Thesis (MPhil (Centre for Health Sciences Education)--University of Stellenbosch, 2010. / AFRIKAANSE OPSOMMING: Doel: Te min spraak-taalterapeute (STT’e) wêreldwyd spreek vlotheidsversteurings aan. Dit mag aan hul gevoelens van onbevoegdheid in die hantering van persone wat hakkel toegeskryf word. Nuut-gegradueerde STT’e, in die Suid-Afrikaanse konteks, het dikwels nie toegang tot ondersteuning en leiding van ervare klinici om hul vaardighede en bevoegdheid in die hantering van persone wat hakkel, te ontwikkel nie. Die doel van hierdie studie was om voorgraadse STTstudente se persepsies van hul eie bevoegdheid om persone wat hakkel te hanteer, te ondersoek en beskryf 1) direk na die voltooiing van hul teoretiese module en voor kliniese plasing, en 2) na blootstelling aan ‘n bykomende opleidingskomponent waar hulle waargeneem het hoe intervensieprosedures op ‘n gesimuleerde pasiënt toegepas word. Metodes: ‘n Beskrywende opnameontwerp, met pre- en post-intervensie-vraelyste is gebruik om die andragogiese benadering se impak op studente, voor en nadat hulle die bykomende opleidingsgeleentheid ontvang het, te evalueer. Resultate: Voor die intervensie het die meeste studente hulself nie as bevoegd geag om persone wat hakkel te evalueer of behandel nie. Na die intervensie is statisties beduidende veranderinge in die studente se self-ervare bevoegdheid vir die meeste aspekte verwant aan die evaluering en behandeling van mense wat hakkel, gerapporteer. Opsomming: Daar is tot die gevolgtrekking gekom dat die studente hierdie tipe innoverende opleidingsmetodologie hoog op prys stel en dat dit ‘n nodige aanvulling tot studente se bestaande kliniese plasings is.

Thesis (MPhil)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Aim: This study aimed to explore the perceptions of third year nursing students regarding the ethics module at Shifa College of Nursing, Islamabad, Pakistan. Methods: Third year nursing students (n=26) completed a retrospective pre/post survey rating their knowledge before and after the ethics module. Focus group discussions (FGDs) addressed the importance of ethics teaching in nursing, the content, teaching and learning strategies of the module as well as whether the application of the concepts learned in the classroom were practiced in the clinical setting. Results: Participants rated their knowledge higher in the post-test (4.00) than the pretest questionnaire (2.26) (p=0.003). The main themes identified during the focus group discussions were: understanding their responsibilities towards the patient; an appreciation of the patient as a human being; applicability of the module to the clinical setting; the role of student nurses in ethical decision making in the clinical setting; and the teaching and learning strategies. The context of the nurse’s practice was also identified as being important. Conclusion: The participants valued the ethics module and its applicability to the clinical setting, but changes in the content of the module and the teaching and learning strategies were suggested.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Home-based rehabilitation (HBR) in under-resourced areas in a primary health care context exposes students to the real life situations of clients. The educational experience of HBR, underpinned by the theory of situated learning, promotes experiential and transformative learning. HBR leads not only to academic learning and personal development, but also to an understanding of social accountability and responsibility. Physiotherapy students and their clients frequently have diverse lingual, socio-economic and cultural backgrounds which may hinder the provision of appropriate treatment to clients in their residences. Increased knowledge of HBR in the physiotherapy context could result in an enhanced experience for both student and client. This study sought to explore the perceptions of physiotherapy students and their clients regarding HBR as part of clinical training in resource-constrained settings. Whether the students felt adequately prepared to perform HBR was also explored. A qualitative research design in the interpretivist paradigm was used. An exploratory case study was performed. Semi-structured interviews were conducted with clients (N=7) living in an under-resourced setting who had received HBR from physiotherapy students. Paired interviews were conducted with final year physiotherapy students (N=6) after their HBR placement. The data were subjected to inductive thematic analysis and themes developed. The findings showed that while clients appreciated the students’ services, there were communication barriers and unmet expectations. Students reported difficulty in adapting to the unfamiliar context, resulting in interventions