenck, 2009: 299). In coping with the large student numbers the Department of Social Work at Unisa is challenged, apart from addressing the theoretical social work programme, to also meet the practical work requirements as set out by the Standard Generating Body of Social Work, in that it needs to provide practical placements for students to conduct their social work practical work training in completion of their Bachelor’s degree in Social Work (BSW) (Lawlor, 2008: 19). The current state of affairs is that the numbers of students requiring practical placements for social work practical work training outnumber the number of practical placements available. In responding to and addressing these challenges, the Bright Site of Sunnyside Service-learning Centre (hereafter called “Bright Site” or the Bright Site”) was established in October 2008 as a strategic project by Unisa’s Department of Social Work. The Bright Site was developed in accordance with the service-learning model proposed by the Council for Higher Education (CHE) with the emphasis on service through learning, and learning through service (Department of Social Work Unisa, 2008:6). / Social Work / M.A. (Social Science)

Thesis (MPhil)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Worldwide the stigma attached to psychiatric patients, psychiatric disorders, psychiatrists and the field of Psychiatry is of great concern. The stigmatising perceptions of medical practitioners and medical students towards psychiatric patients have a negative impact on effective treatment, considering the increasing burden psychiatric disorders are placing on communities and health systems. Numerous efforts were attempted and recommendations made for destigmatising medical students' perceptions towards psychiatric patients. It was found that perception usually improved after a clinical rotation in Psychiatry, but the stigmatising perceptions mostly returned a year later. The first clinical exposure to Psychiatry for medical students at the Faculty of Medicine and Health Sciences, Stellenbosch University, is during the fourth or fifth year of study. This rotation was revised in 2010 and a service-learning component added. The research question which consequently developed, is: What is the influence of a service-learning approach on destigmatising students' perceptions towards psychiatric patients? The research followed a phenomenological school of thought in an interpretative paradigm with a qualitative-inductive approach. On the last day of a rotation students handed in their written reflections and an in-depth focus group interview was conducted. The focus group interviews were repeated a year later. Students' reflections and the transcribed texts were analysed. This served as the basis for conclusions from which recommendations were made. It was found that students had stigmatising perceptions towards psychiatric patients before their first clinical rotation in Psychiatry. Directly after that students' perceptions were destigmatised to a greater extend. A year later non-stigmatising perceptions of understanding, acceptance, comfortableness, compassion, respect and responsibility were still present, although a few students experienced the limited return of stigmatising perceptions. Students attributed the positive changes to their service-learning experience in combination with the clinical placement at a psychiatric hospital with a friendly atmosphere and where they were exposed to patients not suffering from complex and extreme psychiatric disorders. The non-stigmatising perceptions a year after a clinical rotation in Psychiatry demonstrates the transformative value of service-learning. Service-learning is where meaningful and relevant service is rendered with and in the community, social responsiveness is purposefully emphasised and structured reflections are done to enhance academic learning. As a result of this study medical schools worldwide can take cognisance that a service-learning approach made a significant contribution to the stained destigmatisation of medical students' perceptions towards psychiatric patients. / AFRIKAANSE OPSOMMING: Stigma teenoor psigiatriese pasiënte, psigiatriese steurings, psigiaters en Psigiatrie as vakgebied is wêreldwyd ʼn groot bron van kommer. Medici en mediese studente se stigmatiserende persep-sies teenoor psigiatriese pasiënte het ʼn negatiewe impak op effektiewe behandeling, veral gesien in die lig van die