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

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction and Background High fidelity simulation (HFS) refers to a mannequin that is modeled to represent a human and is programmed to produce physiologic functions such as palpable pulses, voices and abdominal sounds through computer interfaces. Recent introduction of HFS for learning nursing skills like critical thinking and problem solving in the developing world (Lesotho) has generated debate. The debate is centered on the acceptability of HFS, its effectiveness as a learning strategy compared to its high cost, especially in resource limited settings. Its acceptability in the developing world to date is mixed, affecting its ultimate utilization. Therefore contextual differences between developing and developed countries suggest that research findings on the evaluation of acceptability of HFS in the two places could be different. Additionally, health sciences education is a highly complex discipline with huge differences in practices within and across classes, schools, sites and countries, making it difficult to generalize findings from other settings to the setting of Lesotho. Aim The purpose of this study was to explore third year diploma in nursing students’ perceptions and experiences of HFS use in learning nursing skills. Methods A qualitative descriptive design was utilized to investigate HFS use at a school of nursing. Sixteen participants took part in three separate focus group discussions in two groups of five, and one group of six participants. The data was analyzed thematically. Results Students had mixed perceptions, positive and negative, based on the nature of their experiences which were both fulfilling and frustrating. This study revealed five key themes that shaped students experiences, hence perceptions of using HFS in learning. The themes are authentic learning environment, unique learning opportunities, access, contextual factors and transfer of skills. Discussion Student nurses had both positive and negative experiences of using HFS in learning. They believe that HFS is a valuable learning strategy but that it needs to be better utilized. Student nurses perceive HFS as providing an authentic learning environment which allows learning of complex skills like critical thinking and problem solving. On the other hand, they believe that learning can be improved if HFS is more accessible for use by students and if supervisors are adequately trained and students are better oriented on the use of HFS in learning. Conclusions HFS is viewed as an effective learning strategy among nursing students in resource limited settings, although there in need to improve its utilization for better learning experiences and outcomes. / AFRIKAANSE OPSOMMING: Inleiding en Agtergrond Hoëtrou-simulasie (HTS) verwys na ’n pop wat gemodelleer is om ’n mens te verteenwoordig en geprogrammeer is om fisiologiese funksies soos tasbare polse, stemme en abdominale klanke te lewer deur rekenaar-koppelvlakke. Onlangse bekendstelling van HTS in die aanleer van verpleegvaardighede soos kritiese denke en probleemoplossing in die ontwikkelende wêreld (Lesotho) het debat laat ontstaan. Die debat sentreer om die aanvaarbaarheid van HTS en sy effektiwiteit as ’n leerstrategie in vergelyking met sy hoë koste, veral in hulpbronbeperkte omgewings. HTS se aanvaarbaarheid op verskillende plekke in die ontwikkelende wêreld tot op datum is gemeng, wat die uiteindelike gebruik daarvan raak. Daarom dui kontekstuele verskille tussen ontwikkelende en ontwikkelde lande aan dat navorsingsbevindings oor die beoordeling van aanvaarbaarheid van HTS in die twee omgewings kan wissel. Bykomend is opleiding in die gesondheidswetenskappe ’n uiters komplekse dissipline met groot verskille in praktyke binne en oor klasse, skole, omgewings en lande, wat dit moeilik maak om bevindings van ander omgewings tot die omgewing van Lesotho te veralgemeen. Doel Die doel van hierdie studie was om derdejaar-diplomaverpleegstudente se persepsies en ervarings van die gebruik van HTS vir die aanleer van verpleegvaardighede te ondersoek. Metodes ’n Kwalitatiewe gevallestudieontwerp is benut om die verskynsel van HTS by Paray Verpleegkundeskool te ondersoek. Sestien deelnemers het aan die verskillende fokusgroepbesprekings deelgeneem in twee groepe van vyf, en een groep van ses deelnemers. Die data is ontleed met die gebruik van die konstante vergelykingsanalise-model. Resultate Studente het gemengde waarnemings, positief en negatief, ervaar, gebaseer op die aard van hul ondervindings wat sowel vervullend as frustrerend was. Hierdie studie het vyf sleuteltemas geopenbaar wat studente se ondervindings, en sodoende hul waarnemings van die gebruik van HTS in opleiding gevorm het. Die temas is outentieke leeromgewing, unieke leergeleenthede, toegang, kontekstuele faktore en oordrag van vaardighede. Bespreking Studentverpleegsters aanvaar die gebruik van HTS om verpleegvaardighede te leer. Hulle glo dat HTS ’n waardevolle leerstrategie is, wat egter beter benut moet word. Studentverpleegsters beskou HTS as ʼn verskaffer van ʼn outentieke leeromgewing wat die aanleer van komplekse vaardighede soos kritiese denke en probleemoplossing toelaat. Aan die ander kant glo hulle dat opleiding verbeter kan word indien HTS meer toeganklik is vir gebruik deur studente en indien toesighouers voldoende opgelei is en studente beter voorgelig word in die gebruik van HTS as opleidingsmiddel. Gevolgtrekkings HTS is ʼn aanvaarbare leerstrategie onder verpleegstudente in omgewings met beperkte hulpbronne, hoewel daar ʼn behoefte is om die benutting daarvan vir beter leerervarings en uitkomstes te verbeter.