not being sufficiently client-centred. They voiced a need for language competency to assist in communication. Earlier facilitated exposure to under-resourced contexts in the early clinical phase was suggested to reduce culture shock. An awareness of home environments in under-resourced areas influenced the students’ interventions in other contexts. To gain maximum benefit from the learning opportunities available through HBR, students require support for client management and client-centred problem solving in an under-resourced setting. Guided reflection should form part of the HBR placement to facilitate the construction of new knowledge, to promote deep transformative learning and to increase the students’ awareness of their role as change agents. Exposure to real life situations in under-resourced settings in the form of HBR provides valuable situated and authentic learning opportunities for physiotherapy students. The experience can be useful in preparing graduates to address the needs of the populations they will serve during community service. / AFRIKAANSE OPSOMMING: Tuisgebaseerde rehabilitasie (TBR) in ondervoorsiende gebiede in die primêre gesondheidsorg-konteks stel studente bloot aan die werklike lewensomstandighede van kliënte. Die opvoedkundige ondervinding van TBR, gerugsteun deur die teorie van gesitueerde leer, bevorder ervarings- en transformasionele leer. TBR lei nie net tot akademiese leer en persoonlike ontwikkeling nie, maar bevorder ook insig in maatskaplike verantwoordbaarheid en verantwoordelikheid. Fisioterapie-studente en hul kliënte het dikwels verskillende taal-, sosio-ekonomiese en kulturele agtergronde wat kan verhinder dat die toepaslike behandeling vir kliënte tuis verskaf word. ’n Toename in kennis van TBR in die fisioterapie-konteks kan lei tot ’n beter ondervinding vir beide die student en die kliënt. Die doel van die studie is om die persepsies van die fisioterapie-studente en hul kliënte met betrekking tot TBR, as deel van die kliniese opleiding in omgewings waar daar beperkte hulpbronne is, na te vors. Daar is ook nagegaan of die studente gevoel het dat hulle genoegsaam voorberei is om die TBR toe te pas. ’n Kwalitatiewe navorsingsontwerp in die interpreterende paradigma is gebruik. ’n Verkennende gevalle-studie is gedoen. Semi-gestruktureerde onderhoude is met die kliënte (N=7) wat in ondervoorsiende omstandighede leef en wat TBR van fisioterapie-studente ontvang het, gevoer. Onderhoude is in pare met fisioterapiestudente in hul finale jaar (N=6) gevoer nadat hulle hul TBR-plasing voltooi het. ’n Induktiewe tematiese analise van die data is gedoen en temas is ontwikkel. Die resultate het getoon dat, alhoewel die kliënte waardering gehad het vir die dienste wat deur die studente gelewer is, daar kommunikasiegapings en onvervulde verwagtinge was. Die studente het gerapporteer dat hulle gesukkel het om aan te pas by die onbekende omgewing met die gevolg dat die intervensies nie genoegsaam kliëntgerig was nie. Hulle het ook aangedui dat daar ’n behoefte is om die nodige taalvaardigheid te ontwikkel om kommunikasie te verbeter. Die kultuurskok wat beleef is, kan moontlik in die vroeë kliniese fase reeds gefasiliteer word deur die studente aan ondervoorsiende kontekste bloot te stel. Die kennis van die tuisomgewings in ondervoorsiende areas het ’n invloed gehad op die studente se intervensies in ander kontekste. Studente benodig ondersteuning in kliëntebestuur en kliëntgesentreerde probleemoplossing in ondervoorsiende omgewings ten einde maksimum voordeel te verkry uit leergeleenthede wat beskikbaar is deur TBR. Begeleide refleksie behoort deel te vorm van die TBR-plasing om die opbou van nuwe kennis te fasilliteer, diepgaande transformatiewe leer te bevorder en die student se bewustheid van hul rol om verandering teweeg te bring, op te skerp. TBR voorsien nie net waardevolle, outentieke leergeleenthede ter plaatse nie, maar gee ook die fisioterapie-studente blootstelling aan die werklike situasies waarin mense hulle in ondervoorsiende omgewings bevind. Hierdie ondervinding kan waardevol wees om graduandi voor te berei om die behoeftes aan te spreek van die bevolkingsgroepe wat hulle tydens hul gemeenskapsdiensjaar sal bedien.