groterwordende las wat die toename in psigiatriese steurings op gemeenskappe en gesondheidsisteme plaas. Heelwat pogings is aangewend en aanbevelings gemaak om mediese studente se persepsies teenoor psigiatriese pasiënte te destigmatiseer. Daar is bevind dat persepsies gewoonlik verbeter direk na ʼn kliniese rotasie in Psigiatrie, maar dat stigmatiserende persepsies meestal binne ʼn jaar terugkeer. Mediese studente aan die Fakulteit Geneeskunde en Gesondheidswetenskappe, Universiteit Stellenbosch, se eerste kliniese blootstelling aan Psigiatrie is tydens die vierde of vyfde studiejaar. In 2010 is dié rotasie hersien en ʼn diensleerkomponent bygevoeg. Die navorsingsvraag wat hieruit ontwikkel is, is: Wat is die invloed van ʼn diensleerbenadering op die destigmatisering van mediese studente se persepsies teenoor psigiatriese pasiënte? Die navorsing het ʼn fenomenologiese denkrigting gevolg in ʼn interpretatiewe paradigma met ʼn kwalitatief-induktiewe benadering. Studente het skriftelike refleksies op die laaste dag van ʼn rotasie ingehandig en ʼn in-diepte fokusgroeponderhoud is gevoer. ʼn Jaar later is die fokus-groeponderhoude herhaal. ʼn Ontleding van studente se refleksies en die getranskribeerde tekste en gedoen. Dit het gedien het as basis vir die gevolgtrekkings waaruit aanbevelings gemaak is. Daar is gevind dat studente voor hulle eerste kliniese rotasie in Psigiatrie, stigmatiserende persepsies teenoor psigiatriese pasiënte gehad het. Direk daarna was studente se persepsies grotendeels gedestigmatiseer. Na ʼn jaar was nie-stigmatiserende persepsies van begrip, aanvaar-ding, gemaklikheid, deernis, respek en verantwoordelikheid steeds teenwoordig, alhoewel stigma-tiserende persepsies tot ʼn mate by sommige teruggekeer het. Studente het die positiewe verande-ring toegeskryf aan die diensleerervaring in kombinasie met 'n kliniese plasing in die psigiatriese hospitaal waar ʼn vriendelike atmosfeer geheers het en waar daar blootstelling was aan pasiënte wat nie aan komplekse en ekstreme psigiatriese steurings gely het nie. Die nie-stigmatiserende persepsies ʼn jaar na ʼn kliniese rotasie in Psigiatrie toon die transformatiewe waarde van diensleer. Met diensleer word sinvolle en relevante diens met en in die gemeenskap gelewer, doelbewuste klem word op sosiale verantwoordbaarheid gelê en ge-struktureerde refleksie word gedoen om beter akademiese leer te laat plaasvind. Na aanleiding van hierdie studie kan mediese skole wêreldwyd kennis neem dat ʼn diensleer-benadering ʼn betekenisvolle bydrae gelewer het tot die volhoubare destigmatisering van mediese studente se persepsies teenoor psigiatriese pasiënte.

Thesis (MPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Amidst debates over the transformation of South African (SA) Higher Education (HE), the core institutional function of community engagement is a possible means of bolstering the developmental role of HE in relation to community needs. The potential for community engagement, and more specifically service-learning, to contribute to community development is yet to be fully explored in the SA context. Broad policy mandates such as the Reconstruction and Development Programme (GNU, 1994) and the White Paper on Transformation of Higher Education (DoE, 1997) have created a policy environment supportive of community engagement as an institutional function of HE advancing the state’s developmental agenda. In the course of the national reorganization of the HE system, the Joint Education Trust (JET) / Community-Higher Education- Service Partnerships (CHESP) initiative undertook feasibility studies of community engagement in SA HE and consulted widely around community engagement. The main outcome has been service-learning’s promotion as an endorsed means of knowledge-based community engagement. Concerted efforts to build the institutional capacities for service-learning nationwide have since been conducted and service-learning is now an increasingly prominent means of community engagement in HE. The conceptual origins of service-learning suggest that mutual student and community benefits are achieved in the course of service-learning programmes, with significant research substantiating student learning outcomes. However, there is limited research available on community outcomes and a lack of empirical evidence on how the community is engaged in service-learning. Conceptualizations of service-learning partnerships in SA yield the introduction of