This descriptive case study examines the use of medical simulation technology in the three-year Thompson Rivers University respiratory therapy training program. Qualitative analysis of data gathered from 78 participants through interviews, observations, and discussion groups reveal a wide variety of low- intermediate- and high-fidelity technologies used for education and evaluation. Deliberate practice is the predominant learning theory informing the use of simulation for safe and ethical training in competencies that would otherwise pose significant risk to patients. Recommendations include enhancements of the existing technology with psychological and environmental fidelity, and for optimal curriculum placement of high-fidelity simulators at hospital sites for student development of critical thinking and team training. Further research into learning with high-fidelity simulation specifically within the context of a student respiratory therapist as an embedded hospital team member is needed. Keywords: respiratory therapy, patient simulation, critical thinking, learning, critical care, deliberate practice

Although it is relatively easy to study and learn about a practice discipline in the safe environment of an academic institution, it is far more complex to make sense of what has been learned when faced with the real world of practice. Practitioners need to think on their feet and have to find new ways of managing complex problems which do not fit directly into the theoretical frameworks learned in a more formal setting. Knowledge of what the various disciplines say is not in itself sufficient, experiential knowledge is necessary. The key to learning in the experiential domain is critical reflective practice and emancipatory learning, which empower practitioners to explicate their implicit theories. If autonomy is the goal of professional education, the key is to help adult learners to distance themselves from their own values and beliefs in order to entertain more abstract modes of perception. The purpose of this inquiry was therefore, to construct a model for facilitation of critical reflective practice, based on thorough analysis of the main concepts (critical thinking and reflection), related viewpoints, models and theories; and the data gathered and analyzed during, the naturalistic inquiry. The inquirer sought to. develop each participant through Socratic & Learning Through Discussion (Dialogical) Technique, Critical Incident Reporting and participation in Critical Reflective Exercises. The constructed model for facilitation of critical reflective practice evolved from empirical observations, intuitive insights of the inquirer and from deductions combining ideas from several fields of inquiry. The model for facilitation of critical reflective practice postulates that practitioners have the inherent potential to change from auto-pilot practice to critical reflective practice. The purpose of the model is the facilitation of heightened awareness of the self, to enable health care professionals to consciously meet community needs and expectations. The desired outcome is transformative intellectuals who will strive to empower others to become critical reflective learners and practitioners. / Health Studies / D.Litt. et Phil. (Nursing Science)

Teoretiese navorsing is onderneem om 'n model vir kurrikulumontwikkeling vir die Diploma vir Registrasie as Verpleegkundige (algemene, psigiatriese, gemeenskaps-) en Vroedvrou te ontwikkel. Twee hooffaktore beinvloed verpleegonderwys. Op globale vlak word verpleegonderwys beinvloed deur die realiteite van 'n inligtingtegnologie-gedrewe samelewing. Dit noodsaak die ontwikkeling van kritiese denke, aanpasbaarheid ten opsigte van konstante sosiale verandering en 'n verbintenis tot lewenslange leer. Op nasionale vlak word verpleegonderwys beinvloed deur 'n nasionale gesondheidstelsel wat gekwalifiseerde verpleegkundiges vereis, wat in staat is om omvattende gesondheidsorg te lewer. 'n Situasie-analise het gelei tot die identifisering van twee hoofkonsepte wat die verpleegkundekurrikulum beinvloed, naamlik lcritiese denke en omvattende gesondheidsorg. Vorige navorsing dui daarop dat verpleegdosente nie paraat is ten opsigte van verwikkelinge in die onderwys nie. Dit kan negatiewe gevolge he vir innoverende kurrikulumontwikkeling in verpleegkunde ten einde die professie strategies te posisioneer om te voldoen aan die eise van die komende eeu. Die navorser het beoog om die leemte te oorbrug deur middel van navorsing wat gemik was op die daarstelling van 'n omvattende kurrikulumontwikkelingstrategie wat kan dien as praktiese riglyn vir die implementering van kurrikulumontwikkeling in verpleegkunde. Op grond van 'n analise van die konsep kurri/culum, 'n situasie-analise