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Introduction: Self-directed learning (SDL) is the essential mechanism of lifelong learning which, in turn, is required for medical professionals to maintain competency due to advancing technology and constantly evolving disease care and contexts. Yet, Nigerian medical schools do not actively strive to develop self-directed learning skills in medical students, neither is it implemented in the College of Health Sciences, University of Uyo (COHUU). - Aim of study : The aim of this study was to evaluate the status of self-directed learning behaviour amongst final year students, and the perceptions of faculty leadership towards SDL in a Nigerian medical school. - Methodology: A mixed method research method was used for the study. A survey design, in which students completed a self-rating scale for self-directed learning as a means of quantitatively assessing their self-directed learning behaviour, was employed. A focus group discussion involving selected faculty leaders provided the qualitative data for this study. - Results: The medical students displayed moderate self-directed learning behaviour, based on the score on the Self-rating Scale for Self-Directed Learning (SRSSDL). Thematic analysis of the qualitative data revealed that the faculty leadership perceived SDL as essentially self-motivated learning by students in a task-sharing partnership with and guided by, their teachers. Faculty expressed concerns over a possible misunderstanding of what SDL implies for students. They furthermore considered their students’ SDL behaviour to be low. Faculty was willing to implement a COHUU model for achieving SDL. - Conclusion: This study suggests the baseline SDL behaviour of medical students at University of Uyo to be low to moderate, based on both the perceptions of Faculty leadership and the SRSSDL. Faculty are willing to implement a COHUU model for achieving SDL.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: This assignment describes an evaluation by experts of an on-line course in Clinical Immunology offered to medical registrars and scientists as a supplement to a practical rotation. Because of a lack of agreement on what constitutes quality in e-learning and to avoid the customary focus on usability evaluation, an open-ended, interpretivist approach was used here which, while not entirely novel, was unusual in an e-learning environment. For this project it was decided to evaluate both content (subject matter) as well as instructional value using two groups of peers from various academic institutions, clinical immunology experts and e-learning experts. Feedback was obtained through participation in a focus group or in writing. Replies were much easier to obtain from the e-learning group. Five out of seven e-learning experts provided a response, versus three out of twenty subject matter experts. Eventually most of the feedback was obtained from colleagues from the home institution. Both groups made valuable, somewhat overlapping suggestions. Subject matter experts indicated that the course materials were of good quality and adequate on a postgraduate level. E-learning experts expressed concern about the ability of the course to facilitate learning and identified also some usability issues. Some of the findings may well apply to other settings. A number of five evaluators in each group appeared to give a good coverage within an open-ended approach. Expert peer review offered insights that neither student feedback nor self-reflection could. Rather than imposing evaluative criteria on the experts through the use of fixed checklists, the open-ended approach allowed them to cumulatively develop their own framework tailor-made for the course. The choice of subject matter plus e-learning experts may be helpful in similar situations of evaluating on-line courses where dual expertise is not readily available. The open-ended interpretivist approach can be used for formative evaluation only and may work well for courses that are still in development or where an amount of uncertainty about teaching effectiveness exists. Future efforts will likely focus on implementing the recommendations, identifying sustainable ways of quality review for the current course and similar open-ended evaluation of other courses. / AFRIKAANSE OPSOMMING: Die