a third party, the partner organization as the host of the service-learning modules in addition to the university and the community. The Triad Partnership Model applied at Stellenbosch University (SU) provides an opportunity to explore the experience of the third party, the partner organization, in what is conceptualized as a dyadic relationship between student and community. As a former student, representative of a partner organization and co-facilitator in a servicelearning module, the author explores the experiences of representatives of partner organizations of service-learning in HE. This dissertation presents the experiences of ten site-supervisors from nine partnering organizations of Stellenbosch University as evidence of some of the developmental outcomes of two service-learning modules. The study discusses the various stages in the process of partnership as it pertains to outcomes experienced by the sitesupervisors of the partner organizations. These experiences help clarify the developmental implications of the Triad Partnership Model for the partner organizations of the two service-learning modules studied. The dissertation concludes by making recommendations for future areas of study and makes some considerations for prospective service-learning modules at SU. / AFRIKAANSE OPSOMMING: Die kern institusionele funksie van gemeenskapsbetrokkenheid is te midde van die debate oor die transformasie van Suid-Afrikaanse (SA) Hoër Onderwys (HO), ‘n moontlike wyse om die ontwikkelingsrol van HO in verhouding tot gemeenskapsbehoeftes te bevorder. Die potensiaal van gemeenskapsontwikkeling, en meer spesifiek diensleer se bydrae tot gemeenskaps-ontwikkeling, is nog nie voldoende in die SA konteks ondersoek nie. As breë beleidsmandate het die Heropbou en Ontwikkelingsprogram (GNU, 1994) en die Witskrif oor die Transformasie van Hoër Onderwys (DoE, 1997) ‘n beleidsomgewing geskep wat ondersteunend is vir gemeenskapsinteraksie as ‘n institusionele dryfkrag van HO om die Staat se ontwikkelingsagenda te bevorder. Ten tye van die nasionale herorganisering van die HO stelsel het die Joint Education Trust (JET) / Community-Higher Education- Service Partnerships (CHESP) inisiatief volhoubaarheidstudies van gemeenskapsbetrokkenheid in SA HO gedoen en ook gekonsulteer oor verskeie aspekte rondom gemeenskapsbetrokkenheid in die breë. Die belangrikste uitkoms hiervan was die bevordering van diensleer as ‘n legitieme wyse van kennisgebaseerde gemeenskapsbetrokkenheid. Doelbewuse pogings is onderneem om die institusionele kapasiteit vir diensleer op nasionale vlak uit te bou, wat vandag ‘n toenemende prominente wyse van gemeenskapsbetrokkenheid in HO is. Die konsepsuele oorsprong van diensleer veronderstel dat gemeenskaplike student- en gemeenskapsvoordele deur die verloop van diensleermodules bereik word. Alhoewel daar heelwat navorsing gedoen is wat fokus op leeruitkomste vir studente, is daar weining navorsing beskikbaar oor gemeenskapsuitkomste, sowel as ‘n tekort aan empiriese bewyse van hoe die gemeenskap betrokke is by diensleer. Konsepsualisering van diensleer vennootskappe in SA sluit ‘n derde party in, die vennootskap-organisasie waar die diensleermodule gehuisves word, bykomend dus tot die universiteit en gemeenskap. Die Triad Vennootskap Model wat by die Universiteit van Stellenbosch (US) toegepas word, bied die geleentheid om ondersoek in te stel na die ervaring van ‘n derde party, die vennootskap-organisasie, oor wat gekonseptualiseer word as ‘n diadiese verhouding tussen student en gemeenskap. As ‘n vorige student, verteenwoordiger van ‘n vennootskap-organisasie en mede-fasiliteerder in ‘n diensleermodule, stel die outeur ondersoek in na die ervarings van verteenwoordigers van vennootskaporganisasies van diensleer in HO. Hierdie verhandeling stel die ervarings van tien supervisors van nege vennootskaporganisasies van die Universiteit van Stellenbosch voor, as bewys van sommige van die potensiële uitkomste van twee diensleer modules. Die ondersoeker bespreek die fases van die proses van vennootskap-vorming soos wat dit verband hou met uitkomste wat supervisors ervaar het. Hierdie ervarings help om die ontwikkeling implikasies van die Triad Vennootskap Model vir die deelnemer-organisasies van die twee diensleermodules wat bestudeer is, te verhelder. Die verhandeling word afgesluit deur aanbevelings te maak vir toekomstige studie-areas en oorweging te skenk vir toekomstige diensleermodules by die US.