Thesis (MPhil)-- Stellenbosch University, 2013. / ENGLISH ABSTRACT: Anatomy remains a foundational subject in the preclinical years of medical and other allied health sciences courses, with exceptionally large volumes of content, and a unique practical aspect: conducting cadaveric dissection and the use of pre-dissected cadaver specimens. The educational climate can be set by incorporating a suitable introduction to the subject, addressing academically and emotionally underprepared students before the formal commencement of the Anatomy curriculum. The literature does not mention what such an Introduction Module should entail. Quantitative means such as questionnaires have been used to evaluate the perceptions and the emotional and psychological influence of Anatomy. It is often assumed that through words meaning is conveyed, providing researchers with data that can be objectively interpreted. But questionnaires are rather pre-emptive of what students might say about what they experience, and the number of possible answers is restricted. The use of drawings might be an opportunity for the students to express their unmediated feelings; strong emotions could appear in the form of images instead of words, allowing students to experience rather than verbalize feelings especially with a limited vocabulary. Qualitative data analysis enables the researcher to get at complex layers of meaning, interprets human behaviour and experiences beyond the surface appearance, provides rich evidence of this behaviour and/or experiences and consequently builds theory inductively from the data source. The primary purpose of this study is to establish the feasibility of using drawings to explore how a diverse group of students from the University of Limpopo, Medunsa Campus, view Anatomy and what insights can be gained from these drawings to inform the Introduction Module. Students were asked to draw their perceptions of Anatomy after approximately 10 weeks of allocated contact time, which includes lectures as well as practical sessions. A total of 74% (134 out of 181) drawings were handed in. A matrix-type method of analysis based on existing literature was formulated to analyse the drawings. Three dimensions were identified for each of the drawings: “what” is illustrated, then “how” is the message conveyed or illustrated, and lastly, the “emotion” communicated through the drawing. The reliability was increased with two interpreters who analysed the drawings. Learning approaches, orientation on human life and death, the general emotional state of individuals influenced by Anatomy, their course of study, the influence of family and friends are some of the aspects that were depicted in the drawings. The rich data encountered through the drawings provided curriculum organisers with insights enabling them to implement necessary changes to the Introduction Module in order to improve student preparedness for what is to follow during the Anatomy curriculum. Further studies are recommended on how student drawings can be utilised to inform curricula and in other educational contexts. / AFRIKAANSE OPSOMMING: Anatomie bly 'n fundamentele vakgebied in die prekliniese jare van mediese en ander verwante gesondheidswetenskappe kursusse, met besonder groot volumes van die studieinhoud en 'n unieke praktiese aspek: die uitvoer van kadawer disseksie en die gebruik van voorafgedissekteerde kadawer monsters. Die opvoedkundige klimaat kan ingestel word deur 'n geskikte Inleiding Module tot die kurrikulum te voeg wat akademies en emosioneel swak voorbereide studente kan voorberei vir die formele Anatomie kurrikulum. Literatuur noem nie wat so 'n Inleiding Module moet behels nie. Kwantitatiewe praktyke soos vraelyste is voorheen gebruik om die persepsies en die emosionele en sielkundige invloed van Anatomie te evalueer. Dit word dikwels aanvaar dat deur woorde betekenis oorgedra word wat navorsers van data voorsien wat objektief vertolk kan word. Maar vraelyste is vooropgestel ten opsigte van dit wat studente mag ervaar, en die aantal moontlike antwoorde is beperk. Sterk emosies kan na vore kom in die vorm van beelde in plaas van woorde, wat studente in staat stel om te ervaar, eerder as om gevoelens te verwoord, veral met 'n beperkte woordeskat. Die gebruik van tekeninge is 'n geleentheid vir die student om hul onverdeelde gevoelens uit te druk. Kwalitatiewe data-ontleding stel die navorser in staat om komplekse lae van betekenis te interpreteer, menslike gedrag en ervarings buite die oppervlak te analiseer, bied voldoende bewyse van hierdie gedrag en ervarings en kan gevolglik teorie induktief uit die data bron bou. Die primêre doel van hierdie studie is om die lewensvatbaarheid van die gebruik van tekeninge te verken in hoe 'n diverse groep studente aan die Universiteit van Limpopo, Medunsa-kampus, Anatomie sien en watter insigte kan verkry word uit hierdie tekeninge om die temas wat in die Inleiding Module aangespreek moet word, vas te stel. Studente is gevra om hul persepsies van Anatomie uit te beeld na ongeveer tien weke se formele kontaktyd, wat lesings, sowel as praktiese sessies insluit. 'n Totaal van 74% (134 uit 181) tekeninge is ingehandig. 'n Matriks-tipe metode van analise gebaseer op bestaande literatuur is geformuleer om die tekeninge te ontleed. Drie dimensies is geïdentifiseer vir elk van die tekeninge: "wat" is geteken, dan "hoe" is die boodskap wat oorgedra word geïllustreer, en laastens die “emosie” gekommunikeer deur die tekening. Die betroubaarheid is verhoog met twee individue wat die tekeninge ontleed. Leerbenaderings, oriëntering op die menslike lewe en die dood, die algemene emosionele toestand van individue en hoe dit hul persepsies van Anatomie beinvloed, die studiekursus waarvoor hul ingeskryf is, die invloed van familie en vriende, is 'n paar aspekte wat in die tekeninge uitgebeeld is. Die ryk data teëgekom in die tekeninge kan kurrikulum organiseerders in staat te stel om die nodige veranderinge aan die Inleiding Module te implementeer ten einde die voorbereiding van studente te verbeter vir wat gaan volg tydens die Anatomy kurrikulum. Verdere studies word aanbeveel oor hoe student tekeninge gebruik kan word om leerplanne en in ander opvoedkundige kontekste in te lig.