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background - The College of Phycians and Surgeons Pakistan (CPSP) was established in 1962 and its role is to oversee the postgraduate medical education within Pakistan. At present, various specialties belonging to the CPSP carry out quality assurance visits including evaluation of the learning environment of the teaching hospitals by asking the supervisors and doctors in training about the qualification and experience of supervisors, equipment, library, infrastructure and type of work load. The CPSP do not make use of a valid and reliable method when performing these assessments and therefore there is a need for the CPSP to develop a standardized method of assessing the learning environments of the teaching hospitals in Pakistan. This method needs not only to be valid and reliable but also reproducible and transferable so that it can be used to measure the learning environments in various departments and teaching hospitals .It can further be used to compare the learning environments across different teaching hospitals and specialties with in Pakistan. The learning environment of teaching hospitals of Pakistan have not been studied before therefore the purpose of this study was to measure the postgraduate learning environment of private and public sector teaching hospitals of twin cities in Pakistan Islamabad and Rawalpindi .Public sector hospitals are fully funded by the government of Pakistan and patients receive free treatment, while private hospitals are commercial hospitals where everything is paid by patients. Following the postgraduate educational environment measurement results between house officers and residents working in the above mentioned environments was then compared. These results can inform supervisors and institutions about short comings as well as strong points with regards to the learning environment. Materials and Methods After approval from the Shifa International Hospital`s Ethical committee and Health Research Ethical committee of the University of Stellenbosch, and informed consent were obtained from research participants. The Postgraduate Hospital Educational Environment Measurement questionnaire (PHEEM) was administered to the house officers and residents of six public and one private sector teaching hospital of twin cities (Islamabad and Rawalpindi) in Pakistan with the help of the supervisors of CPSP based at these hospitals. The PHEEM was completed during their respective teaching sessions at the various hospitals .The supervisors was asked to encourage students to complete the PHEEM questionnaire .Supervisors were instructed to collect the completed questionnaires the from doctors in training at their individual hospitals and then send it back using the enclosed envelope The PHEEM contains of 40 items covering a range of issues directly related to the clinical learning environment of house officers and residents1. These statements make up 3 subscales of the clinical learning environment namely autonomy, social support and teaching. Autonomy (such as the quality of supervision) is represented by 14 statements teaching (the qualities of teachers by 15 statements and social support (such as facilities and atmosphere) by 11statements. Each of the 40 statements can be rated from 0-4 .The respondents are asked to indicate their agreement using a 5 point Likert scale .These range from strongly agree(4) ,agree(3), unsure(2), disagree(1) to strongly disagree (0). Agreement with the items indicates a positive learning environment and will result in high scores. The maximum possible scores are 56 for autonomy, 60 for teaching, 44 for social support and an overall score of 160.It is essential that each junior doctor applies the items to their own current learning place1. - Statistical analysis - The statistical analysis was conducted by using SPSS 16.0 and the four negative items were scored in reverse (question 7, 8, 11, 13). The scores for the total as well as the sub-scales were described by using means and standard deviations (SD). Comparisons of the perception of the educational environments between house officers and residents were expressed as a mean and ± SD and its statistical significance was determined by student t- tests. A p value ≤ 0.05 was considered statistically significant. The results from the three construct of the PHEEM survey were compared among the house officers and residents from surgery, medicine, pediatrics and Obstetrics’ and Gynecology by ANNOVA and post hoc sidak test. A p value ≤ 0.05 was considered statistically significant. - Results - The internal reliability of the questionnaire was good with a total Cronbach`s Alpha value of 0.92 (a Cronbach`s alpha of more than 0.7 or 0.8 is accepted as being good). The questionnaire further revealed Crobach`s alpha value of 0.78, 0.89 and 0.70 for the various subscales of autonomy, teaching and social supports .When this was analyzed to exclude each question in turn, using the alpha if deleted there was no significant improvement in the score, thus confirming all questions were relevant and should be included. A total of 286 out of 300 (95.33% response rates) house officers and residents belonging to the seven different teaching hospitals of twin cities of Islamabad and