The status of curriculum mapping of undergraduate medical programmes in South Africa.

Abstract

Thesis (MPhil)--Stellenbosch University, 2016.ENGLISH SUMMARY : Introduction: Medical schools in South Africa have to provide evidence that the curriculum meets standards for accreditation and that graduates can address the health care needs in society. Curriculum review and renewal is an ongoing process to ensure curricula stay relevant. Curriculum mapping has become a widely used way in which curricula are being managed and reviewed. At Sefako Makgatho Health Sciences University (SMU) the Curriculum Development Committee (CDC) is in the process of developing a curriculum map. The aim of this study was to explore the status of curriculum mapping at medical schools in South Africa and to use the results to make recommendations to the CDC at SMU. Methodology: The study made use of descriptive and interpretive (non-experimental) methods and an exploratory qualitative design. Semi-structured interviews were conducted with curriculum leaders from all eight medical schools in South Africa. Data were transcribed by the researcher and analysed by using the framework model. The analysis was done in a thematic non-linear process, with collection, transcription, and analysis being intertwined. Codes were used to facilitate comparison of data within and between categories. The analysed data were brought into context with knowledge on curriculum mapping processes and curriculum mapping tools elsewhere in the western world. Interpretation of data was done by aggregating patterns, searching for structure and synthesising findings, and explicitly focused on the South African context. Results: All eight of the institutions who offered undergraduate medical training during 2015 participated in the study. In analysing the results it was clear that institutional representatives mainly described the current situation (2015) and the possible future vision. In the current situation, the four categories that emerged were curriculum design, curriculum documentation, strategies used at the institution for curriculum review, as well as challenges experienced. The five emergent categories for the future vision were urgency for the preferred way of mapping, expectations of a mapping platform, elements to be reflected within the platform, stakeholders and stakeholder access, and institutional requirements for successful implementation. None of the medical schools in South Africa have completed a curriculum mapping exercise. All institutions have various and separate documents available to accreditation authorities and external examiners during review visits and have strategies in place for curriculum review and renewal. Institutions experience huge challenges intrinsic both to the curriculum and to the external realities impacting on the implementation of the curriculum. These challenges seem to warrant mapping as a possible strategy to analyse and manage the curriculum, and make improvements. There seems to be a growing awareness of sophisticated electronic mapping as a platform to share the vision of the curriculum and improve coherence, review and manage the curriculum, facilitate benchmarking and accreditation, and contribute to research and faculty development. A national mandate and full institutional support will be necessary for mapping to be successfully implemented at each institution. Conclusion: The non-coherence of some curricula, the inability to formulate core content, and the lack of sufficient buy-in and involvement of clinical training educators are of concern. Curriculum leaders will need to ensure that the mapping platform will meet specific institutional requirements to address the challenges while portraying the unique structure of the curriculum. The expectation of benchmarking and collaboration amongst institutions and standardisation of undergraduate outcomes will require a national mandate. This study contributed to a baseline understanding of the status of curriculum mapping of undergraduate programmes at medical training institutions in South Africa. Additional research will be needed to establish if mapping could indeed address the expectations identified in this study.AFRIKAANSE OPSOMMING : Inleiding: Mediese skole in Suid Afrika is genoodsaak om bewys te lewer dat