en die interpretering daarvan, is die Model vir Kurrikulumontwikkeling in Verpleegkunde gekonseptualiseer. Die model kan verpleegdosente in staat stel om fundamentele kurrikulumverandering te bewerkstellig en 'n relevante kurrikulum daar te stel, deur gespesifiseerde kurrikulumontwikkelingstake stelselmatig af te handel. Die implikasies van die konsepte lcritiese denke en omvattende gesondheidsorg vir die verpleegkundekurrikulum, is uitgespel deur kriteria vir die nuwe verpleegkundekurrikulum te formuleer / The researcher undertook theoretical research to develop a curriculum development model for the Diploma for Registration as a Nurse (General, Psychiatric, Community) and Midwife. There are two main tendencies that influence nursing education. On a global level nursing education is influenced by realities that are inherent in an information technology-driven world. This requires the development of critical thinking skills, adaptability to constant social change and a commitment to life-long learning. Nationally, nursing education is influenced by a national health system requiring trained nurses who are able to render comprehensive health care. A situation analysis resulted in the identification of two main concepts that influence the nursing curriculum namely, critical thinking and comprehensive health care. Previous research indicates that nurse educators are outdated in terms of developments in education. This can have negative consequences for innovative curriculum development in nursing in order to position the nursing profession strategically to meet the demands of the next century. This limitation prompted the researcher to conduct research that was aimed at designing a comprehensive curriculum development strategy to serve as a practical guideline on how to implement curriculum development in nursing. Based on an analysis of the concept curriculum, a situation analysis and the interpretation thereof: the researcher conceptualized the Curriculum Development Model for Nursing. The model will enable nurse educators to effect fundamental curriculum change and the development of a relevant curriculum by completing specified curriculum development tasks systematically. The implications of the concepts critical thinking and comprehensive health care for the nursing curriculum, were elucidated by formulating criteria for a new nursing curriculum. Key terms: curriculum; curriculum development; curriculum foundation; curriculum structure; curriculum design; situation analysis; critical thinking; reflective practice; comprehensive health care; comprehensive nursing curriculum; community based curriculum; problem based learning; media assisted learning; ~ve learning; reflective learning; experiential learning; mediated learning. / Health Studies / D.Litt. et Phil. (Advanced Nursing Science)

Il y a quelques décennies, l’émergence du discours de la promotion de la santé infléchissait un nouveau tournant à la santé publique, orientant sa pratique vers l’action communautaire, participative et intersectorielle. Parallèlement, au Québec, la réforme du système de santé de 2004 réorganisait le niveau de gouverne locale à travers la création des centres de santé et de services sociaux (CSSS). Ceux-ci doivent articuler les secteurs des soins et de la santé publique à travers un continuum de services qui va de la promotion de la santé aux soins palliatifs. Ces changements ont des implications majeures pour les acteurs de la santé et de la santé publique, qui doivent composer avec de nouveaux rôles professionnels et de nouvelles stratégies d’action. Le développement professionnel est considéré comme un levier potentiel pour soutenir ces changements. En 2009, une équipe de la Direction de la santé publique de l’Agence de santé et des services sociaux de Montréal concevait un programme de développement professionnel appelé le Laboratoire de promotion de la santé. Ce programme mise sur une approche d’apprentissage de groupe pour permettre aux professionnels des CSSS de développer de nouvelles compétences, une pratique réflexive ainsi que de nouvelles pratiques de promotion de la santé. Basée sur une méthodologie générale qualitative et une approche d’évaluation collaborative, cette thèse utilise plusieurs stratégies d’investigation afin d’évaluer le Laboratoire de promotion de la santé sous trois angles, qui renvoient à sa conceptualisation, à son implantation et à ses effets. Plus spécifiquement, elle vise à : (1) examiner la plausibilité de la théorie d’intervention du programme; (2) décrire et comprendre les processus d’apprentissage d’équipe ainsi que les facteurs qui les influencent; et (3) explorer, du point de vue des participants, les effets réflexifs du Laboratoire. Afin de répondre à ces objectifs, la thèse