Embodied subjectivities : exploring the stories of HIV-positive African women through body mapping and narrative theory.

Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.This qualitative research project attempts to consider how HIV-infected African women position themselves, through the stories that they tell, within the dominant discourses of HIV in contemporary South Africa. The research is couched within the theoretical framework of social constructionism which upholds that there are no absolute truths but rather that individuals inhabit different 'realities' and possess different 'knowledges' relative to their social and cultural context. In this view language is the medium through which discursive practices inscribe identities with meanings. Seen through a Foucauldian lens, these discursive practices, in the case of South Africa, operate as forms of surveillance and social control to 'silence' those living with HIV. Through cultural and patriarchal norms operating in conjunction with the racialising legacy left by apartheid, women, particularly African women, have come to be the group most infected with HIV. Despite their often-difficult circumstances, narrative research has shown that, through acts of storytelling, many African women are able to construct positive versions of their lives. Using body mapping in conjunction with narrative interviewing, a small group of African women of varying ages and from diverse locations, but all belonging to a single Durban-based HIV support group, were asked to tell stories about their lives and how their experiences of themselves had been impacted by HIV. Their body maps and stories showed that, while dominant discourses about HIV/AIDS do function to limit their positions for positive self-definition, these women also produced counter-narratives that resisted some of the discrediting social constructions of the illness. Four dimensions relating to self in time, self in relation to others, HIV as a disruptive event, and spiritual beliefs and morality were found to be operating in their narratives. In addition, a fifth dimension, looking at how research practices themselves are 'situated' and construct 'subjects' in particular ways was considered and this called on 'the researcher' to deconstruct the subject positions of his (in this case) own discursive positioning

Communicating curriculum reform to students: Advice in hindsight.....

BACKGOUND: In view of the changing health care needs of communities, curriculum reform of traditional curricula is inevitable. In order to allay the apprehension that may accompany such change, curriculum development and implementation should be an inclusive process, with both staff and students being well informed of the planned reform. In 2001, the Nelson R. Mandela School of Medicine implemented Year 1 of a problem-based learning curriculum. During the design phase, students and staff were invited to take part in the development and were kept abreast of developments through meetings and newsletters. METHOD: A survey of Years 1–5 students of the last intake into the traditional curriculum was undertaken a few months prior to the implementation of the new programme. RESULTS: Students were generally well informed about the impending change, having heard about it from fellow students and staff. The more senior the students, the less the perceived impact of the reform. Although most of what students had heard was correct, some, however, had misconceptions that were generally extreme views (e.g. all self-directed learning; no Anatomy) about the new programme. Others expressed valid concerns (e.g. underpreparedness of students from disadvantaged schools; overcrowding in hospitals). CONCLUSIONS: Advice offered to institutions considering curriculum reform include using various methods to inform internal and external affected parties, ensuring that the student representative body and staff is well informed, reiterating the need for the change, confirming that the new programme meets recognised standards and that the students most affected are reassured about their future studies

Introducing a reward system in assessment in histology: A comment on the learning strategies it might engender

BACKGROUND: Assessment, as an inextricable component of the curriculum, is an important factor influencing student approaches to learning. If assessment is to drive learning, then it must assess the desired outcomes. In an effort to alleviate some of the anxiety associated with a traditional discipline-based second year of medical studies, a bonus system was introduced into the Histology assessment. Students obtaining a year mark of 70% were rewarded with full marks for some tests, resulting in many requiring only a few percentage points in the final examination to pass Histology. METHODS: In order to ascertain whether this bonus system might be impacting positively on student learning, thirty-two second year medical students (non-randomly selected, representing four academic groups based on their mid-year results) were interviewed in 1997 and, in 1999, the entire second year class completed a questionnaire (n = 189). Both groups were asked their opinions of the bonus system. RESULTS: Both groups overwhelming voted in favour of the bonus system, despite less than 45% of students failing to achieve it. Students commented that it relieved some of the stress of the year-end examinations, and was generally motivating with regard to their work commitment. CONCLUSIONS: Being satisfied with how and what we assess in Histology, we are of the opinion that this reward system may contribute to engendering appropriate learning approaches (i.e. for understanding) in students. As a result of its apparent positive influence on learning and attitudes towards learning, this bonus system will continue to operate until the traditional programme is phased out. It is hoped that other educators, believing that their assessment is a reflection of the intended outcomes, might recognise merit in rewarding students for consistent achievement

What can we learn from facilitator and student perceptions of facilitation skills and roles in the first year of a problem-based learning curriculum?

BACKGROUND: The small group tutorial is a cornerstone of problem-based learning. By implication, the role of the facilitator is of pivotal importance. The present investigation canvassed perceptions of facilitators with differing levels of experience regarding their roles and duties in the tutorial. METHODS: In January 2002, one year after problem-based learning implementation at the Nelson R. Mandela School of Medicine, facilitators with the following experience were canvassed: trained and about to facilitate, facilitated once only and facilitated more than one six-week theme. Student comments regarding facilitator skills were obtained from a 2001 course survey. RESULTS: While facilitators generally agreed that the three-day training workshop provided sufficient insight into the facilitation process, they become more comfortable with increasing experience. Many facilitators experienced difficulty not providing content expertise. Again, this improved with increasing experience. Most facilitators saw students as colleagues. They agreed that they should be role models, but were less enthusiastic about being mentors. Students were critical of facilitators who were not up to date with curriculum implementation or who appeared disinterested. While facilitator responses suggest that there was considerable intrinsic motivation, this might in fact not be the case. CONCLUSIONS: Even if they had facilitated on all six themes, facilitators could still be considered as novices. Faculty support is therefore critical for the first few years of problem-based learning, particularly for those who had facilitated once only. Since student and facilitator expectations in the small group tutorial may differ, roles and duties of facilitators must be explicit for both parties from the outset

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