Rawalpindi, Pakistan participated in the study. The PHEEM questionnaire was completed by all the participating doctors composing of 51% house officers and 49 % residents .Both genders were almost equally represented in the two groups comprising of 52% male and 48% female doctors. The distribution of male and female gender is different among respondents from various specialties. There was 23.60% male and 15.03% females in surgery, 22.20% males and 18.30% females in medicines, 6.20% males and 4.32% females in Pediatrics and 10.33% females in obstetrics. House officers and residents belonging to all major specialties took part in the study with the distribution looking as follows, Medicine 44.8%, Surgery 33.6% Obstetrics and Gynecology11.2% and Pedriatics10.50%. The mean score (M) and the standard deviation (SD) for each of the subscale namely the perceptions of autonomy, teaching and social support of house officers and residents are shown Table number 1 (Autonomy), Table number 2 (Teaching) and Table number 3 (Social support) respectively. These tables also show the mean of the total scores of each subscale. The lowest recorded score was 1.37 for question number 4.Question number 1, 4,5,9,11,17 and 32 with in the autonomy section were found to have a relatively low rating as shown in table number 1. Teaching quality questions 3, 21 and 33 showed a low rating as demonstrated in table number 2. Social support showed a low rating for question number 19, 20, 25, 26, 36 and 38 again shown in table number 3. The results from the three subscales of the PHEEM survey were compared between residents and house officers from the teaching hospitals of the twin cities are shown in Table number 1, 2, and 3 respectively. The perception of autonomy was higher amongst residents with a mean of 28.74 compared to house officers 28.27. The difference, however, was not statistically significant between the two groups but there was a statistically significant difference between the two groups in question number 32, where the residents perceived that work load for them was better than house officers. It seems as the residents have better opportunities to access and participate in educational events and programs compared to the house officers seeing that there was a statistically significant difference in question numbers 12 and 21 respectively as shown in table number 1. The perceived level of quality of teaching was higher for residents with mean of 32.02 as compared to the house officers with a mean of 31.12. However this difference was not statistically significant as shown in table 2. The perception of social support was high amongst house officers with a mean of 19.66 compared to residents with a mean of 19.06. There was statistically no difference between the two groups regarding the social support provided at these teaching hospitals; however the house officers felt physically more save compared to residents as shown in table 3 Regarding the difference between private and public sector hospitals, the mean score of the three subscales of the PHEEM, namely the mean score for the perception of autonomy (28.71 vs. 27.14, p=0.24) teaching (33.08 vs. 32.37, p=0.25) and social support (21.94 vs. 21.22, p=0.24) were not statistically significant. The results from the three subscales of the PHEEM survey were compared amongst the junior doctors from Surgery, Medicine, Pediatrics and Obstetrics’ and Gynecology by ANNOVA and post hoc sidak test. There was no statistically significant difference among these junior doctors in the majority of the PHEEM questions. For question number 4, I had an informative induction programme, there was statistically significant difference between the junior doctors of medicine and obstetrics & gynecology .Regarding the question number 5, I had appropriate level of responsibility in this post, and there was statistically significant difference between junior doctors of surgery & pediatrics and surgery and obstetrics & gynecology. There was significant difference between the junior doctors of medicine and Obstetrics and gynecology for question number 29, I feel part of the team working here. Regarding perception of question number 30, I have opportunity to acquire the appropriate practical procedures for my grade; there was significant difference between the junior doctors of obstetrics & gynecology and surgery. For perception of teaching, there was a significant difference between the junior doctors of medicine and obstetrics & gynecology in the following questions. Question number 10: my clinical teachers have good communication skills; Question number 23: my clinical teachers are well organized; and question number 27: I have enough clinical learning opportunity of my needs. In the subscale of