Analysis of a foundational biomedical curriculum: exploring cumulative knowledge-building in the rehabilitative health professions
- Authors: De Bie, Gabrielle
- Date: 2017
- Subjects: Medical education -- Curricula , Human anatomy -- Study and teaching -- Curricula , Physiology -- Study and teaching -- Curricula , Occupational therapy -- Study and teaching -- Curricula , Physical therapy -- Study and teaching -- Curricula , Medical rehabilitation -- Study and teaching -- Curricula , Knowledge, Theory of
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/18617 , vital:22361
- Description: This study was motivated by the researcher's experience that students in the rehabilitative health professional programmes were finding it difficult to access fundamental knowledge upon which their professional practices and clinical contexts are based. An important focus of the research was the extent to which cumulative knowledge-building was impacted after the foundational biomedical curriculum became an interdisciplinary programme. The study explored whether the organisation of the interdisciplinary foundational curriculum served the fundamental needs of the professions, and whether, as a matter of social justice, students' access to powerful knowledge was enabled by the form that the fundamental curriculum assumed. This curriculum study at a particular Faculty of Health Sciences foregrounds the structuring, organisation and differentiation of disciplinary knowledge, and reflects a twenty year period that included not only transitions in professional education but also extensive transformation in, and a different approach to, health delivery. At the institution, physiology and anatomy, the biomedical sciences basic to the health professions, underwent disciplinary merging and subsequent altered positioning in curricula. Medicine opted for a problem-based learning approach whereas the rehabilitation health sciences did not. Legitimation Code Theory (LCT) provided the means for analysis of the extent to which interdisciplinary organisation in the foundational curriculum for Physiotherapy and Occupational Therapy enabled integrative, cumulative building of knowledge for professional and clinical contexts. Specialisation and Semantics dimensions of Legitimation Code Theory were used to reveal the principles underpinning practices, contexts and dispositions of Anatomy and Physiology at the Faculty of Health Sciences over a twenty year period post democratisation in South Africa (1994 - 2013). Disciplinary positioning in curriculum prior- and post-merger, were compared and contrasted. LCT were used to characterise the distinctiveness of Physiotherapy and Occupational Therapy at the university including the kind of knowledge and the kind of knower that specialises the different professions, and what is valorised and legitimated for each kind of professional. Semantic gravity was used to explore the expected knowledge recontextualisations in diverse and complex clinical settings for each of the professions. Registered professionals who are clinical educators as well as curriculum designers for clinical studies were interviewed. Profession-specific course outlines were further data sources. The biomedical disciplines Anatomy and Physiology were characterised for their measures of distinction and their respective knowledge-knower structures. Analysis traced each discipline from its strongly classified form in autonomous curricula when there were separate learner-cohorts for physiotherapists and occupational therapists, to post-merger when the disciplines were framed as human biology in an integrated foundational curriculum for a joint cohort of students. Curricular documents for the twenty year period were analysed quantitatively and qualitatively to establish the positioning of Physiology and Anatomy before and after the disciplines merged to a single course of Human Biology. Teaching staff were interviewed for their understanding of what specialises the physiological and anatomical components of the Human Biology curriculum, what they considered as powerful knowledge for the professions, and who they envisaged as the ideal student-knower exiting the basic sciences platform to enter more advanced clinical studies. The degree of context-dependence for meaning-making in the different disciplinary domains and the condensation of meanings inherent in the respective practices and contexts, were analysed. The thesis argues that following the merger Anatomy is preferentially legitimated as powerful knowledge at the expense of Physiology; that the ideal of disciplinary integration is not reached, and that the segmental organisation and structuring of the curriculum negatively impacted on cumulative knowledge-building and application of professional knowledge in the clinical arena. After the merger the disciplines lost their shape, and in particular the hierarchical knowledge structure of Physiology collapsed. By not having access to the necessary disciplinary knowledge structures and their associated practices, students' ability for scaffolding and integrating knowledge into the clinical arena was constrained. The organisation of the current Human Biology curriculum does not facilitate cumulative learning, and in so doing may not contribute to the envisaged graduate professional who is required to practice within a complex and demanding healthcare work environment. The significance of this study conveys that interdisciplinary programmes should be carefully considered, and there is an added imperative in the health professions which ultimately realise treatment of patients. If, aside from interdisciplinary teaching, there are also merged cohorts of participant students, then a sound understanding of the epistemic requirements of each profession is required. Those involved in curriculum development in various fields need to take these recommendations into account to enable cumulative learning and enable epistemological access to powerful knowledge for an increasingly diverse student body.