evaluering deur kundiges van ’n aanlyn-kursus in Kliniese Immunologie word in hierdie opdrag bespreek. Hierdie kursus word bykomend tot ‘n praktiese rotasie vir kliniese assistente (medies) en wetenskaplikes aangebied. Aangesien daar nie eenstemmigheid is oor wat gehalte in e-leer behels nie, en om die gebruiklike fokus op die evaluering van gebruiksmoontlikhede te vermy, is ’n interpreterende benadering in hierdie geval gebruik. Alhoewel hierdie benadering nie heeltemal nuut is nie, is die gebruik daarvan ongewoon in die eleer- omgewing. Daar is besluit om vakinhoud sowel as onderrigwaarde in hierdie projek te evalueer. Twee ewe-kniegroepe van verskillende akademiese inrigtings, kundiges in kliniese immunologie sowel as kundiges in e-leer is gebruik. Terugvoer is ontvang deur die deelname aan fokusgroeponderhoude of deur skriftelike terugvoer. Terugvoer is makliker van die e-leergroep verkry. Vyf uit die sewe e-leerkundiges het gerespondeer teenoor drie uit die twintig vakkundiges. Uiteindelik is die meeste terugvoer verkry van kollegas van die tuisinstelling. Beide groepe het waardevolle, maar dikwels oorvleuelende aanbevelings gemaak. Die vakkundiges het aangedui dat die kursusmateriaal van ’n goeie gehalte en geskik op ’n nagraadse vlak is. Die eleerkundiges het hul kommer uitgespreek oor die vermoë van die kursus om leer te fasiliteer en het ook ’n aantal kwessies ten opsigte van bruikbaarheid uitgewys. Sommige van die bevindinge kan moontlik ook in ander kontekste van toepassing wees. Dit het geblyk dat ongeveer vyf evalueerders in elke groep ’n goeie verslag met die oopvrae-benadering gegee het. Vakkundige ewe-kniebespreking het insigte opgelewer wat nie moontlik was met studente-terugvoer of selfrefleksie nie. In plaas daarvan dat evaluerende kriteria deur vaste vraelyste op die kundiges afgedwing is, het die oopvrae-benadering hulle die geleentheid gebied om kummulatief hul eie toepaslike raamwerk vir hierdie spesifieke kursus te ontwikkel. Die keuse van vakkundiges en e-leerkundiges mag nuttig wees in soortgelyke situasies waar aanlynkursusse geëvalueer word en die tweeledige kundigheid nie geredelik beskikbaar is nie. Die oopvraeinterpreterende benadering kan slegs vir formatiewe evaluering gebruik word en mag moontlik goed werk vir kursusse wat nog ontwikkel word en waar daar heelwat onsekerheid oor die doeltreffendheid van die onderrig bestaan. Verdere ontwikkeling sal waarskynlik fokus op die implementering van die aanbevelings, die identifisering van volhoubare maniere van gehalte-beoordeling vir die huidige kursus en soortgelyke oopvrae-evaluering van ander kursusse.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: A. Background - Registrars play a significant role as teachers for undergraduate medical students and junior doctors in the clinical setting. (Jack et al. 2010; Busari & Scherpbier 2004). Many however teach ineffectively as registrars are rarely taught how to teach (Morrison et al. 2002, Busari et al. 2002; Thomas et al. 2002). This has prompted a number of universities to implement “Registrar-as-Teacher” training programs as part of faculty development (FD) initiatives (Leslie et al. 2014; Post et al. 2009, Hill et al. 2009). Although available evidence has demonstrated a positive impact of these programs on the teaching performance of registrars, large differences exist in the interventions, curricula content and participant characteristics. Few studies identified a conceptual framework that informed the design. Most studies focused on a quantitative approach to evaluate outcome; ignoring contextual factors that may shape the successful implementation of new knowledge and skills gained. At Tygerberg Hospital, education is a key performance area of registrar’s staff performance management agreement but no formal training program for registrars as teachers exists. The Centre for Health Professions Education at Stellenbosch University thus piloted a half-day workshop for newly appointed registrars from various disciplines with the aim to develop the clinical supervision skills of registrars as clinical educators. B. Research Design and Methodology - The overall aim of this study was to evaluate the outcome of a pilot “Registrar-as-Teacher” workshop at the University of Stellenbosch. The specific objectives included: - To evaluate registrar perceived relevance of workshop content - To evaluate registrar self-evaluation of teaching practices - To identify factors affecting the teaching practices of registrars - To observe and evaluate registrar teaching practices in the clinical setting - To increase the “Registrar-as-Teacher” workshop effectiveness A two-phased mixed method design was used, using semi-structured interviews and observation of registrars. Phase one comprised of semi-structured interviews to elicit both numerical and text-based data. Phase two included observer ratings to further explore the application of knowledge, skills and attitudes gained. The “Registrar-as-Teacher” program content was informed by the