Browsing by Author "Weiss, Rachel"

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    Multimodal textbook design : analyzing the construction of the discourses of pharmacology
    (2008) Weiss, Rachel
    The aim of the research is to contribute to a pedagogy of Multiliteracies in the context of Health Sciences. A Multiliteracies approach sees text in terms of a process of 'redesigning' meaning from a range of available resources. These include multimodal semiotic resources such as visual and verbal modes, as well as particular discursive and social practices that the text draws upon. The study originates from a disagreement over which Pharmacology textbook fourth year medical students should use. The founding argument is that a Pharmacology textbook can be seen as constructing the discourses of the 'prescribing physician' As such, it simultaneously constructs and bears imprints of particular ideologies, discursive formations and social relations which are relevant in the field of medicine and science, as well as those from private and public life-worlds. As a teacher, I am interested in how the textbooks' ideologies contribute to or contest that of the new problem-based medical curriculum. I also analyze the respective designs in terms of their accessibility and suitability specifically for undergraduate medical students. The theoretical framework is provided by Fairclough's notion of 'orders of discourse' together with Halliday's metafunctional view of text, and is operationalized through a social semiotic analysis of sections of two textbooks. The textbooks analyzed are 'Pharmacology' by Rang et al ('Rang'), and 'the Oxford Textbook of Clinical Pharmacology and Drug therapy' ('Oxford'). I focus on the grammatical system of transitivity to construct the respective textbooks' views of social reality, and I use an analysis of modality in the texts to construct the social relations between writers, readers and the subject of Pharmacology. The analytical 'toolkit' includes verbal as well as visual semiotic resources within a framework of textual coherence. The study concludes that while Rang constructs social relations and identities that resonate with a contemporary society, its interest in Pharmacology is scientific rather than clinical. Furthermore, its design features may limit access specifically for undergraduate medical students. Oxford, on the other hand, is dominated by the discourses of clinical medicine and medical education. It constructs the subject of Pharmacology in terms of therapy or 'process', rather than in terms of drugs or 'products', and in this sense may be more suitable as a 'tutor'. However, it does not prepare the student for critical engagement with the changing social realities and relations of power in a post-Fordist society. The value of the study is two-fold. Firstly, it reiterates the importance of critical reflection on the various aspects of a curriculum. This includes reflection on alignment between the ideologies of textbooks and that of the new curriculum, and between curricular objectives, activities and assessment practices. Secondly, it has led to the operationalizing of a metalanguage of design, specifically in a Health Sciences context. This metalanguage may be used not l ' only for improving the communicative value of students' assignments, but also to expand their cultural perspectives through critical engagement with aspects of social identities and relations.
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    Patient-centred communication and patient education: a multimodal social semiotic approach
    (2017) Weiss, Rachel; Archer, Arlene
    Patient-centred communication and patient education: a multimodal social semiotic approach This study explores the phenomenon of patient-centred communication within the South African health context. Patient-centred communication involves several distinct but interlinked elements, namely, taking a holistic approach to illness, 'seeing' through the patient's eyes, 'co-constructing' a shared understanding or therapeutic alliance, and sharing decision-making and responsibility where possible. While adopted by medical curricula across the world, a lack of conceptual clarity is common among students, educators, researchers and policy-makers. Furthermore, little research has been done that accounts for contextual factors and non-western settings. This study looks at how fourth year medical students operationalise the 'classroom-taught' principles of patient-centred communication during a health education encounter with patients. Drawing on a qualitative, interpretivist paradigm, the research focuses on communication in the context of language barriers, cultural value differences and socio-economic inequality. This study views students' multimodal health education artefacts as instances of 'informed flexibility' to patients' needs and challenges. The research is located within a Pharmacology curriculum activity where medical students produce personalized health promotion artefacts for rheumatic heart disease patients. Their artefacts are instances of patient-centred communication as well as instances of purposeful pedagogic recontextualisation, in that they realise both epistemic and relational dimensions of health education. Students also write a critique on the process, reflecting on the patient interview and motivating their design choices. Taking a multimodal social semiotic approach, the study draws on Bezemer and Kress' semiotic principles of recontextualisation (2008) for analysis of artefacts. Thematic analysis of students' critical reflections as well as follow-up interviews with their patients illuminate the context and assumptions underpinning students' design choices. The study is significant in several ways. It highlights the complex, multifaceted, multi-layered nature of doctor-patient communication, argues for realism in what can be taught and assessed in a classroom and suggests novel pedagogic approaches. The study also brings an African perspective to patient-centred communication, and in highlighting challenges relevant to the South African health care system, it supports contemporary calls for 'decolonisation' of health sciences curricula. The research contributes to ongoing efforts to eradicate rheumatic heart disease by giving patients a 'voice', raising awareness and supporting preventative programs. Methodologically, the study contributes to Bezemer and Kress' (2008) pursuit of articulating a semiotic methodological framework for multimodal texts.
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    A qualitative study on 6th year medical students' perceptions of and self-reported competence in clinical practice after receiving resuscitation-based simulation training
    (2016) Jansen, Marvin Jeffrey; Weiss, Rachel; Geduld, Heike
    Background: Despite practicing resuscitation skills in a simulation environment, medical students often express anxiety about having to participate in patient resuscitation in the clinical environment. This fear can lead to an unwillingness to initiate or participate in resuscitations, and a decreased confidence in their skills. Exploring the perceptions of final year medical students can provide valuable insight for improving the current simulation programme at the University of Cape Town. Aim: The aim of the study is to explore 6th year medical students' perceptions and self-reported competence for clinical practice after receiving Resuscitation-Based Simulation training.