- Full Text:
- Date Issued: 2017
- Authors: De Bie, Gabrielle
- Date: 2017
- Subjects: Medical education -- Curricula , Human anatomy -- Study and teaching -- Curricula , Physiology -- Study and teaching -- Curricula , Occupational therapy -- Study and teaching -- Curricula , Physical therapy -- Study and teaching -- Curricula , Medical rehabilitation -- Study and teaching -- Curricula , Knowledge, Theory of
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/18617 , vital:22361
- Description: This study was motivated by the researcher's experience that students in the rehabilitative health professional programmes were finding it difficult to access fundamental knowledge upon which their professional practices and clinical contexts are based. An important focus of the research was the extent to which cumulative knowledge-building was impacted after the foundational biomedical curriculum became an interdisciplinary programme. The study explored whether the organisation of the interdisciplinary foundational curriculum served the fundamental needs of the professions, and whether, as a matter of social justice, students' access to powerful knowledge was enabled by the form that the fundamental curriculum assumed. This curriculum study at a particular Faculty of Health Sciences foregrounds the structuring, organisation and differentiation of disciplinary knowledge, and reflects a twenty year period that included not only transitions in professional education but also extensive transformation in, and a different approach to, health delivery. At the institution, physiology and anatomy, the biomedical sciences basic to the health professions, underwent disciplinary merging and subsequent altered positioning in curricula. Medicine opted for a problem-based learning approach whereas the rehabilitation health sciences did not. Legitimation Code Theory (LCT) provided the means for analysis of the extent to which interdisciplinary organisation in the foundational curriculum for Physiotherapy and Occupational Therapy enabled integrative, cumulative building of knowledge for professional and clinical contexts. Specialisation and Semantics dimensions of Legitimation Code Theory were used to reveal the principles underpinning practices, contexts and dispositions of Anatomy and Physiology at the Faculty of Health Sciences over a twenty year period post democratisation in South Africa (1994 - 2013). Disciplinary positioning in curriculum prior- and post-merger, were compared and contrasted. LCT were used to characterise the distinctiveness of Physiotherapy and Occupational Therapy at the university including the kind of knowledge and the kind of knower that specialises the different professions, and what is valorised and legitimated for each kind of professional. Semantic gravity was used to explore the expected knowledge recontextualisations in diverse and complex clinical settings for each of the professions. Registered professionals who are clinical educators as well as curriculum designers for clinical studies were interviewed. Profession-specific course outlines were further data sources. The biomedical disciplines Anatomy and Physiology were characterised for their measures of distinction and their respective knowledge-knower structures. Analysis traced each discipline from its strongly classified form in autonomous curricula when there were separate learner-cohorts for physiotherapists and occupational therapists, to post-merger when the disciplines were framed as human biology in an integrated foundational curriculum for a joint cohort of students. Curricular documents for the twenty year period were analysed quantitatively and qualitatively to establish the positioning of Physiology and Anatomy before and after the disciplines merged to a single course of Human Biology. Teaching staff were interviewed for their understanding of what specialises the physiological and anatomical components of the Human Biology curriculum, what they considered as powerful knowledge for the professions, and who they envisaged as the ideal student-knower exiting the basic sciences platform to enter more advanced clinical studies. The degree of context-dependence for meaning-making in the different disciplinary domains and the condensation of meanings inherent in the respective practices and contexts, were analysed. The thesis argues that following the merger Anatomy is preferentially legitimated as powerful knowledge at the expense of Physiology; that the ideal of disciplinary integration is not reached, and that the segmental organisation and structuring of the curriculum negatively impacted on cumulative knowledge-building and application of professional knowledge in the clinical arena. After the merger the disciplines lost their shape, and in particular the hierarchical knowledge structure of Physiology collapsed. By not having access to the necessary disciplinary knowledge structures and their associated practices, students' ability for scaffolding and integrating knowledge into the clinical arena was constrained. The organisation of the current Human Biology curriculum does not facilitate cumulative learning, and in so doing may not contribute to the envisaged graduate professional who is required to practice within a complex and demanding healthcare work environment. The significance of this study conveys that interdisciplinary programmes should be carefully considered, and there is an added imperative in the health professions which ultimately realise treatment of patients. If, aside from interdisciplinary teaching, there are also merged cohorts of participant students, then a sound understanding of the epistemic requirements of each profession is required. Those involved in curriculum development in various fields need to take these recommendations into account to enable cumulative learning and enable epistemological access to powerful knowledge for an increasingly diverse student body.