social support there was a significant difference for item number 13 which states that there is sex discrimination in this post between the junior doctors of surgery and pediatrics .The junior doctors from medicine perceive that there was more calibration among the doctors of medicine as compared to pediatrics. - Discussion and conclusion - This study shows that the PHEEM questionnaire consists of a practical, reliable and simple set of questions to measure the learning environment of doctors in training at teaching hospitals of Pakistan; a country which is socially, culturally and economically different from the country where this questionnaire was originally constructed. This could imply that the perceptions of doctors in training are similar regardless of geographical boundaries and economic conditions of the country where they live. . Other studies that employed PHEEM in different parts of the world show similar scores. This study does not show a statistically significant difference between house officers and residents in terms of teaching, role of autonomy and social support. The reasons for this may be that house officers and residents share the same infrastructure for accommodation, catering and social support. Furthermore, there is no practically organized structured training programme with a specified job description for doctors at different levels of training. This study therefore does not confirm results of the studies performed in United Kingdom and Australia, where house officers experienced a better learning environment than residents in many respects. This study was completed by house officers and residents from private as well as public sector teaching hospitals. We did not find a statistical difference in the level of perceptions between doctors in training working in these two different set up of hospitals. This goes against the common notion present amongst junior doctors that training at public sector hospitals have a higher level of satisfaction due to better and more learning opportunities than at private sector hospitals because in these hospitals independent work is not allowed. The result off this study indicates that the perception level of house officers and residents in training in various specialties was different regarding the learning environment. This difference was even more marked for the specialty of Gynecology and obstetrics where the PHEEM items were scored lessened compared to the other specialties. The reason for this could be due to better training opportunities, more structured and availability of mentors in Surgery, Medicine and Pediatrics compared to the female dominated specialty of Gynecology and obstetrics. The female work and learn in different way because they score three items directly related to perception of teaching lower compare to male dominated specialities. The PHEEM questionnaire results have been taken from seven teaching hospitals of the twin cities, and therefore provide a good overall picture of the learning environments of teaching hospitals in Pakistan seeing that the teaching hospitals of Pakistan almost have similar infrastructure and faculties with few individual variations. This sample represents all major specialties thus provide a good picture of the learning environment for all doctors in training. It is clear that in order to ensure high standards in education and training of junior doctors, the importance of the learning environment cannot be ignored. The following are recommendations for the CPSP so that they take steps in collaboration with administrative and medical staff to improve the learning environments where needed. 1. A meeting between the CPSP and administrative staff should held every year to overcome the weakness pointed out in this study 2. Teaching hospitals should publish an informative junior doctors hand book , with a job description, responsibilities, expectation and information about working hours 3. The junior doctors should have protected time for educational activities 4. The attendance at educational sessions must be supported by the Supervisors of CPSP 5. Career advice and counseling opportunities should be avaible at each regional center of CPSP 6. Accommodation should meet the appropriate standards 7. Good quality hygienic catering facilities should be present around the clock for junior doctors. 8. Each teaching hospital should administer the PHEEM ever year to measure their quality and potentially improve their standards. In conclusion this study shows a great need for the creation of a supportive environment as well as designing and implementing interventions to remedy unsatisfactory elements of the educational environment if effective and successful learning is to be realized by the CPSP.