teaching roles described by Harden and Crosby (2000). As educational strategy, Knowles’ adult learning theory (1980) was applied. The study was conducted at Tygerberg Hospital, a Stellenbosch University Faculty of Health Sciences affiliated teaching hospital in Cape Town, South Africa. The study population included newly appointed registrars (year 1 and 2) from the Departments of Internal Medicine, Paediatrics, Obstetrics and Gynaecology, Surgery, and Orthopaedics. An inductive approach was used to analyze the qualitative data. Demographic, registrar self- evaluations and workshop evaluation data was analyzed using descriptive statistics. This study was approved by the Health Research Ethics Committee of Stellenbosch University (protocol number S13/10/177). C. Results - Seven of the fifteen registrars attending the pilot workshop agreed to take part in phase 1 of the study; five from the Department of Paediatrics and Child Health, and one from Surgery and Obstetrics & Gynaecology respectively. Five agreed to take part in phase 2 of the study; all from the Department of Paediatrics and Child Health. Participants reported satisfaction with the program and experienced the workshop as a positive learning experience (Kirkpatrick level 1). Participants self-reported positive changes in attitudes, including motivation, self-confidence, enthusiasm, and conceptions of teaching. Knowledge and skills were gained, as self-reported and observed. Individual benefits such as increased self-awareness of teaching ability and increased awareness of student needs were reported (Kirkpatrick level 2). Participants self-reported behavior changes in their teaching practices. Participants, bar one, demonstrated appropriate educational practices and teaching skills (Kirkpatrick level 3). Participants in our study reported their expanded conceptions of the roles of a teacher as one of the most useful aspects of the workshop. Role modelling was singled out as the most useful session. Participants generally had a positive view on their contribution to student learning. They saw it as a formative influence on how students view the profession and discipline. Unique aspects of registrar teaching were highlighted as being more informal in nature, more practice orientated; and working in a closer relationship with students; thus complementary to the consultant teaching role. Participants recognized that they are still developing their clinical teaching skills. Most participants rely on observed teaching methods or borrow from their own experiences as students. Participants based their self-assessment of being a good teacher on their personal views that mirrored their conceptions of a good teacher; seldom asking for or receiving feedback on their teaching skills to shape their own learning or performance as clinical teachers. Most participants in our study asked for regular or follow up training where they could reflect on their development and also receive feedback on progress made. Few participants felt comfortable to give feedback to students or to use the ‘one-minute preceptor’ compared to other aspects of clinical teaching. Our FD program’s session on teaching in the clinical setting and the ‘one-minute preceptor’ thus worked less well. This speaks to how to increase the effectiveness of future workshops. Even though all participants enjoyed teaching students, reported barriers to effective teaching were many. Participants often felt frustrated and overwhelmed by their teaching task. Limited time with competing responsibilities such as huge service demands and administrative duties impacted negatively on participants’ ability to teach students. Participants mostly felt unsupported and undervalued as teachers by their various departments, with little guidance on the expected student teaching content, process or learning outcomes. Although the expectation to teach is clearly communicated by the various departments, there is no training, supervision structure, formative feedback, or appreciation of their teaching performance. This lack of orientation and communication was further highlighted by participants pointing to the explanation of the MBChB undergraduate curriculum structure as the second most useful component of the course after role modelling. D. Conclusion and Recommendations - Our study confirmed the important role of registrars as teachers in the clinical setting. Apart from sharing theoretical and on-the-job knowledge, registrars teach practical skills and act as role models for the profession. Participants perceived the pilot “Registrar-as-Teacher” workshop content as relevant and the workshop shaped their teaching conceptions and practices. But workplace barriers like limited time with competing responsibilities impacted negatively on participants’ ability to teach students. A reported lack of guidance and support from the respective departments further undermined their ability to develop as clinical teachers. Future “Registrar-as-Teacher” FD initiatives at Stellenbosch