mobilise diverses perspectives théoriques liées à l’apprentissage individuel, d’équipe et organisationnel. Les résultats des analyses démontrent que : (1) malgré quelques améliorations possibles, le modèle du programme est généralement bien conçu pour parvenir aux résultats visés; (2) l’implantation de ce modèle dans deux sites a donné lieu à des processus d’apprentissage d’équipe différents, bien que conditionnés par des facteurs communs liés aux participants, à l’équipe, au contexte organisationnel et à l’implantation du programme; (3) tel que visé, les participants des deux sites ont développé de la réflexivité vis-à-vis leur pratique et leur rôle professionnel – cette réflexivité adoptant une fonction formative ou critique en regard de l’expérience professionnelle. Ces résultats soulignent le potentiel que représente l’évaluation de la théorie d’intervention pour améliorer la conceptualisation d’un programme de développement professionnel, ainsi que l’intérêt et la pertinence d’évaluer les processus d’apprentissage au niveau de l’équipe dans le cadre d’une approche collective de développement professionnel. De plus, ils appuient l’importance de l’apprentissage réflexif pour l’amélioration des pratiques et l’engagement social des professionnels. En ce sens, ils proposent différentes avenues qui ont le potentiel de consolider les capacités de la main-d’œuvre de santé publique et d’influer conséquemment sur son efficacité à améliorer la santé des collectivités dans le prochain siècle. / The emergence of the health promotion discourse a few decades ago steered public health practice into a new direction, orienting it toward community-based, participatory, and intersectoral action. Meanwhile, in Quebec, the 2004 healthcare system reform restructured the local level through the creation of health and social services centres. The mandate of these new organizations is to integrate the public health and the healthcare sector across a continuum of services ranging from health promotion all the way to palliative care.All these changes have significant implications for healthcare and public health practitioners, who must come to terms with new professional roles and new intervention strategies. Professional development is considered to be a potential lever for action to support these changes. In 2009, a team from the Public Health Directorate of the Health and Social Services Agency of Montreal designed a professional development program called the Health Promotion Laboratory. This program builds on a team learning approach to enable participants to develop new competencies, a reflexive practice, and new health promotion practices within the organization. Based on a qualitative methodology and a collaborative evaluation approach, this doctoral thesis used several investigation strategies to evaluate three components of the Health Promotion Laboratory, i.e., the program’s conceptualization, implementation, and outcomes. More specifically, this thesis aims to: (1) examine the plausibility of the program’s intervention theory; (2) describe and understand the team learning processes involved in the program, as well as the factors influencing them; and (3) explore, from the participants’ perspective, the reflexivity outcomes of the program. In pursuing these objectives, this thesis adopts several theoretical perspectives related to adult learning, team learning, and organizational learning. The results show that: (1) while there is room for improvement, the program’s model is generally well designed to achieve the intended outcomes; (2) the model’s implementation in two sites resulted in different team learning processes, both of which depended on common factors related to the participants, the team, the organizational context, and the implementation of the program itself; and (3) as intended, participants from both sites developed reflexivity with regard to their practice and their professional roles, with this reflexivity taking on a formative and a critical function in terms of their professional experience. These results highlight the potential offered by the evaluation of a program’s intervention theory for improving the conceptualization of a professional development program. They also demonstrate the importance and relevance of assessing the learning process at a group level in the context of a collective professional development approach. Finally, the findings support the importance of reflexive learning for improving professional practice and fostering the social engagement of practitioners. Thus, they suggest different avenues having the potential to strengthen the capacities of the public health workforce and thereby to increase its effectiveness in improving the health of communities in the coming century.