Thesis (MPhil (Centre for Health Science Education))--University of Stellenbosch, 2009. / Introduction: Exposure to the clinical learning environment forms an essential part of nursing education. Individual student perceptions of this multi-dimensional context can greatly influence their clinical learning experiences. Insight into these perceptions may assist nurse educators in facilitating optimal learning outcomes. Aim: The aim of this study was to promote an awareness of the possible impact of various aspects of the clinical learning environment and nursing students’ perceptions thereof, on their learning experiences; and to generate guidelines for facilitating optimal learning outcomes. Methods: A qualitative, interpretive study, investigating nine individual second-year nursing students, was undertaken in a private hospital in South Africa. Interview transcripts were thematically analyzed. Results: Four themes and eleven sub-themes emerged, highlighting the impact of student nurses’ perceptions of the various aspects of the clinical learning environment on their learning experiences. Discussion: The impact of students’ perceptions of the clinical learning environment on their learning experiences is discussed. Recommendations are provided for measures to increase the focus on student-centered learning in the selected clinical context. Conclusion: The challenge remains to best prepare students for the complexities and dynamics of the workplace learning environment, while at the same time modifying this environment to effectively meet students’ learning needs.

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.

Thesis (MPhil)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Background: The theoretical / cognitive component of ethics and professionalism teaching to undergraduate medical students at Stellenbosch University (SU) is well developed, but a concern exists about the need for teaching and assessment of clinical ethics and professionalism on ward rounds. Some teaching does take place during clinical rotations in the form of role modelling as part of the hidden curriculum. Opportunities should be created for explicit teaching of ethics and professionalism beyond the hidden curriculum. Assessment of the cognitive component of ethical and professionalism occurs, but assessment of clinical ethics and professionalism during clinical rotations remains a challenge. Methods: This was a non-experimental study and included three subgroups of undergraduate medical students in their clinical years as well as a random sample of educators involved in clinical training. Questionnaires were distributed to the students and educators. This was followed by focus group interviews among the students. Results: A majority of the students (88%) had indicated that they had experienced ethical and professional dilemmas while working in the wards or during ward rounds. The main dilemmas revolved around inadequate consent processes, lack of confidentiality and privacy, disrespect for patients, poor communication and students being expected to perform tasks they were not trained for. An average of 64% of students indicated that ethical and professional issues were not discussed during the clinical rotations in hospitals. Seventy-eight percent of students indicated that they did not feel free to discuss their own feelings or beliefs on ward rounds. All of the educators felt that there was a need for increased teaching and assessment of the medical students during their clinical rotations. Conclusions: Deliberate opportunities need to be created for teaching ethics and professionalism on clinical ward rounds. This could be a shared responsibility between the clinical departments with continuous input throughout the clinical years of study. Strong institutional support and commitment are necessary to make the teaching sustainable and successful. Structured opportunities need to be developed where students can discuss ethical and professional issues in a safe environment. Further research is needed for the development of an appropriate curriculum and assessment tools. / AFRIKAANSE OPSOMMING: Geen opsomming