University should thus provide registrars with optimal approaches and best teaching practices for busy clinical settings; enabling them to merge teaching with work. Strengthening FD requires the adoption of a broader conceptual framework that does not just focus on the individual participant, but link FD to the development of the department or institution as a whole (Swanwick & McKimm 2012). Workplace communities that include departmental faculty members should be involved in FD programs; allowing for ongoing learning and professional development of registrars as clinical teachers (O’Sullivan & Irby 2011; Steinert et al. 2010; Webster-Wright 2009; Hunter et al. 2008; Thorndyke et al. 2006). This requires a longitudinal strategy. Our “Registrar-as-Teacher” FD program should thus move away from the one-time workshop and instead create multiple learning events with opportunities for application and reflection. / AFRIKAANSE OPSOMMING: A. Agtergrond - Kliniese Asssistente (KAs) speel ‘n belangrike rol as onderwysers vir voorgraadse studente en junior dokters in die kliniese omgewing (Jack et al. 2010; Busari & Scherpbier 2004). Baie gebruik egter oneffektiewe onderrigmetodes omdat hulle selde opleiding ontvang oor onderrig (Morrison et al. 2002, Busari et al. 2002; Thomas et al. 2002). Verskeie universiteite het die probleem aangespreek deur “KA-as-Onderwyser” opleidingsprogramme as deel van hul Fakulteitsontwikkelings inisiatiewe te loots (Leslie et al. 2014; Post et al. 2009, Hill et al. 2009). Alhoewel beskikbare bewyse dui op ‘n positiewe impak van die programme op die onderrig prestasies van Kliniese Assistente, kom groot verskille voor in die intervensies, kurrikulum inhoud en deelnemer eienskappe. Min studies het sover ‘n konseptuele raamwerk geidentifiseer wat die studie ontwerp belig. Meeste studies fokus ook op slegs ‘n kwantitatiewe benadering as evalueringsuitkoms; en ignoreer die kontekstuele faktore wat die suksesvolle implementering van nuwe kennis en vaardighede mag beinvloed. By Tygerberg Hospitaal is onderrig ‘n sleutel prestasie area vir Kliniese Assistente se personeel prestasie bestuur ooreenkoms, maar geen formele opleidingsprogram vir KAs bestaan nie. Die Sentrum vir Gesondheidsberoepe Onderwys by Stellenbosch Universiteit het dus ‘n halfdag werkswinkel geloots vir nuutaangestelde KAs van verskeie departemente met die doel om hul kliniese supervisie vaardighede te ontwikkel. B. Navorsingontwerp en Metodiek - Die oorkoepelende doel van die studie was om die uitkoms van die nuwe “KA-as-Onderwyser” werkswinkel by die Universiteit van Stellenbosch te evalueer. Die spesifieke doelwitte het ingesluit: - Om die KAs se relevansie van die werkswinkel inhoud te evalueer - Om KAs se self-evaluasie van hul onderrigpraktyke te evalueer - Om faktore te identifiseer wat onderrigpraktyke van KAs beinvloed - Om KAs se onderrigpraktyke in die kliniese omgewing te observeer en te evalueer - Om die effektiwiteit van die “KA-as-Onderwyser” werkswinkel te verbeter. ‘n Twee-fase gemengde metodiek ontwerp is gebruik wat die gebruik van semi- gestruktureerde onderhoude en observasies van KAs ingesluit het. Fase een het bestaan uit semi- gestruktureerde onderhoude om beide numeriese en teks-data te ontlok. Fase twee het ingesluit observasies en gradering van onderrig aktiwiteite om die toepassing van nuwe kennis, vaardighede en houdings te verken. Die “KA-as-Onderwyser” program inhoud is deur die onderwyser rolle soos beskryf deur Harden en Crosby (2000) toegelig. As onderrigstrategie is Knowles se volwasse leerteorie (1980) toegepas. Die studie is uitgevoer by Tygerberg Hospitaal, ‘n Stellenbosch Universiteit Fakulteit van Geneeskunde en Gesondheidswetenskappe geaffilieerde onderrighospitaal. Die studie populasie het ingesluit nuutaangestelde KAs (jaar 1 en 2) van die Departemente Interne Geneeskunde, Pediatrie, Obstetrie en Verloskunde, Chirurgie en Ortopedie. ‘n Induktiewe benadering is gevolg om die kwalitatiewe data te analiseer. Demografiese, KA self- en geobserveerde evaluasies, en werkswinkel evaluasie data is met behulp van beskrywende statistiese metodes geanaliseer. Die studie is goedgekeur deur die Gesondheids Navorsings Etiese Komitee van Stellenbosch Universiteit (protokol nommer S13/10/177). C. Resultate Sewe van die vyftien KAs wat die werkswinkel bygewoon het, het ingestem om deel te neem aan fase 1 van die studie; vyf van die Departement van Pediatrie en Kindergesondheid, en een elk van Chirurgie en Obstetrie en Verloskunde. Vyf het ingestem om deel te wees van fase 2 van die studie; almal van die Departement van Pediatrie en Kindergesondheid. Deelnemers was gelukkig met die program en het die werkswinkel as ‘n positiewe leerervaring beskryf (Kirkpatrick vlak 1). Deelnemers het positiewe veranderinge in houding, insluitend motivering, selfvertroue, entoesiasme, en opvattings van onderrig rapporteer. Beide selfbeskrywende en geobserweerde kennis en vaardighede is uitgebrei. Individuele voordele soos verhoogde self bewustheid van onderrig