An evaluation of a pilot community-based, interdisciplinary, primary health care teaching programme for health sciences students

Master Thesis


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University of Cape Town

The focus of this research is an evaluation of a pilot community-based interdisciplinary, primary health care teaching programme for health sciences students, at the University of Cape Town. The pilot programme was located in the Neighbourhood Old Age Homes project (NOAH) in Woodstock, Cape Town. The research took place in 1997, the year of implementation of the programme. The evaluation focused on the perceptions and experiences of the staff and students who participated in the programme. Dietetic, medical, occupational therapy and physiotherapy students participated in the programme. The staff who planned and implemented the programme were interdisciplinary, representing all the above professions, including nursing and social work. The research attempted to gain an understanding of the contextual, curriculum and organisational conditions necessary for effective interdisciplinary education, as experienced by students and staff. The study was contextualised within the changes taking place in higher education, the provision of health care services and health professional education in South Africa. The Woodstock Interdisciplinary Programme was contextualised within a review of interdisciplinary education internationally and locally. Discursive shifts within traditional and changing health professional education were analysed. This led to an exploration of discourse and role theory in relation to changing learner and educator roles and changing power relationships. The research was conducted within a qualitative research paradigm. The main methodology was case study research and the form of evaluation was illuminative evaluation. Four semi-structured focus group interviews with 15 students and semi-structured in-depth individual interviews with ail six participating staff were used to collect the core data. Since the researcher was a member of the planning and implementing staff, participant observation was also used as a method of gathering data. The data from the focus group interviews and individual interviews was coded, categorised and analysed. This constituted a rich core of information for the study. Course evaluation forms, comprising mostly closed-ended questions, completed by 38 of the 41 medical students, were used in the analysis phase as a form of triangulation to increase the reliability of the results. The research explored questions in relation to kinds of learnings gained; the students’ and staffs’ experiences of interdisciplinary learning; the conditions perceived as facilitating or hindering learning; the attitudes towards their own role and those of other health professionals and how students viewed the hierarchy within the health team. The findings supported the literature in that interdisciplinary education can be effective in a community-based setting using problem-based or orientated learning, but limitations may arise related to contextual, organisational and curricular factors. Students learnt about each other's roles and different approaches to health care. They all felt there was insufficient time to learn enough about each other and that they needed to learn and work together on a regular basis. The findings illuminated the need to pay more attention to the disjunction that results from shifting discourses and associated shifts in learner roles, new professional identities and changing power relationships. The thesis ends with recommendations for curriculum development and suggestions for further research.

Includes bibliographical references.