- Full Text:
- Date Issued: 2017
Exercise Physiology: HMS 313
- Authors: Van Gent, M , Lyoka, P
- Date: 2012-11
- Language: English
- Type: Examination paper
- Identifier: vital:17931 , http://hdl.handle.net/10353/d1012197
- Description: Exercise Physiology: HMS 313, supplementary examination June 2011.
- Full Text: false
- Date Issued: 2012-11
- Authors: Van Gent, M , Lyoka, P
- Date: 2012-11
- Language: English
- Type: Examination paper
- Identifier: vital:17931 , http://hdl.handle.net/10353/d1012197
- Description: Exercise Physiology: HMS 313, supplementary examination June 2011.
- Full Text: false
- Date Issued: 2012-11
Physiology: BKN 122
- Authors: Van Gent, M , Xoxo, T
- Date: 2009-11
- Language: English
- Type: Examination paper
- Identifier: vital:17868 , http://hdl.handle.net/10353/d1010496
- Description: Physiology: BKN 122, supplementary degree examination 2009.
- Full Text: false
- Date Issued: 2009-11
- Authors: Van Gent, M , Xoxo, T
- Date: 2009-11
- Language: English
- Type: Examination paper
- Identifier: vital:17868 , http://hdl.handle.net/10353/d1010496
- Description: Physiology: BKN 122, supplementary degree examination 2009.
- Full Text: false
- Date Issued: 2009-11
Plant Ecology, Genetics, Taxonomy & Physiology: BOT 221
- Buwa, L V, Magwa, M L, Afolayan, A J, Mhinana, Z M
- Authors: Buwa, L V , Magwa, M L , Afolayan, A J , Mhinana, Z M
- Date: 2012-02
- Subjects: Botany
- Language: English
- Type: Examination paper
- Identifier: vital:17735 , http://hdl.handle.net/10353/d1010187
- Description: Plant Ecology, Genetics, Taxonomy & Physiology: BOT 221, supplementary examination February 2012.
- Full Text: false
- Date Issued: 2012-02
- Authors: Buwa, L V , Magwa, M L , Afolayan, A J , Mhinana, Z M
- Date: 2012-02
- Subjects: Botany
- Language: English
- Type: Examination paper
- Identifier: vital:17735 , http://hdl.handle.net/10353/d1010187
- Description: Plant Ecology, Genetics, Taxonomy & Physiology: BOT 221, supplementary examination February 2012.
- Full Text: false
- Date Issued: 2012-02
Plant Ecology, Plant Physiology and Plant Diversity: BOT 121
- Authors: Mayekiso, B , Buwa, L
- Date: 2012-01
- Language: English
- Type: Examination paper
- Identifier: vital:17738 , http://hdl.handle.net/10353/d1010291
- Description: Plant Ecology, Plant Physiology and Plant Diversity: BOT 121, supplementary examination January 2012.
- Full Text: false
- Date Issued: 2012-01
- Authors: Mayekiso, B , Buwa, L
- Date: 2012-01
- Language: English
- Type: Examination paper
- Identifier: vital:17738 , http://hdl.handle.net/10353/d1010291
- Description: Plant Ecology, Plant Physiology and Plant Diversity: BOT 121, supplementary examination January 2012.
