Office of the Dean: Health Sciences
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Item Open Access A competency-based continuous assessment programme as part of a revised curriculum for postgraduate radiology training at the University of the Free State(University of the Free State, 2015-02) Janse van Rensburg, Jacques; Nel, M. M.; Van Zyl, G. J.; De Vries, C. S.English: Recent times have witnessed a shift in the educational philosophy of postgraduate radiology training programmes. Internationally, curricula have undergone revision, with many changes based on the principles of outcomes-based education. As such, these curricula prescribe learning outcomes and essential competencies – including generic competencies central to all competent physicians. Continuous assessment is commonplace and many curricula prescribe regular formal formative workplace-based assessments that contribute to learning and training. Comparing the University of the Free Sate (UFS) postgraduate radiology training programme with the recently revised international curricula revealed several important shortcomings such as the lack of an outcomes-based educational methodology, the absence or poor definition of learning outcomes and competencies – in specific the absence of CanMEDS (Canadian Medical Education Directives for Specialists) competencies – the absence of formative assessment that culminate in feedback and remedial action, and the neglect of behaviour and attitudes during formal assessment. These shortcomings represented a problem in terms of ensuring the quality of radiology graduates and the safety of their patients. Addressing the problem required a revision of the UFS postgraduate radiology curriculum – defining learning objectives, formulating outcomes and incorporating all required competencies – as well as the development of a formative competency-based continuous assessment programme for postgraduate radiology training. The research was therefore aimed at the development of a competency-based, continuous assessment programme that could be integrated into a revised curriculum for postgraduate radiology training at the UFS. The methods used to achieve this aim included a literature overview, Delphi survey and semi-structured interviews. The conceptualisation and contextualisation of postgraduate radiology education was accomplished through an extensive literature overview that garnered information on the concepts of competence and performancebased education, as well as essential concepts related to assessment in education. The Delphi method guides decision-making through consensus; an ideal research method for determining what should and should not be included in a revised curriculum. The content of the revised curriculum was therefore researched using a Delphi questionnaire survey. The effectiveness of assessment, and decisions about its implementation, are influenced by the views and opinions of those responsible for assessment. Qualitative methods of research collect rich, detailed and descriptive data and as such, semi-structured interviews are ideal for gaining a detailed understanding of individuals’ ideas and views of a particular topic. In this study, semi-structured interviews with pivotal role-players involved in South African postgraduate radiology education informed decisions about the proposed continuous assessment programme for radiology training at the UFS. The results of the research contributed richly to achieving the aim of the research. A combination of the information from the literature overview, the results of the Delphi survey and the findings of the semi-structured interviews informed the development of the continuous assessment programme. This assessment programme was based on formative workplace-based assessments, conducted formally and resulting in feedback and remedial action. The assessments included in the programme ensured appraisal of the entire spectrum of competencies including knowledge, skills and the generic physician competencies (communication, teamwork, professionalism, management and administrative skills, research and education, and patient support and advocacy). Recommendations about curricular changes were based on information from the literature overview and the results and conclusions from the Delphi survey. Some of the more important recommendations were the compartmentalisation of the curriculum according to levels of increasing difficulty and integration, merging competencies (knowledge and skills) according to the different levels of training, the inclusion of CanMEDS-based generic physician competencies and the insertion of a summative assessment prior to independent after-hours radiology call, and a mandatory intermediate summative examination halfway through the training period. The research culminated in the development of a performance-based formative continuous assessment programme, blueprinted on a revised postgraduate radiology curriculum – these addressed the shortcomings of the UFS postgraduate curriculum. Assessment according to the curriculum aims to guide a registrar through the different instructional periods (training levels), document the trainee’s progress and ensure the acquisition of essential competencies – all in a bid to ensure the quality of radiology graduates and the safety of the public they serve.Item Open Access Factors that influence the academic performance of medical students with prior tertiary education(University of the Free State, 2016-05-06) Berghout, Esther; Nel, P. P. C.An in-depth study was carried out with a view to provide the School of Medicine, University of the Free State, with more insight into the academic performance of senior students (i.e. students with prior tertiary education) and factors influencing the performance in their medical studies. Many studies have been done to investigate the influence of factors on academic performance with a view to enhance understanding of academic performance, to predict academic performance and to select the students who are best equipped to study medicine. Many factors have been identified and measured in the past years, but no study has focussed on the factors that influence the academic performance of senior students specifically. In this study, the specific characteristics of senior students were identified and analysed for having influence on academic performance. The research methods comprised a literature review, a retrospective-cohort study (quantitative data) and semi-structured interviews (qualitative data). The literature review provided the study with a theoretical framework. Recent and relevant studies were used to gather information about characteristics of senior students, factors that have an influence on academic performance and student selection. Quantitative data were gathered from the database of the University of the Free State to measure and compare the academic performance of senior students with the rest of the class. The quantitative data underwent statistical analyses to identify factors that influence the academic performance of senior students. Semi-structured interviews were conducted with the intent to include personal experiences, opinions and ideas of the senior students on their academic performance and the influence of their previous studies and other factors. The quantitative and qualitative results were combined when the results were interpreted and discussed. Different factors that were found to have an influence in previous studies were confirmed, new factors were found and a few results differed from what was found in the literature. Different characteristics of senior students were identified in the semi-structured interviews; factors such as intrinsic motivation, maturity and more awareness of learning style have a positive influence on academic performance. Social division from the rest of the class, financial strain and family commitments, however, have a negative influence on academic performance. The type of previous tertiary education had a limited influence on academic performance. The number of previous courses and the number of years studied were found to have an influence (two or more courses and more than five years have positive influence). Many students were of the opinion that their previous tertiary education helped them in the transition to medical school. The quantitative data analysis concluded that students with a Health Profession background perform significantly better than the other senior students in first and second year. Non-Science students start their medical studies significantly better than biomedical science students in the first year, but their performance drops far below the class average over time. A Biomedical Science background has a lower pass rate in the first year compared to students who study Biomedical science for only one year. Demographic factors that were found to have a positive influence in every year were female gender and studying in the mother language. Older age showed to have a negative influence on academic performance in fourth and fifth year. The findings of this study made a valuable contribution to the knowledge base of health professions education. The study ends with a list of recommendations with regard to student selection and student support and development as well as further research. The sound research approach and methodology ensured quality, reliability and validity.