Reflective practice, though ill-defined, has become an accepted educational concept within many health care disciplines particularly in nursing. Subsequently it has become benchmarked within Paramedic Sciences as a professional requirement for continuing education and clinical practice. However, despite the vast literature in nursing and the increasing growth of reflective practice in paramedic curricula it is unclear how it influences the students’ learning in preparation for graduate practice as future reflective practitioners. This research explored ‘to what extent does reflective practice in the paramedic curriculum influence the students’ academic and clinical learning leading to graduate practice’? A mixed methods approach with cohort samples of undergraduate health care students comprised four studies including surveys and non-participant observations of clinical simulation that were conducted in a university learning environment. The results showed overall that Paramedic students believed that they understood reflective practice and perceived it to be useful for their academic studies and clinical practice; although this is probably influenced more by formal teaching rather than the result of their own views. Students were able to describe reflective practice in ideal theoretical terms and were positive towards it regardless of their individual learning styles. However, in a clinical context, they applied it differently with significant emphasis on technical reflection. Evidence of the nature of reflective practice as it occurred during and after clinical simulation scenarios highlights a need for revised approaches to existing learning/teaching strategies with paramedic students. An extended understanding and refinement of reflective practice concepts including a new pedagogic framework to promote enhanced reflectivity are proposed. This theoretical framework is designed to accommodate reflective learning for both personal and collaborative learning related to curriculum outcomes. The use of clinical simulation for the development of reflective practice in the paramedic curriculum is supported with recommendations for further studies in academic and clinical settings.

Il y a quelques décennies, l’émergence du discours de la promotion de la santé infléchissait un nouveau tournant à la santé publique, orientant sa pratique vers l’action communautaire, participative et intersectorielle. Parallèlement, au Québec, la réforme du système de santé de 2004 réorganisait le niveau de gouverne locale à travers la création des centres de santé et de services sociaux (CSSS). Ceux-ci doivent articuler les secteurs des soins et de la santé publique à travers un continuum de services qui va de la promotion de la santé aux soins palliatifs. Ces changements ont des implications majeures pour les acteurs de la santé et de la santé publique, qui doivent composer avec de nouveaux rôles professionnels et de nouvelles stratégies d’action. Le développement professionnel est considéré comme un levier potentiel pour soutenir ces changements. En 2009, une équipe de la Direction de la santé publique de l’Agence de santé et des services sociaux de Montréal concevait un programme de développement professionnel appelé le Laboratoire de promotion de la santé. Ce programme mise sur une approche d’apprentissage de groupe pour permettre aux professionnels des CSSS de développer de nouvelles compétences, une pratique réflexive ainsi que de nouvelles pratiques de promotion de la santé. Basée sur une méthodologie générale qualitative et une approche d’évaluation collaborative, cette thèse utilise plusieurs stratégies d’investigation afin d’évaluer le Laboratoire de promotion de la santé sous trois angles, qui renvoient à sa conceptualisation, à son implantation et à ses effets. Plus spécifiquement, elle vise à : (1) examiner la plausibilité de la théorie d’intervention du programme; (2) décrire et comprendre les processus d’apprentissage d’équipe ainsi que les facteurs qui les influencent; et (3) explorer, du point de vue des participants, les effets réflexifs du Laboratoire. Afin de répondre à ces objectifs, la thèse mobilise diverses perspectives théoriques liées à l’apprentissage individuel, d’équipe et organisationnel. Les résultats des analyses démontrent que : (1) malgré quelques améliorations possibles, le modèle du programme est généralement bien conçu pour parvenir aux résultats visés; (2) l’implantation de ce modèle dans deux sites a donné lieu à des processus d’apprentissage d’équipe différents, bien que conditionnés par des facteurs communs liés aux participants, à l’équipe, au contexte organisationnel et à l’implantation du programme; (3) tel que visé, les participants des deux sites ont développé de la réflexivité vis-à-vis leur pratique et leur rôle professionnel – cette réflexivité adoptant une fonction formative ou critique en regard de l’expérience professionnelle. Ces résultats soulignent le potentiel que représente l’évaluation de la théorie d’intervention pour améliorer la conceptualisation d’un programme de développement professionnel, ainsi que l’intérêt et la pertinence d’évaluer les processus d’apprentissage au niveau de l’équipe dans le cadre d’une approche collective