- Full Text: false
- Date Issued: 2012-01
Exercise Physiology, HUS 222
- Authors: Van Gent, Maya , Lyoko, Phil
- Date: 2011-11
- Language: English
- Type: Examination paper
- Identifier: vital:18255 , http://hdl.handle.net/10353/d1011249
- Description: Exercise Physiology, HUS 222, supplementary examination November 2011.
- Full Text: false
- Date Issued: 2011-11
- Authors: Van Gent, Maya , Lyoko, Phil
- Date: 2011-11
- Language: English
- Type: Examination paper
- Identifier: vital:18255 , http://hdl.handle.net/10353/d1011249
- Description: Exercise Physiology, HUS 222, supplementary examination November 2011.
- Full Text: false
- Date Issued: 2011-11
Advanced topics in selected fields of crop physiology: AGC 612
- Chiduza, C, Mutengwa, C, Eiasu, B K, Soundy, P
- Authors: Chiduza, C , Mutengwa, C , Eiasu, B K , Soundy, P
- Date: 2011-06
- Subjects: Field crops
- Language: English
- Type: Examination paper
- Identifier: vital:17638 , http://hdl.handle.net/10353/d1010016
- Description: Advanced Topics in Selected Fields of Crop Physiology: AGC 612, degree examinations June 2011.
- Full Text: false
- Date Issued: 2011-06
- Authors: Chiduza, C , Mutengwa, C , Eiasu, B K , Soundy, P
- Date: 2011-06
- Subjects: Field crops
- Language: English
- Type: Examination paper
- Identifier: vital:17638 , http://hdl.handle.net/10353/d1010016
- Description: Advanced Topics in Selected Fields of Crop Physiology: AGC 612, degree examinations June 2011.
- Full Text: false
- Date Issued: 2011-06
Exercise Physiology: HMS 313
- Lyoka, P A, Van Ghent, Maya, Coopoo, Y
- Authors: Lyoka, P A , Van Ghent, Maya , Coopoo, Y
- Date: 2011-06
- Language: English
- Type: Examination paper
- Identifier: vital:17932 , http://hdl.handle.net/10353/d1012198
- Description: Exercise Physiology: HMS 313, examination June 2011.
- Full Text: false
- Date Issued: 2011-06
- Authors: Lyoka, P A , Van Ghent, Maya , Coopoo, Y
- Date: 2011-06
- Language: English
- Type: Examination paper
- Identifier: vital:17932 , http://hdl.handle.net/10353/d1012198
- Description: Exercise Physiology: HMS 313, examination June 2011.
- Full Text: false
- Date Issued: 2011-06
Exercise Physiology: HUS 511
- Van Ghent, Maya, Lyoka, P, Coetzee, Ben
- Authors: Van Ghent, Maya , Lyoka, P , Coetzee, Ben
- Date: 2011-06
- Language: English
- Type: Examination paper
- Identifier: vital:18246 , http://hdl.handle.net/10353/d1011239
- Description: Exercise Physiology: HUS 511, honours degree examination June 2011.
- Full Text: false
- Date Issued: 2011-06
- Authors: Van Ghent, Maya , Lyoka, P , Coetzee, Ben
- Date: 2011-06
- Language: English
- Type: Examination paper
- Identifier: vital:18246 , http://hdl.handle.net/10353/d1011239
- Description: Exercise Physiology: HUS 511, honours degree examination June 2011.
- Full Text: false
- Date Issued: 2011-06
Insect Physiology, Cytology and Biochemistry: ENT 505
- Authors: Stemele, M A , Olckers, T
- Date: 2011-06
- Language: English
- Type: Examination paper
- Identifier: vital:17895 , http://hdl.handle.net/10353/d1011064
- Description: Insect Physiology, Cytology and Biochemistry: ENT 505, honuors examination June 2011.
- Full Text: false
- Date Issued: 2011-06
- Authors: Stemele, M A , Olckers, T
- Date: 2011-06
- Language: English
- Type: Examination paper
- Identifier: vital:17895 , http://hdl.handle.net/10353/d1011064
- Description: Insect Physiology, Cytology and Biochemistry: ENT 505, honuors examination June 2011.