vermoeens en verhoogde bewustheid van studentbehoeftes is gerapporteer (Kirkpatrick vlak 2). Deelnemers het veranderinge in hul onderrig praktyke rapporteer. Alle deelnemers, behalwe een, het ook toepaslike onderrig praktyke en onderrig vaardighede demonstreer (Kirkpatrick vlak 3). Deelnemers van ons studie het die nuwe opvattings oor hul rol as kliniese onderwysers as een van die waardevolste aspekte van die werkswinkel beskryf. Rolmodellering was uitgesonder as die mees waardevolste sessie. Deelnemers het in die algemeen ‘n positiewe siening van hul bydrae tot studente onderrig gehad. Hulle sien dit as ‘n formatiewe invloed op hoe studente die mediese professie en spesifieke dissiplines beskou. Unieke aspekte van KA onderrig wat uitgelig is was die meer informele aard van hul onderrig, dat dit meer prakties georienteerd is, en dat hul ‘n nouer verhouding met studente het; dus ‘n komplementere rol tot die onderrig rol van die konsultant. Deelnemers erken dat hul steeds ontwikkel as kliniese onderwysers. Meeste deelnemers maak staat op geobserweerde onderrigmetodes of leen van hul eie ervarings as student. Deelnemers baseer hul siening oor hulself as goeie onderwysers op hul persoonlike siening van ‘n goeie onderwyser en vra selde terugvoer oor hul onderrig praktyke om sodoende hul eie leer en prestasie as kliniese onderwysers te vorm. Meeste deelnemers in ons studie het egter gevra vir gereelde en opvolg opleiding sodat hulle oor hul eie onderrig praktyke kan reflekteer. Min deelnemers was gemaklik om terugvoer aan studente te gee of om die ‘one-minute preceptor’ strategie te gebruik in vergelyking met ander onderrig strategiee. Ons werkswinkel sessie oor onderrig en strategiee in die besige kliniese omgewing was dus minder suksesvol en sal in toekomstige werkswinkels aangespreek moet word. Alhoewel deelnemers studente onderrig oor die algemeen geniet, is baie hindernisse tot effektiewe studente onderrig beskryf. Deelnemers voel dikwels gefrustreerd en oorweldig deur hul onderrig taak. Min tyd, met kompeterende verantwoordelikhede soos dienslewering en administratiewe pligte beinvloed onderrig negatief. Deelnemers rapporteer dat hul nie voldoende ondersteuning ontvang van hul verskeie departemente nie, en voel ondergewaardeer as onderwysers. Min leiding word verskaf oor verwagte studente leeruitkomste, prosesse of kennis wat oorgedra moet word. Alhoewel die verwagting dat KAs moet onderrig gee duidelik gekommunikeer word deur die verskeie departemente, vind geen opleiding, supervisie of terugvoer oor hul prestasies plaas nie. Hierdie gebrek aan orientering en kommunikasie was verder uitgelig deurdat deelnemers die verduideliking van die MBChB voorgraadse kurrikulum struktuur as die waardevolste sessie naas rolmodellering beskryf het. D. Opsomming en Aanbevelings - Ons studie bevestig die belangrike rol van KAs as onderwysers in die kliniese omgewing. Behalwe dat teoretiese en praktiese kennis en vaardighede geleer word, tree hul ook as rolmodelle vir die mediese professie op. Deelnemers het die “KA-as-Onderwyser” werkswinkel inhoud as relevant beskou en rapporteer dat dit hul onderrig opvattings en praktyke positief beinvloed het. Werksplekhindernisse soos beperkte tyd en kompeterende verantwoordelikhede beinvloed onderrig van studente egter negatief. ‘n Gerapporteerde gebrek aan leiding en ondersteuning van hul onderskeie departemente ondermyn verder KAs se ontwikkeling as kliniese onderwysers. Toekomstige “Kliniese Assistent-as-Onderwyser” Fakulteitsontwikkelings-inisiatiewe by Stellenbosch Universiteit moet dus KAs voorsien van optimale strategiee en onderrig praktyke om werk en onderrig suksesvol te kan kombineer. Om Fakulteitsontwikkelings-inisiatiewe verder te versterk, moet ‘n breer konseptuele raamwerk aanvaar word wat nie net fokus op die individuele deelnemer nie, maar wat Fakulteitsontwikkeling koppel aan die ontwikkeling van departemente en instansies (Swanwick & McKimm 2012). Werksplek gemeenskappe wat departementele konsultante insluit, moet betrokke wees by Fakulteitsontwikkeling om KAs in staat te stel om professioneel te ontwikkel as kliniese onderwysers (O’Sullivan & Irby 2011; Steinert et al. 2010; Webster-Wright 2009; Hunter et al. 2008; Thorndyke et al. 2006). Hierdie vra vir ‘n longitudinale strategie. Ons “KA-as-Onderwyser” Fakulteitsontwikkelingsprogram moet weg beweeg van eenmalige werkswinkels en eerder veelvuldige leergeleenthede skep met geleenthede vir toepassing en refleksie.