Context: Self-learning (i.e., students learning independently) and clinical simulation are essential components in contemporary health professions education (HPE). Self-learning is discussed often, yet the concept is seldom the target of rigorous study. Likewise, simulation modalities are abundant, though educational theory that guides their use in HPE remains elusive. Objectives: This dissertation investigates the effects of directed self-guided learning (DSGL) on novice health professions students’ skill acquisition, retention, and transfer in the context of simulation-based education. The objective is to explore how the combination of external direction and student self-guidance influences: students’ cognitive and metacognitive processes, students’ interactions with the learning environment and available resources, and how students learn in different DSGL contexts. Methods: Three research studies used randomized, controlled experimental designs to address five hypotheses. All studies included a performance assessment one-week after the initial practice session that evaluated skill retention and/or skill transfer. Data analysis employed univariate and multivariate analyses of variance and correlational techniques. Results: Regarding students’ cognitive and metacognitive processes, the data show a relation between DSGL and goal-setting. The results suggest that self-guided students benefit when they are directed to set goals related to performance processes, rather than performance outcomes. Regarding the learning environment, when students are directed to practice on simulators that increase progressively in fidelity (i.e., realism) they self-guide their advancement between those simulators effectively and display successful skill transfer. Finally, self-guided students that controlled their learning progression and learning sequence selected the theoretically most appropriate practice schedule (i.e., progressive learning). Students in this latter group seemed able, surprisingly, to direct their own self-guidance. Conclusions: This dissertation adds support to the hypothesis that self-guided students benefit due to their autonomy in controlling practice conditions to meet their own learning needs. Thus, the question of whether or not DSGL is effective, becomes how best to augment the DSGL experience. The instructional design of elements such as goals lists and task structuring (e.g., progressive increases in simulator fidelity) represent techniques that an educator can use to fulfill the role of director in a student’s SGL.

Context: Self-learning (i.e., students learning independently) and clinical simulation are essential components in contemporary health professions education (HPE). Self-learning is discussed often, yet the concept is seldom the target of rigorous study. Likewise, simulation modalities are abundant, though educational theory that guides their use in HPE remains elusive. Objectives: This dissertation investigates the effects of directed self-guided learning (DSGL) on novice health professions students’ skill acquisition, retention, and transfer in the context of simulation-based education. The objective is to explore how the combination of external direction and student self-guidance influences: students’ cognitive and metacognitive processes, students’ interactions with the learning environment and available resources, and how students learn in different DSGL contexts. Methods: Three research studies used randomized, controlled experimental designs to address five hypotheses. All studies included a performance assessment one-week after the initial practice session that evaluated skill retention and/or skill transfer. Data analysis employed univariate and multivariate analyses of variance and correlational techniques. Results: Regarding students’ cognitive and metacognitive processes, the data show a relation between DSGL and goal-setting. The results suggest that self-guided students benefit when they are directed to set goals related to performance processes, rather than performance outcomes. Regarding the learning environment, when students are directed to practice on simulators that increase progressively in fidelity (i.e., realism) they self-guide their advancement between those simulators effectively and display successful skill transfer. Finally, self-guided students that controlled their learning progression and learning sequence selected the theoretically most appropriate practice schedule (i.e., progressive learning). Students in this latter group seemed able, surprisingly, to direct their own self-guidance. Conclusions: This dissertation adds support to the hypothesis that self-guided students benefit due to their autonomy in controlling practice conditions to meet their own learning needs. Thus, the question of whether or not DSGL is effective, becomes how best to augment the DSGL experience. The instructional design of elements such as goals lists and task structuring (e.g., progressive increases in simulator fidelity) represent techniques that an educator can use to fulfill the role of director in a student’s SGL.

