3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Effects of curriculum change on medical graduates' preparedness for internship(2012-04-10) Smuts, Kathleen BridgetINTRODUCTION: The University of the Witwatersrand (Wits) changed its medical curriculum in 2003 from a traditional, six-year curriculum to an integrated, problem-based, four year Graduate Entry Medical Programme (GEMP), preceded by two years of basic and medical sciences at university level or a suitable undergraduate degree. AIMS: To compare the preparedness for internship of Wits graduates from the old and new curricula on fifty seven items grouped into nine categories which were identified during the development and validation of a Model of the Competent South African Intern. METHODS: A stratified random sample of interns was drawn from the last graduates of the traditional curriculum and a matched sample of interns from the first graduates of the GEMP. Both quantitative and qualitative methods were used. For each sampled intern a supervisor, colleague and patient were selected by convenience sampling. A questionnaire was completed by interns, supervisors and colleagues followed by an interview to qualify responses at the extremes of the Likert-type scale and link them to curriculum learning opportunities. A semi- structured interview was conducted with patients and a global score allocated. The Cochran-Mantel-Haenszel Statistic for ordinal data was used. Comparisons were drawn between the competence of graduates from the traditional and GEMP curricula from the perspectives of interns, supervisors, colleagues and patients. Interview data were analysed using thematic analysis techniques. RESULTS: Significant differences were reported by interns in six of the nine categories. In one category, “fundamental theoretical knowledge” the GEMP graduates rated themselves significantly less prepared in the basic medical sciences (Pathology, Microbiology and Pathophysiology, p=0.01; Pharmacology, p<0.0001) but highly significantly better prepared in the theory of interpersonal communication, p<0.000001). The GEMP graduates rated themselves significantly better prepared in the other five categories, “medical problem solving” (p=0.009), “holistic patient management” (p=0.0004), “community health” (p=0.0002), “communication skills” (p=0.02) and “self directed learning” (p=0.0001). vii Supervisors reported significant differences in “teamwork” (p=0.045) and “personal attributes” (p=0.045) giving fewer low scores to the GEMP graduates. There were no significant differences between the category scores for colleagues. Qualitative analysis included vertical summaries of interview data and horizontal or comparative interpretations with quotations in order not to lose the voice of the interns, supervisors, colleagues and patients. DISCUSSION AND CONCLUSION: GEMP graduates rated themselves better prepared in those areas which had been identified as reasons for curriculum change but less prepared in specific basic medical sciences. Although these were not reported as significantly different by supervisors or colleagues they require attention. Other than this, according to the judgements of the informants, the competence of GEMP graduates was similar to that of traditional graduates in certain areas and significantly better in others, which appears to justify the major medical curriculum change undertaken at this University.Item Schools as learning organizations(2006-10-26T06:47:53Z) Nsibande, Njabuliso H.Since the 1990s, the corporate concept of learning organizations has been promoted as a solution to problems caused by ever-changing educational reforms and as a model for schools in the twenty-first century. Through an indepth analysis of two South African secondary schools in Gauteng, this study examines how organizational learning is nurtured and sustained, and considers whether and how the concept of learning organizations is applicable in schools. Three perspectives on learning organizations are considered: the normative, developmental and capability perspectives. The investigative framework links theories on organizational memory, organizational learning, organizational change and complexity theory to provide insights into why some organizations are ‘smarter’ than others and why educational reforms and innovations often fail. The study used a multi-method approach, within a nested case design, at two contrasting schools, each facing the challenges of a changing society and education system, but under very different conditions: a state school in a poor informal settlement and a wealthy faith-based, independent school. Research participants included two principals, four heads of departments, ten teachers and fourteen learners. Although learners were included, the study focuses primarily on teachers and school leaders. At each school, key informants were selected from among those acknowledged to have contributed significantly to the school, either individually or as team members. In-depth interviews, as well as teachers’ narrative accounts of their own learning and unlearning, and a variety of schoolgenerated documents provided the data set. Two approaches were used for the stories of learning and unlearning – personal writing and elicitation through narrative interviews. Findings pertain to participating schools, but also provide a basis for more general claims. In ethos, practices and leadership, both schools reflect a deep commitment to improving learners’ lives. However, schools cannot operate as learning organizations unless they can harness individual staff members’ aspirations as well. Internal and external circumstances impeded organizational learning and reciprocal professional commitment among staff. These included: personal problems; an individualistic school learning system with limited social interaction; concomitant anxiety about collaborative professional learning; a value system that favours competition; routine rather than reflective contexts for professional learning and communication; and unacknowledged gender issues. Another feature of a learning organization is a reflective openness to change. Yet both schools strive for stability and conformity to rules, and neither has developed tools for recognizing turning points, disjunctures and triggers for change. Learning organizations emphasize collective learning; yet teachers and department heads are ‘starving’ for personal recognition, especially in cases where they have become multi-skilled in the course of career advancement. The study also analyses complexities of school leadership and resulting trade-offs that have to be made between satisfying the diverse needs of school members and responding to external demands, especially at the level of policy. Overall, the vi study demonstrates that while the related concepts of learning organizations and organizational learning are generative for understanding, structuring and leading schools, the definitive purposes of schools and the external pressures one them preclude a simple transfer from the corporate world.