Master of Science / Department of Architectural Engineering and Construction Science / Raphael A. Yunk / Autism Spectrum Disorders, (ASD) are being diagnosed at an alarming rate. Students with ASD face many challenges in educational environments and struggle to overcome daily distractions. Students with ASD have variances in neuron connections that cause them to receive and understand their environment differently than a student without special needs. In the educational classrooms, fluorescent lighting is a significant source of extraneous stimuli that not only a source of annoyance but can also trigger common symptoms of ASD. Fluorescent fixtures economically provide an acceptable uniformity and quality of illumination, but also have disadvantages that can aggravate symptoms in students with ASD. Ballasts are required for the operation of fluorescent fixtures. These ballasts, especially if not replaced at the end of their usable life, can generate an audible hum and cyclical flickering of light. Alternative light sources, such as incandescent lamps and fixtures should be evaluated and installed not only in special needs classrooms but standard group classrooms as well. Providing additional sources or quality sources of light may help students with ASD focus on the information presented in the classroom. Traditional classroom design needs to be re-evaluated to accommodate the needs of those students with ASD to better provide a comfortable and less distracting learning environment. It is difficult to establish rigid standards for lighting designs sensitive to individuals and special needs occupants'. By understanding the symptoms of ASD and taking into account the occupants needs lighting designers will be better able to design an environment that is both comfortable and educational. This report will address the classroom environment and student considerations in order to develop parameters and design practices that will assist new lighting designers.

Thesis (MPhil)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Background: Academic support programmes have an important part to play in addressing the needs of students experiencing difficulties. A quality assurance exercise by the national accreditation body highlighted the fact that academic staff involved in non-academic counselling had no prior training. Aim: The aim of this study was to evaluate the academic advisor programme in a Malaysian medical school from the academic advisors’ perspective in order to determine their understanding of their role, their experiences and needs. Method: Focus group discussions (FGDs) involving 10 academic advisors were conducted using a semi-structured interview schedule. Results: Study participants demonstrated some instinctive understanding of their role (especially as role models in their professional development) although they did not have clear guidelines. They strongly expressed a need for training in counselling skills and better administrative support. There was some reluctance to undertake the task of academic advising as there were no perceived rewards or incentives. Conclusions: The training of academic advisors needs to be addressed in faculty development programmes. Strong institutional administrative support is important with efficient channels of communication to academic advisors on student performance and other relevant information. Teaching activities need due institutional recognition and reward. / AFRIKAANSE OPSOMMING: Geen opsomming

The purpose of the proposed study is to explore the contribution of different types of continuing professional education (CPE) to the upward career mobility of current health services administrators working in a hospital setting. The objectives of the study were to determine the pattern of participation in CPE of a sample of hospital administrators, to ascertain the degree of upward career mobility over a 10-year period and to investigate the degree of association between these two factors as well as respondents' opinions concerning the impact of CPE on upward career mobility. / Data were collected by mailing a self-administered questionnaire to a national sample of senior-level health services administrators and to the chairpersons of the board from the same institutions. The sample of health services administrators was selected in such a manner as to eliminate confounding variables of education, length of professional experience and age. Respondents reported spending an average of 83 hours per year in formal varieties of CPE and over twenty times as much, or 1,673 hours per year, in informal varieties. In the informal domain, the greatest amount of time was spent in personal discussions, followed by personal reading. Most of the formal hours of CPE were spent in training provided during professional meetings. / The level of participation in CPE--both formal and informal--turned out to be significantly but weakly associated with indicators of the actual upward career mobility of these health services administrators. At the same time, both they and the board members responsible for hiring and firing them accorded CPE participation low causal weight in career success. Its principal effects seem due to the chance it offers to improve administrative competencies that contribute to professional development and to "network" with colleagues and influential parties who may support career advancement. / Source: Dissertation Abstracts International, Volume: 55-04, Section: A, page: 0831. / Director: Peter Easton. / Thesis (Ph.D.)--The Florida State University, 1994.