Traditional models for public health professional education tend to be didactic, with brief, discrete practica appended. National reports of both practitioners and academicians have called for more competency-driven, interdisciplinary-focused, community-based, service-oriented, and experientially-guided learning for students across the curriculum. East Tennessee State University began its own curricular revisioning in health professions education nearly 2 decades ago with a grant from the W.K. Kellogg Foundation, emphasizing competencies development through community-based learning in community-academic partnerships. This article describes 3 examples that grew from that initiative. In the first example, students in multiple classes delivered a longitudinal community-based employee wellness intervention for a rural county school district. BS public health students conducted needs assessments and prepared health education materials; MPH students conducted health assessments and worked with school wellness councils to deliver client-centered interventions; DrPH students supervised the project and provided feedback to the schools using participatory methods. In the second example, MPH students in a social-behavioral foundations course used experiential learning to investigate the region's elevated cancer mortality ranking. Following meetings with multiple community groups, students employed theoretical constructs to frame regional beliefs about cancer and presented findings to community leaders. One outcome was a 5-year community-based participatory research study of cancer in rural Appalachia. In the third example, MPH students in a health-consulting course assessed local African Americans' awareness of the university's health and education programs and perceptions of their community health issues. Students learned consultation methods by assisting at multiple regional African American community meetings to discover issues and interest that resulted in the organization of a regional African American health coalition, multiple community health interventions, and the region's first health disparities summit. Lessons learned are presented which identify key elements of success and factors that influence adoption of community-based teaching and learning in public health.

Objective: A collaborative campus-community partnership program provided the framework for an intervention to reduce motor vehicle accident fatalities along a rural Appalachian highway. Students from public health, nursing and medicine worked with community members to identify the problem and plan the strategy to address it. Methods: An inquiry-based learning model proved to be an appropriate approach to engage student teams with community leaders in identifying and resolving health needs. Inquiry-based strategies place students in guided learning situations where their investigations lead to working solutions. The inquiry-based model matched the curricular objectives of the Community Partnership Program (CPP) more closely than the classroom oriented problem-based learning approach. Implementation: In the spring of 1994, students, along with citizens and officials of a rural Appalachian county, initiated a community-based prevention project focused on reducing deaths from motor vehicle accidents employing the principles of an inquiry-based learning model. Discussion: This project effectively demonstrates the role that students can play in mobilizing diverse elements of the community to address identified health and safety concerns. It provides an illustration that a longitudinal, community-based, service-learning approach to health professions education is beneficial to both student learners and communities. Conclusions: Through the use of inquiry-based learning methods, students gained real life experience in applied principles of health statistics, epidemiology, community organization, health risk communication, health education planning and program implementation. Outcomes of the project included a measurable reduction in automobile-related fatalities and the initiation by the state department of transportation of a series of investigations expected to pave the way for physical improvements to the roadway.

My thesis examines patients’ and caregivers’ perspectives on educating healthcare providers(HCPs). Specifically, it examined two research questions: 1) What do patients think about their involvement in the education of HCPs? and 2) What roles do patients want to have in the education of HCPs? It is important for educational leaders and HCPs to understand answers to these questions, from patients’ own perspectives, to make effective changes in current and future health professions education and ultimately, the delivery of patient-centred care. I conducted semi-structured interviews with 27 patients and caregivers for this study. Through conventional content analysis, I identified five themes for what patients think about their involvement in the education of HCPs. Namely, patient involvement in the education of HCPs: (1) is challenging because of power-differentials between themselves and HCPs; (2) requires patient training; (3) needs to start early in HCPs’ education process; (4) can improve patient-HCP partnerships; and (5) requires compensation for patients. I also identified three roles that patients want to have in the education of HCPs. Specifically, they want to: (1) teach HCPs about patients’ expectations, experiences, and perspectives through case studies, storytelling, and research; (2) provide direct feedback to HCPs; and (3) advise on curricula development and admission boards for HCPs. My research adds to the limited research on patients’ and caregivers’ perspectives on their involvement in the education of HCPs, identifies barriers to patient involvement, and provides a foundation that HCPs and educational leaders can use to improve patients’ active involvement in the education of HCPs. Further, it highlights that patients’ voices are important to the education of HCPs. It also illuminates my own perspectives on patient involvement in the education of HCPs, which I share as part of my positionality as a researcher who conducted this study.