- Full Text: false
- Date Issued: 2011-06
Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605
- Muchenje, V, Nkukwana, T T, Chimonyo, M, van de Vyver, F
- Authors: Muchenje, V , Nkukwana, T T , Chimonyo, M , van de Vyver, F
- Date: 2011-02
- Subjects: Ruminants -- Digestive organs
- Language: English
- Type: Examination paper
- Identifier: vital:17526 , http://hdl.handle.net/10353/d1009808
- Description: Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605, supplementary examination February 2011.
- Full Text: false
- Date Issued: 2011-02
- Authors: Muchenje, V , Nkukwana, T T , Chimonyo, M , van de Vyver, F
- Date: 2011-02
- Subjects: Ruminants -- Digestive organs
- Language: English
- Type: Examination paper
- Identifier: vital:17526 , http://hdl.handle.net/10353/d1009808
- Description: Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605, supplementary examination February 2011.
- Full Text: false
- Date Issued: 2011-02
Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605
- Muchenje, V, Nkukwana, T T, Chimonyo, Van de Vyver, F
- Authors: Muchenje, V , Nkukwana, T T , Chimonyo , Van de Vyver, F
- Date: 2011-02
- Subjects: Ruminants -- Metabolism
- Language: English
- Type: Examination paper
- Identifier: vital:17525 , http://hdl.handle.net/10353/d1009807
- Description: Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605, supplementary examination February 2010.
- Full Text: false
- Date Issued: 2011-02
- Authors: Muchenje, V , Nkukwana, T T , Chimonyo , Van de Vyver, F
- Date: 2011-02
- Subjects: Ruminants -- Metabolism
- Language: English
- Type: Examination paper
- Identifier: vital:17525 , http://hdl.handle.net/10353/d1009807
- Description: Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605, supplementary examination February 2010.
- Full Text: false
- Date Issued: 2011-02
Introduction to Physiology: HUS 122
- Authors: Vimiso, P , Van Gent, Maya
- Date: 2011-01
- Language: English
- Type: Examination paper
- Identifier: vital:18241 , http://hdl.handle.net/10353/d1011233
- Description: Introduction to Physiology: HUS 122, Supplementary examination January 2010.
- Full Text: false
- Date Issued: 2011-01
- Authors: Vimiso, P , Van Gent, Maya
- Date: 2011-01
- Language: English
- Type: Examination paper
- Identifier: vital:18241 , http://hdl.handle.net/10353/d1011233
- Description: Introduction to Physiology: HUS 122, Supplementary examination January 2010.
- Full Text: false
- Date Issued: 2011-01
Anatomy and Physiology: AGV 221
- Authors: Masika, P J , Marufu, M C
- Date: 2010-11
- Language: English
- Type: Examination paper
- Identifier: vital:17559 , http://hdl.handle.net/10353/d1009887
- Description: Anatomy and Physiology: AGV 221, degree examination November 2010.
- Full Text: false
- Date Issued: 2010-11
- Authors: Masika, P J , Marufu, M C
- Date: 2010-11
- Language: English
- Type: Examination paper
- Identifier: vital:17559 , http://hdl.handle.net/10353/d1009887
- Description: Anatomy and Physiology: AGV 221, degree examination November 2010.
- Full Text: false
- Date Issued: 2010-11
Introduction to Physiology: HUS 122
- Authors: Vimiso, P , Van Gent, Maya
- Date: 2010-11
- Language: English
- Type: Examination paper
- Identifier: vital:18251 , http://hdl.handle.net/10353/d1011245
- Description: Introduction to Physiology: HUS 122, degree examination November 2010.
- Full Text: false
- Date Issued: 2010-11
- Authors: Vimiso, P , Van Gent, Maya
- Date: 2010-11
- Language: English
- Type: Examination paper
- Identifier: vital:18251 , http://hdl.handle.net/10353/d1011245
- Description: Introduction to Physiology: HUS 122, degree examination November 2010.