ENGLISH ABSTRACT: The setting for this study was the University of the Western Cape, Faculty of Community and Health Sciences, first year undergraduate students. All students who participated in the compulsory interprofessional programme were from the following disciplines: Occupational Therapy; Physiotherapy; Psychology; Social Work; Natural Medicine; Dietetics; Human Ecology; Sports Sciences and Nursing. The objectives of this study were to measure the attitudes and perceptions of first year students who participated in an undergraduate interprofessional programme. The attitudes and perceptions were further measured in relation to the specific lecturers involved, the age of the students, their gender, race, background as well their specific discipline. This was primarily a quantitative study incorporating two qualitative questions in which 657 students were issued with a questionnaire designed to determine their attitudes and perceptions towards interprofessional education. A sample size of 264 students resulted in 95% confidence intervals with a maximum precision of 5%. The questionnaire was adapted, with permission, from Cameron; Rennie; DiProspero; Langlois & Wagner (2009). MS Excel was used to capture the data and STATISTICA version 9 (StatSoft Inc. (2009) STATISTICA (data analysis software system), www.statsoft.com.) was used to analyze the data from the questionnaires. Descriptive statistics was used to describe the main features of the sample of this study and summary statistics was further used to summarize the findings of this study in order to communicate the bulk of the information as simple as possible. Two open-ended questions were included at the end of the questionnaire and this was used to triangulate the data. The Kruskal-Wallace test was used to measure the results, whereby a p-value of <0.05 indicated statistical significance. Of all the factors used to measure the attitudes and perceptions of students, the following three were significant: Gender; Race and Discipline. No other factors impact on the attitudes and perceptions of students towards interprofessional education. Student attitudes and perceptions towards interprofessional education were found to be very positive. The findings revealed that the most significant factor in the study was the lack of understanding of various disciplines participating in the programme and their understanding of the relevance of the teaching approach (interprofessional) as well as their specific role in the health care team. This clearly illustrated the need to recommend to the co-ordinating unit of the programme that this be defined more clearly for the students and specifically the Sports Sciences students. / AFRIKAANSE OPSOMMING: Die studie het plaasgevind by die Universiteit van die Wes-Kaap, in die Fakulteit van Gemeenskap en Gesondheidswetenskappe, met eerste jaar voorgraadse studente wat die verpligte interprofessionele program doen. Studente sluit in die volgende dissiplines: Arbeidsterapie; Fisioterapie, Sielkunde, Maatskaplike Werk, Natuurlike Medisyne, Dieetkunde, Menslike Ekologie, Sport en Verpleegkunde. Die doelwitte van hierdie studie was om die houdings en persepsies van die eerste jaar studente wat deelgeneem het in 'n voorgraadse interprofessionele program te meet. Houdings en persepsies was gemeet met betrekking tot die ouderdom geslag, ras,agtergrond sowel dissipline van spesifieke studente. Daar was ook gekyk of die betrokke dosente ń invloed het op studente se houdings en persepsies teenoor die program. Die studie was hoofsaaklik kwantitatiewe met n kwalitatiewe komponent. Vraelyse was uitgereik aan 657 studente om hul houdings en persepsies teenoor interprofessionele onderwys te bepaal. 'n Steekproefgrootte van 264 studente het in 95% vertrouensintervalle met 'n maksimum akkuraatheid van 5%. Die vraelys is aangepas, met toestemming, van Cameron, Rennie; DiProspero Langlois & Wagner (2009). MS Excel was gebruik om die data op te vang en Statistica weergawe 9 [StatSoft Inc (2009) STATISTICA (data-analise sagteware stelsel), www.statsoft.com] is gebruik om die data van die vraelyste te analiseer. Beskrywende statistiek is gebruik om te beskryf die belangrikste kenmerke van die steekproef van hierdie studie. Opsommingstatistiek is verder gebruik om op te som die bevindinge van hierdie studie met die doel om die grootste deel van die inligting so eenvoudig as moontlik te kommunikeer. Twee oop vrae is ingesluit aan die einde van die vraelys en dit is gebruik om die data te trianguleer. Die Kruskal-Wallace-toets is gebruik om die resultate, waar 'n p-waarde van <0,05 aangedui word statistiese betekenisvolheid te meet. Van al die faktore wat gebruik was om die houdings en persepsies van studente te meet, was die volgende drie beduidende: geslag, ras en dissipline. Geen ander faktore impakteer op die houdings en persepsies van studente in interprofessionele onderwys. Studente se houdings en persepsies teenoor interprofessionele onderwys was beduidend positief. Die studie het bevind dat daar ń algemene gebrek aan begrip is vir die relevansie van die program. Dit sluit in hoekom die verskillende dissiplines aan die program deelneem as ook wat hulle spesifieke rolle in die gesondheidsorg span is. Die aanbeveling is dus dat die koördinerings eenheid van die program die kursus meer duidelik sal moet definieer om so doende die studente se kennis in terme van relevansie van die interprofessionele program uit te brei met spesifiek verwysing na die Sport studente.