de développement professionnel. De plus, ils appuient l’importance de l’apprentissage réflexif pour l’amélioration des pratiques et l’engagement social des professionnels. En ce sens, ils proposent différentes avenues qui ont le potentiel de consolider les capacités de la main-d’œuvre de santé publique et d’influer conséquemment sur son efficacité à améliorer la santé des collectivités dans le prochain siècle. / The emergence of the health promotion discourse a few decades ago steered public health practice into a new direction, orienting it toward community-based, participatory, and intersectoral action. Meanwhile, in Quebec, the 2004 healthcare system reform restructured the local level through the creation of health and social services centres. The mandate of these new organizations is to integrate the public health and the healthcare sector across a continuum of services ranging from health promotion all the way to palliative care.All these changes have significant implications for healthcare and public health practitioners, who must come to terms with new professional roles and new intervention strategies. Professional development is considered to be a potential lever for action to support these changes. In 2009, a team from the Public Health Directorate of the Health and Social Services Agency of Montreal designed a professional development program called the Health Promotion Laboratory. This program builds on a team learning approach to enable participants to develop new competencies, a reflexive practice, and new health promotion practices within the organization. Based on a qualitative methodology and a collaborative evaluation approach, this doctoral thesis used several investigation strategies to evaluate three components of the Health Promotion Laboratory, i.e., the program’s conceptualization, implementation, and outcomes. More specifically, this thesis aims to: (1) examine the plausibility of the program’s intervention theory; (2) describe and understand the team learning processes involved in the program, as well as the factors influencing them; and (3) explore, from the participants’ perspective, the reflexivity outcomes of the program. In pursuing these objectives, this thesis adopts several theoretical perspectives related to adult learning, team learning, and organizational learning. The results show that: (1) while there is room for improvement, the program’s model is generally well designed to achieve the intended outcomes; (2) the model’s implementation in two sites resulted in different team learning processes, both of which depended on common factors related to the participants, the team, the organizational context, and the implementation of the program itself; and (3) as intended, participants from both sites developed reflexivity with regard to their practice and their professional roles, with this reflexivity taking on a formative and a critical function in terms of their professional experience. These results highlight the potential offered by the evaluation of a program’s intervention theory for improving the conceptualization of a professional development program. They also demonstrate the importance and relevance of assessing the learning process at a group level in the context of a collective professional development approach. Finally, the findings support the importance of reflexive learning for improving professional practice and fostering the social engagement of practitioners. Thus, they suggest different avenues having the potential to strengthen the capacities of the public health workforce and thereby to increase its effectiveness in improving the health of communities in the coming century.

According to the South African White Paper 5 on Early Childhood Development (ECD), the initiative of the Department of Education (DoE), whereby grade R is being implemented as part of compulsory education, is directed at the poorest of the poor. Grade R teachers responsible for the education of 5/6 year old learners will therefore have to possess knowledge and skills to enable them to lead grade R learners from deprived circumstances to optimal development and learning readiness. For under-or unqualified Foundation Phase teachers who work and live in rural areas, distance learning is often the only option for professional development and concurrent increase in compensation. The School of Continuing Teacher Education of the North-West University designed an open distance learning model to provide in the educational needs of under and unqualified teachers. The Foundation Phase Curriculum within the Professional Educator Development programme of the Advanced Certificate in Education presented by the North West University (hereafter referred to as the NWU Foundation Phase ACE programme) is delivered via open distance learning. The National Curriculum Statements (Grade R-9) include grade R to three in the Foundation Phase Curriculum and therefore the NWU Foundation Phase ACE programme will be a financially viable option to train a large number of grade R teachers to provide in the need for qualified grade R teachers. This study investigates the way in which the NWU Foundation Phase ACE programme enables grade R teaching competency as programme