- Full Text: false
- Date Issued: 2010-11
Anatomy and Physiology: AGV 221
- Authors: Masika, P J , Marufu, M C
- Date: 2010-02
- Subjects: Agriculture
- Language: English
- Type: Examination paper
- Identifier: vital:17523 , http://hdl.handle.net/10353/d1009805
- Description: Anatomy and Physiology: AGV 221, examination February 2010.
- Full Text: false
- Date Issued: 2010-02
- Authors: Masika, P J , Marufu, M C
- Date: 2010-02
- Subjects: Agriculture
- Language: English
- Type: Examination paper
- Identifier: vital:17523 , http://hdl.handle.net/10353/d1009805
- Description: Anatomy and Physiology: AGV 221, examination February 2010.
- Full Text: false
- Date Issued: 2010-02
Plant Ecology/Genetics/Taxonomy/Physiology: BOT 221
- Buwa, L V, Magwa, M L, Afolayan, A J, Mhinana, Z M
- Authors: Buwa, L V , Magwa, M L , Afolayan, A J , Mhinana, Z M
- Date: 2010-02
- Subjects: Botany
- Language: English
- Type: Examination paper
- Identifier: vital:17731 , http://hdl.handle.net/10353/d1010180
- Description: Plant Ecology/Genetics/Taxonomy/Physiology: BOT 221, supplementary examination February 2010.
- Full Text: false
- Date Issued: 2010-02
- Authors: Buwa, L V , Magwa, M L , Afolayan, A J , Mhinana, Z M
- Date: 2010-02
- Subjects: Botany
- Language: English
- Type: Examination paper
- Identifier: vital:17731 , http://hdl.handle.net/10353/d1010180
- Description: Plant Ecology/Genetics/Taxonomy/Physiology: BOT 221, supplementary examination February 2010.
- Full Text: false
- Date Issued: 2010-02
Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605
- Chimonyo, M, Van de Vyver, F
- Authors: Chimonyo, M , Van de Vyver, F
- Date: 2010-01
- Subjects: Ruminants -- Metabolism
- Language: English
- Type: Examination paper
- Identifier: vital:17529 , http://hdl.handle.net/10353/d1009819
- Description: Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605, supplementary examination January 2010.
- Full Text: false
- Date Issued: 2010-01
- Authors: Chimonyo, M , Van de Vyver, F
- Date: 2010-01
- Subjects: Ruminants -- Metabolism
- Language: English
- Type: Examination paper
- Identifier: vital:17529 , http://hdl.handle.net/10353/d1009819
- Description: Physiology of Digestion and Ruminology and Energy and Protein Metabolism: AGA 605, supplementary examination January 2010.
- Full Text: false
- Date Issued: 2010-01
Plant Ecology, Plant Physiology and Plant Diversity: BOT 121
- Authors: Mayekiso, B , Buwa, L
- Date: 2010-01
- Subjects: Plant ecology
- Language: English
- Type: Examination paper
- Identifier: vital:17737 , http://hdl.handle.net/10353/d1010194
- Description: Plant Ecology, Plant Physiology and Plant Diversity: BOT 121, supplementary examination January 2010.
- Full Text: false
- Date Issued: 2010-01
- Authors: Mayekiso, B , Buwa, L
- Date: 2010-01
- Subjects: Plant ecology
- Language: English
- Type: Examination paper
- Identifier: vital:17737 , http://hdl.handle.net/10353/d1010194
- Description: Plant Ecology, Plant Physiology and Plant Diversity: BOT 121, supplementary examination January 2010.
- Full Text: false
- Date Issued: 2010-01
Anatomy and Physiology: AGV 221
- Authors: Masika, P J , Marufu, M C
- Date: 2009-11
- Language: English
- Type: Examination paper
- Identifier: vital:17556 , http://hdl.handle.net/10353/d1009884
- Description: Anatomy and Physiology: AGV 221, degree examination November 2009.
- Full Text: false
- Date Issued: 2009-11
- Authors: Masika, P J , Marufu, M C
- Date: 2009-11
- Language: English
- Type: Examination paper
- Identifier: vital:17556 , http://hdl.handle.net/10353/d1009884
- Description: Anatomy and Physiology: AGV 221, degree examination November 2009.
- Full Text: false
- Date Issued: 2009-11