hulle aan akkreditasiestandaarde voldoen wat verseker dat gegradueerdes gesondheidsorg-behoeftes kan aanspreek. Kurrikulum hersiening and vernuwing as ‘n deurlopende proses kan verseker dat kurrikula relevant bly. Kurrikulum kartering is ‘n algemene aanvaarbare praktyk om kurrikula te bestuur en te hersien. By Sefako Makgatho Gesondheidswetenskappe Universiteit (SMU) is die kurrikulumkomitee in die proses daarvan om ‘n kaart van die kurrikulum te ontwikkel. Die doel van hierdie studie is om die status van kurrikulum kartering van die voorgraadse program by mediese skole te ondersoek, en om die resultate te gebruik vir aanbevelings na die kurrikulumkomitee. Metode: Die studie maak gebruik van beskrywende and interpreterende (nie-eksperimentele) metodes in ‘n kwalitatiewe benadering. Semi-gestruktureerde onderhoude is met kurrikulumleiers aan al agt die mediese skole in Suid Afrika gevoer. Die navorser het die data getranskribeer en analise is gedoen deur middel van die raamwerk-model. Nie-liniêre tematiese analise is gedoen deur data insameling, transkripsie and analise te kombineer. Toegekende kodes is gebruik om vergelykings te tref binne en tussen die kategorieë van alle datastelle. Die analise van data is beskryf binne die konteks van kennis rakende kurrikulum kartering, prosesse en instrumente soos beskryf in die literatuur. Interpretasie is gebaseer op sintesering van patrone wat gevind is binne die data, en fokus eksplisiet op die SuidAfrikaanse konteks. Resultate: Al agt die universiteite wat voorgraadse programme gedurende 2015 aangebied het, het aan die studie deelgeneem. Dit was duidelik dat die deelnemers hulle huidige (2015) situasie beskryf het en ook gefokus het op ‘n moontlike visie vir die toekoms. As huidige situasie is vier kategorieë geïdentifiseer, naamlik kurrikulum ontwerp, kurrikulum dokumentering, strategieë wat die universiteit gebruik vir kurrikulum hersiening, asook uitdagings wat hulle ervaar. Die vyf kategoriee wat na vore gekom het in die moontlike visie vir die toekoms sluit in: dringendheid vir die verkose manier van kartering, verwagtinge van ‘n karteringsplatform, elemente wat reflekteer behoort te word, rolspelers en rolspelertoegang, asook institusionele vereistes vir suksesvolle implementering. Geeneen van die mediese skole in Suid-Afrika het op hierdie stadium (2015) ‘n volledige kurrikulum karterings proses voltooi nie. Al die skole beskik wel oor dokumentasie wat beskikbaar gestel word aan gesaghebbendes en akkreditasieliggamme gedurende akkreditasie besoeke. Mediese skole ondervind groot uitdagings beide ten opsigte van die kurrikulum en die eksterne realiteite om die kurrikulum te implementeer. Hierdie uitdagings blyk kartering voor te staan as moontlike strategie om die kurrikulum te analiseer en te bestuur, asook verbeterings aan te bring. Daar blyk ‘n groeiende bewustheid te ontwikkel dat gesofistikeerde karteringsplatforms nodig gaan wees om die visie van ‘n kurrikulum met rolspelers te deel, om die samevattende geheel te verbeter, om die kurrikulum te hersien en te bestuur, om maatstawwe te ontwikkel en akkreditasies te fasiliteer, en om by te dra tot ontwikkeling van personeel en navorsing. ‘n Nasionale mandaat and volle institusionele ondersteuning sal egter nodig wees vir kartering om suksesvol by die mediese skole geimplementeer te word. Samevatting: Die oënskynlike gebrek aan samehang van sommige kurrikula, die onvermoë om ‘n kern kurrikulum te formuleer en die gebrek aan voldoende betrokkenheid van sommige kliniese fasiliteerders is kommerwekkend. Kurrikulumleiers sal moet verseker dat ‘n karteringsplatvorm aan die vereistes en behoeftes van die rolspelers in die mediese skool voldoen en die unieke struktuur van die program verteenwoodig terwyl dit die uitdagings aanspreek. Die verwagting dat kartering maatstawwe en norms kan aanspreek en samewerking tussen mediese skole fasiliteer om gestandardiseered voorgraadse uitkomste te verseker, sal ‘n nasionale mandaat vereis. Hierdie studie lewer ‘n bydrae deur die status van kurrikulum kartering van voorgraadse programme in mediese skole in Suid Africa op hierdie stadium te beskryf. Addisionele navorsing sal nodig wees om vas te stel of kartering wel aan die verwagtinge, soos in die studie geidentifiseer, te voldoen

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