outcome. To attain the research aims of the study a literature and empirical study were performed. The research aims of the literature study include the establishment of the knowledge, skills and attitudes to be included in a training programme with the aim of capacitating grade R teachers to facilitate the optimal development of five/six year olds from deprived circumstances. The literature is further researched to determine national and international criteria for effective design and content for training programmes for teachers of 5/6 year old learners. Through the literature study the criteria for effective training programmes for grade R teachers are determined and more specific the criteria for the effective implementation of distance learning for the training of grade R teachers. A comparative study between the NWU Foundation Phase ACE programme and similar distance learning programmes implemented internationally also serves as benchmarking for the evaluation of the NWU Foundation Phase ACE programme. Findings from the literature study serves as benchmark for the evaluation of the NWU Foundation Phase ACE programme and for the designing of questionnaires as measurement instruments for the empirical study. The empirical research has as its first aim to determine how the NWU Foundation Phase ACE programme provides grade R teacher-students the opportunity to develop the necessary knowledge, skills and attitudes to facilitate the optimal development and learning readiness of five/six year olds from deprived circumstances. Secondly the empirical study aims to determine how the design and content of the NWU Foundation Phase ACE programme accommodates the profile and educational needs of the target population namely the teacher who will be responsible for the education of five/six year old learners from deprived circumstances. Although a combination of both qualitative and quantitative statistical methods is used in the empirical study, this evaluation research is primarily seen as a quantitative study grounded in the post-positivist epistemology. The mixed method serves as verification of findings on the data. Empirical data were captured by means of questionnaires comprising structured and open questions. Data captured through structured questions were statistically analysed Iwhile responses in open questions were interpreted qualitatively by the researcher. Data triangulation serves as verification of findings as the researcher gathered data from three study populations namely the NWU Foundation Phase ACE teacher-students, the facilitators who facilitate the NWU Foundation Phase ACE programme at the various contact centres countrywide as well as lecturers presenting a similar Foundation Phase ACE programme at other tertiary institutions in the country. A comparison of responses from the structured questions and open questions with data from related literature further provides for methodological triangulation and verification of findings. Data from the literature study as well as from all three study populations in the empirical investigation converged regarding inadequacies in the way the design and content of the NWU Foundation Phase ACE programme enable the development of grade R teaching competencies as outcome. Deficiencies were identified in the way the programme accommodates the situated and personal circumstances of the teacher student. The opportunity provided by programme design and content for an inexperienced grade R teacher-student to develop grade R knowledge and skills through experience learning, social learning and learning through reflection within the grade R teaching and learning context, was also found to be lacking. Recommendations based on the findings are made for consideration of future programme design. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2010.

According to the South African White Paper 5 on Early Childhood Development (ECD), the initiative of the Department of Education (DoE), whereby grade R is being implemented as part of compulsory education, is directed at the poorest of the poor. Grade R teachers responsible for the education of 5/6 year old learners will therefore have to possess knowledge and skills to enable them to lead grade R learners from deprived circumstances to optimal development and learning readiness. For under-or unqualified Foundation Phase teachers who work and live in rural areas, distance learning is often the only option for professional development and concurrent increase in compensation. The School of Continuing Teacher Education of the North-West University designed an open distance learning model to provide in the educational needs of under and unqualified teachers. The Foundation Phase Curriculum within the Professional Educator Development programme of the Advanced Certificate in Education presented by the North West University (hereafter referred to as the NWU Foundation Phase ACE programme) is delivered via open distance learning. The National Curriculum Statements (Grade R-9) include grade R to three in the Foundation Phase Curriculum and therefore the NWU Foundation Phase ACE programme will be a financially viable option to train a large number of grade R teachers to provide in the need for