People and pedagogy : problem-based learning in the MBChB curriculum at UKZN medical school.
Sommerville, Thomas Edward.
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This study explores problem-based learning (PBL) as a form of pedagogy, and its interrelationships with the students, staff members and institution of the Medical Faculty at the University of KwaZulu-Natal. Little has been written previously about the interaction of student diversity and resource-constrained circumstances with PBL. I investigate perceptions and experiences of PBL as a pedagogic strategy, using Bernstein's theories of classification and framing as an organising framework. I draw also on his writings on discourses and knowledge structures and the pedagogic device. Within an interpretive methodology, I use three methods to generate data. I analyse numerically the test marks of a cohort of 202 students over three years for demographic influences on pedagogic engagement. I explore in semi-structured interviews the perceptions and experiences of PBL of 19 students and 6 staff members, and relate these to Faculty documents; I analyse these sources thematically in order to describe the roles of student, teacher and institution. These perceptions and experiences I then examine according to the eight elements of Bernstein's classification and framing. A number of contradictions emerge: between PBL theory, echoed by Faculty documents on one hand, and staff/student perceptions and experiences on the other; between staff members and students at some points but not at others; between high-achieving and low-achieving students; between different respondents' under-standings of "integration". Some demographic characteristics prove on analysis to be highly significant influences while others, counter-intuitively, are not. Bernstein's theories about knowledge structures are pertinent to the tensions revealed. Medicine has thought of itself as akin to the pure sciences – implying a hierarchical structure in which all knowledge aggregates towards a point of abstraction. However, the structure and function revealed by respondents suggests a horizontal knowledge structure, in which disciplinary knowledge is kept distinct. Students and teachers thus struggle to integrate areas of knowledge that are inherently discrete. In terms of Bernstein's "pedagogic device", some students are able to discern PBL's implicit rules of engagement, while others are not. Consensus on medicine‟s knowledge structure might settle ambiguities and help PBL achieve its potential as a complex pedagogy in a complex field.