Thesis (MPhil)--Stellenbosch University, 2012. / Background: Preceptorship refers to a teaching and learning approach through which a well experienced clinician is contracted to provide clinical teaching, supervision, role‐modeling of professional and clinical practice skills and assessment of students in a clinical setting. This approach often involves three groups of people, namely: faculty, students, and clinicians (preceptors). The preceptor in this study refers to a registered nurse who supervises and conducts clinical assessment of students in a clinical area, while at the same time is responsible for patient care. The focus of this study was to explore preceptors’ opinions regarding the implementation of preceptorship in the diploma in the nursing curriculum diploma in the nursing curriculum in Botswana. Emphasis was placed on seeking information on how preceptorship is implemented, the strengths and challenges regarding its implementation and suggestions as to how it should be strengthened to contribute positively towards teaching and learning of students. Methodology: A mixed cross‐sectional descriptive design, using a survey was used. . The design was adopted because of its ability to provide a broad understanding of the concept under study by allowing participants to share their experiences and opinions about a specified situation. Both the qualitative and quantitative data were collected simultaneously. A standardized self‐developed structured questionnaire using both closed ended and few open ended questions and consisting of scaled self‐report items and checklists was used to collect data from forty‐four (44) preceptors and three (3) third year level coordinators from the three (3) health training institutions. Quantitative data were analyzed using SPSS, while the qualitative data were analyzed for frequency of common themes. Descriptive statistics in the form of frequency tables and charts, as well as measures of central tendencies, were used in the analysis of quantitative data. Results: The findings revealed that preceptorship program was not well coordinated as there were no preceptorship manuals to guide the implementation of preceptorship program. On the positive side, however, preceptors felt comfortable and competent to supervise and assess students, despite the fact that most of them had not received preceptorship training or orientation. With regard to preceptor support, it was evident that there was need for major support in regard to improved communication between preceptor and faculty, improved support by the health facility manager and the need for strengthening preceptor training and orientation. The majority of the respondents have recommended for preceptorship orientation /training targeted at addressing some of the following topics: Student and preceptor roles, curriculum requirements, clinical teaching and assessment skills, leadership skills and how to access resources from the health training institutions. A significant number of preceptors felt that it was important to receive feedback about students’ progress from faculty and to receive feedback from students regarding their experiences in the clinical internship sites. Lastly, preceptors also felt that there was need for introducing incentives into the preceptorship program Conclusion The key areas that emerged from the study indicated an uncoordinated and unstructured preceptorship program in the diploma nursing curriculum. Preceptor support is limited as evidenced by report of lack of training or orientation of preceptors to their preceptorship role. To ensure sustainability of preceptorship program there is need to improve the following areas: preceptorship training and orientation, and preceptorship support by both the health training institution and the health facility managers. Key words: Preceptors, preceptorship, orientation, socialization, student assessment, and faculty support, clinical teaching, mentor, clinical supervisor.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Since the SPICES (S: student centred; P: problem-based learning; I: integration; C: community based/hospital based; E: electives; and S: systematic apprenticeship based) model of medical curriculum was proposed by Harden, most medical schools worldwide have introduced curriculum changes toward a paradigm shift in teaching and learning. Walter Sisulu University (WSU) introduced such changes in 1992 when problem-based learning (PBL) was implemented in the medical school. This research assignment examines the level of horizontal integration within the WSU Bachelor of Medicine and Bachelor of Surgery (MBChB III) programme. The purpose of the study was to determine the students’ and tutors’ perceptions of integration in the curriculum. A cross-sectional descriptive survey was designed and piloted in 2009 and the questionnaire was then administered to MBChB III students who agreed to form part of the study. The tutors’ opinions on integration were also explored. A questionnaire on integration using a five-point Likert scale, was administered to both the students (12 questions) and the tutors (six questions). Six open-ended questions on integration were added to the students’ instrument and one to the tutors’ instrument, for qualitative analysis and to assist in triangulation. In addition, semi-structured interviews were conducted with the tutors individually. As a result of the survey, it seemed that all the students were “satisfied” or “very satisfied” with the level of integration of content and learning. All the tutors were aware of the need for integration, but some were not familiar with how the learning environment could be modified to enhance students’ approach to integration. MBChB III students at WSU highly valued the integration of learning and teaching during tutorials. Thirty-three per cent of the tutors, though, believed that integration increased their workload. All the tutors thought that integration facilitated students’ learning skills and promoted student engagement, learning and interaction with faculty. / AFRIKAANSE OPSOMMING: Sedert Harden die SPICES-model as mediese kurrikulum voorgestel het, het die meeste mediese skole in die wêreld kurrikulumveranderings ingevoer as ʼn paradigmaskuif in onderrig en leer. (S – studentgesentreerde; P – problemgebaseerde leer; I – integrasie; C – gemeenskaps-/hospitaalgebaseer; E– keusevakke; en S – gebaseer op sistematiese vakleerlingskap.) Die Walter Sisulu-universiteit (WSU) het in 1992 sulke veranderings aangebring toe probleemgebaseerde leer (PBL) in die mediese skool geïmplementeer is. Hierdie navorsingswerkstuk ondersoek die mate van integrasie in die Baccalaureus in Geneeskunde-program en Baccalaureus in Chirurgie-program (MBChB III) aan die WSU verder as die PBL-tutoriale kan vorder. Die doel van die studie was om te bepaal wat studente en studieleiers se persepsies oor die integrasie van die kurrikulum is. ʼn Beskrywende deursnee-opname is in 2009 opgestel en ’n loodsstudie is gedoen. Die opname is weer gebruik met MBChB III-studente wat ingestem het om aan die studie deel te neem. Studieleiers se menings oor integrasie is ook ondersoek. ʼn Vraelys oor integrasie volgens 'n vyfpunt Likert-skaal, is aan die studente (12 vrae) sowel as die studieleiers (ses vrae) gestel. Ses oop vrae oor integrasie is by die studente se instrument gevoeg en een by die vraelys vir die studieleiers ter wille van kwalitatiewe ontleding en triangulasie. Daarbenewens is ʼn semigestruktureerde onderhoud met elke studieleier individueel gevoer. Na afloop van die toepassing en ontleding van die opname was al die studente “tevrede” of “baie tevrede” met die vlak van integrasie van leer, met begrip en met die vlak van integrasie van inhoud. Al die studieleiers was bewus van die behoefte aan integrasie, maar sommige was nie vertroud met hoe die leeromgewing aangepas kan word om die studente se benadering tot integrasie te bevorder nie. MBChB III-studente aan die WSU het 'n hoë waarde geheg aan die integrasie van leer en onderrig tydens tutoriale. Drie-en-dertig persent van die studieleiers het egter geglo dat integrasie hulle werkslading verhoog. Al die studieleiers was van mening dat integrasie die studente se leervaardighede fasiliteer en die studente se deelname, leer en interaksie met akademiese personeel bevorder.

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)--Stellenbosch University, 2012. / Background: Formative feedback is an important process in facilitating student learning as it helps students identify learning gaps early enough and devise means of covering those gaps. Most health professional educators spend most of the time designing summative assessment tools and pay little emphasis to giving qualitative feedback to students throughout the learning process. This problem has been identified at Makerere University College of Health Sciences (MaKCHS) and forms the basis of this study. Objectives: To investigate prior understanding of students and lecturers about formative feedback. The study also aimed at exploring experiences of students and lecturers regarding implementation of feedback in a resource-constrained context. Methods: This was an action research study using a participatory approach. Results: Initially, lecturers had some prior knowledge of feedback, however, students had misconceptions of what feedback could mean. After introducing a written feedback form, all participants expressed satisfaction with the feedback process. Key themes that emerged included: enhancing motivation, enhancing learning, promoting reflection and clarifying understanding. Conclusion: Students` motivation to learn can be greatly enhanced through formative qualitative feedback. A simple structured form is one way of providing qualitative formative feedback to students in resource-limited settings. Key words: formative feedback, structured form, action research.