qualified grade R teachers. This study investigates the way in which the NWU Foundation Phase ACE programme enables grade R teaching competency as programme outcome. To attain the research aims of the study a literature and empirical study were performed. The research aims of the literature study include the establishment of the knowledge, skills and attitudes to be included in a training programme with the aim of capacitating grade R teachers to facilitate the optimal development of five/six year olds from deprived circumstances. The literature is further researched to determine national and international criteria for effective design and content for training programmes for teachers of 5/6 year old learners. Through the literature study the criteria for effective training programmes for grade R teachers are determined and more specific the criteria for the effective implementation of distance learning for the training of grade R teachers. A comparative study between the NWU Foundation Phase ACE programme and similar distance learning programmes implemented internationally also serves as benchmarking for the evaluation of the NWU Foundation Phase ACE programme. Findings from the literature study serves as benchmark for the evaluation of the NWU Foundation Phase ACE programme and for the designing of questionnaires as measurement instruments for the empirical study. The empirical research has as its first aim to determine how the NWU Foundation Phase ACE programme provides grade R teacher-students the opportunity to develop the necessary knowledge, skills and attitudes to facilitate the optimal development and learning readiness of five/six year olds from deprived circumstances. Secondly the empirical study aims to determine how the design and content of the NWU Foundation Phase ACE programme accommodates the profile and educational needs of the target population namely the teacher who will be responsible for the education of five/six year old learners from deprived circumstances. Although a combination of both qualitative and quantitative statistical methods is used in the empirical study, this evaluation research is primarily seen as a quantitative study grounded in the post-positivist epistemology. The mixed method serves as verification of findings on the data. Empirical data were captured by means of questionnaires comprising structured and open questions. Data captured through structured questions were statistically analysed Iwhile responses in open questions were interpreted qualitatively by the researcher. Data triangulation serves as verification of findings as the researcher gathered data from three study populations namely the NWU Foundation Phase ACE teacher-students, the facilitators who facilitate the NWU Foundation Phase ACE programme at the various contact centres countrywide as well as lecturers presenting a similar Foundation Phase ACE programme at other tertiary institutions in the country. A comparison of responses from the structured questions and open questions with data from related literature further provides for methodological triangulation and verification of findings. Data from the literature study as well as from all three study populations in the empirical investigation converged regarding inadequacies in the way the design and content of the NWU Foundation Phase ACE programme enable the development of grade R teaching competencies as outcome. Deficiencies were identified in the way the programme accommodates the situated and personal circumstances of the teacher student. The opportunity provided by programme design and content for an inexperienced grade R teacher-student to develop grade R knowledge and skills through experience learning, social learning and learning through reflection within the grade R teaching and learning context, was also found to be lacking. Recommendations based on the findings are made for consideration of future programme design. / Thesis (M.Ed.)--North-West University, Potchefstroom Campus, 2010.

Although it is relatively easy to study and learn about a practice discipline in the safe environment of an academic institution, it is far more complex to make sense of what has been learned when faced with the real world of practice. Practitioners need to think on their feet and have to find new ways of managing complex problems which do not fit directly into the theoretical frameworks learned in a more formal setting. Knowledge of what the various disciplines say is not in itself sufficient, experiential knowledge is necessary. The key to learning in the experiential domain is critical reflective practice and emancipatory learning, which empower practitioners to explicate their implicit theories. If autonomy is the goal of professional education, the key is to help adult learners to distance themselves from their own values and beliefs in order to entertain more abstract modes of perception. The purpose of this inquiry was therefore, to construct a model for facilitation of critical reflective practice, based on thorough analysis of the main concepts (critical thinking and reflection), related viewpoints, models and theories; and the data gathered and analyzed during, the naturalistic inquiry. The inquirer sought