This study identified and assessed perceptions of eight (8) roles engaged in, and characteristic of, the competent allied health consultant. One hundred and thirty-eight respondents from across the nation completed a specially-designed questionnaire rating scale, and their responses were classified according to whether they were (1) consultants, (2) consultees, or (3) those who had served in both capacities. / The major thrust of this investigation was to determine how closely respondents approximated hypothesized role perceptions derived from a model by Lippitt and Lippitt (1986), to determine the degree to which three groups, identified above, converged on, or diverged from, one another (in the aggregate), and to determine if the rankings of the eight roles in terms of their importance were related to the groups' status, that is, whether consultant, consultee, or a combination of both. / A subsidiary consideration of this study, which proved late in the investigation to be salient, was whether respondents had some sense of the flow of the eight roles through the consultation process along a continuum from a nondirective to a directive conclusion. / Results indicated that no significant differences distinguished any one group from another and that respondents showed a midpoint approximation of the perceptions reflected in the model by Lippitt and Lippitt. Results also indicated that little, if any, sense of the temporal appearance of roles, as exhibited by the model, was evidenced. / Summaries revealed that traditional views of consultation as (1) fact finder, (2) problem solver, and (3) information specialist predominated in importance. A central conclusion was that, in spite of the general view that little, if any, consensus exists as to what constitutes a consultant, there was close agreement with the Lippitts' version of consultant roles. Thus, the model by Lippitt and Lippitt exhibits role perceptions around which allied health consultation can cohere. / Source: Dissertation Abstracts International, Volume: 51-06, Section: A, page: 1838. / Major Professor: Joseph Beckham. / Thesis (Ph.D.)--The Florida State University, 1990.

The purposes of this study were (1) to identify the factors present in negligence suits found in case law involving prehospital care providers and (2) based on those factors, to develop a typology of causation of legal actions that could be used by postsecondary educators to emphasize specific areas in the initial training and continuing education of EMTs and paramedics. An additional purpose was to provide data which could be used to develop standards and protocols for quality assurance programs. / Using traditional legal research methods, 182 state and federal cases were identified. It was found that lawsuits involving prehospital care providers and systems have been increasing. A marked increase since 1981 was noted. / Elements of alleged negligence were identified, coded, and ultimately used to develop a typology of causation. The four major categories of causation were, in decreasing order of frequency, (1) treatment and care issues; (2) ambulance accidents; (3) dispatch and transport issues; and (4) other issues, such as training, staffing, and administration. Although alleged treatment and care negligence was the most frequent category, it involved a myriad of types of patient scenarios. On the other hand, the number one most frequent single cause of alleged negligence was ambulance accidents. / Implications of the typology for postsecondary educators, administrators, policy makers, and others were discussed. It was suggested that the typology be used to emphasize and/or alter certain aspects of educational curricula, such as driving skills, assessment skills, spinal immobilization, and others. / Legal precedents set down by the courts were dissected in order to view trends. Precedents, such as, immunity issues, emergency vehicle status, guest statutes, common carrier status, constitutional issues, and duty of care were discussed. The similarities and differences found in case law regarding these precedents were also evaluated. / Source: Dissertation Abstracts International, Volume: 53-03, Section: B, page: 1275. / Major Professor: Louis Bender. / Thesis (Ed.D.)--The Florida State University, 1992.