Thesis (Doctor of Radiography)--Cape Peninsula University of Technology, 2020 / Radiation therapy has undergone significant changes with regard to new medical imaging technologies, including computerised tomography (CT) and magnetic resonance imaging (MRI). Practitioners now have access to technologies that provide anatomical information in an infinite selection of views. Earlier advances in three-dimensional conformal radiation therapy (3D-CRT) allowed for the site of treatment to be accurately located. Intensity modulated radiotherapy (IMRT) enabled practitioners to accurately focus the ionising radiation beam, while modulating the intensity of the dose being administered. Currently, using image-guided radiotherapy (IGRT) methods, radiation therapists can track the effectiveness of treatment in real-time to provide better protection for the organs and tissue that are not targeted for treatment. The changes described above have fundamentally changed radiation therapy practice, and thus have implications for the training of radiation therapists. This thesis argues that without a deep understanding of the science underpinning the advancements in radiation therapy techniques, practitioners will be unlikely to achieve the necessary level of accuracy and consistency in treatment. Radiation physics concepts, such as sources and types of ionising radiation, ionisation, the isocentre and the Inverse Square Law underpin competent and safe practice. Threshold concepts, such as those listed above, have been identified as concepts that pose difficulty to students due to its complexity and the increased levels of cognitive challenge required to master a threshold concept. In applied disciplines, such as radiation physics, threshold concepts are strongly associated with competent practice. This study focused on the first year radiation physics curriculum and addressed the overarching research question: What is the relationship between threshold concepts in the radiation physics curriculum and radiation therapy practice? The study was guided by a translation device that combined two conceptual frameworks namely the Threshold Concept Framework and Legitimation Code Theory’s (LCT) Semantics dimension. LCT is a knowledge base theory that explains the complexity of knowledge structures. The Semantics dimension provided an explanation of the difficulty of concepts and proposed five pedagogies for the cumulative learning of complex concepts. A case study research design and methodology guided the research process. Data for the study comprised curriculum documents, and semi structured focus group and individual interviews with students, academic staff and clinical educators. The data were analysed using a translation device to show the semantic profile of curriculum documents, pedagogies and participants’ different understandings of the threshold concepts in radiation physics. The study found that threshold concepts in radiation physics underpin competent and safe practice. An external language of description was developed to identify the characteristics of threshold concepts. A virtual clinical environment was proposed as one of the pedagogies to aid mastering of threshold concepts through visualisation of the unseen by facilitating students’ understanding of threshold concepts for competent and safe radiation therapy practice. The study showed that students’ mastery of threshold concepts in radiation physics is critical for practice.

No description available.

<p>This thesis explores the Cognitive Load Theory (CLT) framework with health professions education research, and applies the principles of CLT to one specific area of health professions education: the acquisition of cardiac and respiratory auscultation and physical assessment skill in undergraduate nursing students. The first study evaluates context-based learning environments on the acquisition of auscultation skill and physical assessment performance. Results suggest that for novice level students, high-context-based learning environments may contribute to extraneous cognitive load and may not be beneficial for learning. The next cluster of studies evaluates auscultation test performance following manipulation of cognitive load variables. The interleaving approach instruction was found to be most helpful for auscultation test performance. The series of studies conducted in this thesis demonstrate a useful direction for health professions research and promotes the use of cognitive load theory as a framework for instructional design and evaluation.</p> / Doctor of Philosophy (PhD)

Thesis (MPhil)--Stellenbosch University, 2014. / INTRODUCTION: For this MPhil research assignment, I have chosen to write an article based on a small scale research project conducted in the Clinical Skills Centre (CSC) at Stellenbosch University. Medical students’ perceptions were gathered in order to evaluate the usefulness and relevance of the Clinical Skills module and the different components thereof as experienced by the students themselves. This in the end led to valuable feedback that were given to the course coordinators which in turn may lead to curricula changes being made to improve the overall teaching and learning experience for future medical students rotating through the CSC.