to. develop each participant through Socratic & Learning Through Discussion (Dialogical) Technique, Critical Incident Reporting and participation in Critical Reflective Exercises. The constructed model for facilitation of critical reflective practice evolved from empirical observations, intuitive insights of the inquirer and from deductions combining ideas from several fields of inquiry. The model for facilitation of critical reflective practice postulates that practitioners have the inherent potential to change from auto-pilot practice to critical reflective practice. The purpose of the model is the facilitation of heightened awareness of the self, to enable health care professionals to consciously meet community needs and expectations. The desired outcome is transformative intellectuals who will strive to empower others to become critical reflective learners and practitioners. / Health Studies / D.Litt. et Phil. (Nursing Science)

Teoretiese navorsing is onderneem om 'n model vir kurrikulumontwikkeling vir die Diploma vir Registrasie as Verpleegkundige (algemene, psigiatriese, gemeenskaps-) en Vroedvrou te ontwikkel. Twee hooffaktore beinvloed verpleegonderwys. Op globale vlak word verpleegonderwys beinvloed deur die realiteite van 'n inligtingtegnologie-gedrewe samelewing. Dit noodsaak die ontwikkeling van kritiese denke, aanpasbaarheid ten opsigte van konstante sosiale verandering en 'n verbintenis tot lewenslange leer. Op nasionale vlak word verpleegonderwys beinvloed deur 'n nasionale gesondheidstelsel wat gekwalifiseerde verpleegkundiges vereis, wat in staat is om omvattende gesondheidsorg te lewer. 'n Situasie-analise het gelei tot die identifisering van twee hoofkonsepte wat die verpleegkundekurrikulum beinvloed, naamlik lcritiese denke en omvattende gesondheidsorg. Vorige navorsing dui daarop dat verpleegdosente nie paraat is ten opsigte van verwikkelinge in die onderwys nie. Dit kan negatiewe gevolge he vir innoverende kurrikulumontwikkeling in verpleegkunde ten einde die professie strategies te posisioneer om te voldoen aan die eise van die komende eeu. Die navorser het beoog om die leemte te oorbrug deur middel van navorsing wat gemik was op die daarstelling van 'n omvattende kurrikulumontwikkelingstrategie wat kan dien as praktiese riglyn vir die implementering van kurrikulumontwikkeling in verpleegkunde. Op grond van 'n analise van die konsep kurri/culum, 'n situasie-analise en die interpretering daarvan, is die Model vir Kurrikulumontwikkeling in Verpleegkunde gekonseptualiseer. Die model kan verpleegdosente in staat stel om fundamentele kurrikulumverandering te bewerkstellig en 'n relevante kurrikulum daar te stel, deur gespesifiseerde kurrikulumontwikkelingstake stelselmatig af te handel. Die implikasies van die konsepte lcritiese denke en omvattende gesondheidsorg vir die verpleegkundekurrikulum, is uitgespel deur kriteria vir die nuwe verpleegkundekurrikulum te formuleer / The researcher undertook theoretical research to develop a curriculum development model for the Diploma for Registration as a Nurse (General, Psychiatric, Community) and Midwife. There are two main tendencies that influence nursing education. On a global level nursing education is influenced by realities that are inherent in an information technology-driven world. This requires the development of critical thinking skills, adaptability to constant social change and a commitment to life-long learning. Nationally, nursing education is influenced by a national health system requiring trained nurses who are able to render comprehensive health care. A situation analysis resulted in the identification of two main concepts that influence the nursing curriculum namely, critical thinking and comprehensive health care. Previous research indicates that nurse educators are outdated in terms of developments in education. This can have negative consequences for innovative curriculum development in nursing in order to position the nursing profession strategically to meet the demands of the next century. This limitation prompted the researcher to conduct research that was aimed at designing a comprehensive curriculum development strategy to serve as a practical guideline on how to implement curriculum development in nursing. Based on an analysis of the concept curriculum, a situation analysis and the interpretation thereof: the researcher conceptualized the Curriculum Development Model for Nursing. The model will enable nurse educators to effect fundamental curriculum change and the development of a relevant curriculum by completing specified curriculum development tasks systematically. The implications of the concepts critical thinking and comprehensive health care for the nursing curriculum, were elucidated by formulating criteria for a new nursing curriculum. Key terms: curriculum; curriculum development; curriculum foundation; curriculum structure; curriculum design; situation analysis; critical thinking; reflective practice; comprehensive health care; comprehensive nursing curriculum; community based curriculum; problem based learning; media assisted learning; ~ve learning; reflective learning; experiential learning; mediated learning. / Health Studies / D.Litt. et Phil. (Advanced Nursing Science)