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    An exploration of the learning environment and career intentions: a mixed methods study of paediatric interns at KwaZulu-Natal.
    (2018) Naidoo, Kimesh Loganathan.; Van Wyk, Jacqueline Marina.
    Background: Globally, there is increased pressure on health professions education to be responsive to inequities in health care. These imperatives are clearly evident in KwaZulu-Natal (KZN) with its high disease burden. Poor doctor to patient ratios here are exacerbated by migration of medical practitioners to urban areas, private practice and developed countries. South Africa’s two–year internship aims at producing primary health care clinicians for the public health system. Gaps in knowledge of internship and intern career intentions, in resource challenged contexts, have translated to the failure by both higher education authorities and national health departments to include the internship period in strategies, to ensure that the inequities in health care are addressed. Aim: This explorative study used a mixed methodology approach to explore the factors that influence perceptions of the learning environment (LE) during internship and their influence on career intentions. Methods: The study used a social constructivist worldview drawing on a sequential explanatory mixed methods design to understand the construct of the LE and its influence on career intentions. Both quantitative and qualitative methods that included surveys using a locally validated version of the Postgraduate Hospital Educational Environment Measure (PHEEM) and focus group discussions were generated. This study was conducted among interns in Paediatrics at four hospital complexes in KwaZulu-Natal in 2015. The Communities of Practice theory and the Social Cognitive Career Theory were drawn on and supplemented by the theory of alienation and engagement to develop a conceptual framework that informed the analyses of the relationship between perceptions of the LE and career intentions. Results/Findings: Perceptions of the LE were found to be influenced by both external (disease burden, workload and resource constraints) and individual related contextual factors (supervisor -intern relationships, mentorship, feedback and demography). These factors acted as alienating influences that curtailed access and restricted participation within communities of practice in internship. A narrow view of the role and scope of interns was reflected in significant differences between interns and their supervisor’s perceptions of the LE and gaps in assessment practices of SA interns compared with international best practices. Poor perceptions of the LE drove interns away from SA’s public health system and from caring for children. There were strong aspirations to specialise and weaker aspirations to enter primary health care amongst the sampled interns. Conclusion: Contextual factors in a resource limited LE impacted on identity and career self-efficacy formation of SA interns who failed to see a future role for themselves in primary health care and child health within the public health system. Expanding on the framework of communities of practice a new model of understanding, of how the interplay of contextual factors in resource challenged contexts affects internship learning and career interest formation, was developed. This new knowledge of context on learning and career interest provides the framework to understand the discordance between national health needs and career aspirations of interns in resource challenged environments. This new understanding provides the theoretical underpinning for changes in policy, practice, curricula content and future research to improve access and create an expansive participatory framework for SA interns. These proposed changes in the SA learning environment has the potential to ensure a sustainable public health system and redress the inequity seen in distorted doctor patient ratios in areas of need.
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    Teaching and learning coping strategies adopted by teenage mothers during coronavirus disease lockdown in Makhado Municipality, Limpopo Province.
    (2023) Moganedi, Shonisane Emily.; Mudau, Tshimangadzo Selina.
    Background: The COVID-19 pandemic exposed inequalities in access to technology between rich and poor, rural, and urban, girls and boys and across and within countries. The other negative social and health related impacts that COVID-19 and related restrictions had on the poorest, most marginalized, and vulnerable sectors of society are likely to have been disproportionately affected by school closures due to COVID-19. Teenage mothers living in rural areas have fewer resources such as access to the internet, smartphones, and computers to adapt to and implement measures needed to continue with online learning during school closures. The aim of the study was to explore and describe teaching and learning coping strategies adopted by teenage mothers in the rural communities of Makhado Municipality during the coronavirus disease lockdown in Limpopo Province, South Africa. Design: The study adopted a qualitative critical participatory action research through the community engagement approach. Methods: Purposive and snowballing recruitment were employed in this study. Methods of generation of data included semi-structured face-to-face interviews which were audio-taped, transcribed verbatim, and participatory arts were also applied to generate data. Data was analysed using qualitative thematic analysis. Findings: Thematic analysis of data revealed that teenage mothers experienced challenges such as stigma and discrimination, stress, inability to cope with self-study, financial constraints in caring for and supporting their babies, lack of gadgets and the internet essential for home learning, and inconsistent support from parents and teachers. Recommendations: Policies need be reviewed to address the issue of stigmatization and discrimination in schools. Authorities in education need to be geared in enriching social change towards transformative learning and addressing the issue of the digital divide in rural communities. Conclusion: It was concluded that the COVID-19 pandemic has broadened a huge gap between the rich and the poor, urban and rural learners. It was concluded by the researcher that there was evidence of social segregation and social injustice for teenage mothers in teaching and learning.
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    Teaching and learning support received by teenage mothers during the coronavirus disease lockdown in Makhado Municipality, Vhembe district.
    (2023) Makaleng, Kepse Christina.; Mudau , Tshimangadzo Selina.
    Background: In the wake of the Coronavirus disease lockdown, schools, creches and higher education institutions worldwide closed their doors, disrupting teaching and learning. All learners, including teenage mothers were forced to study from home due to a shift from traditional classrooms to online learning platforms, increasing the probability of school dropouts. Home learning became overwhelming to teenage mothers as they had to balance motherhood and learning while studying from home. The sudden shift worsened education inequality, thus negatively impacting the achievement of the Sustainable Development Goal 3; namely, Good Health and Wellbeing since quality education promotes health. Learners from poor provinces such as Limpopo, specifically those living in rural areas such as the Makhado municipality, face obstacles such as poor connectivity and limited access to the internet. Purpose: The purpose of the study, therefore, is to explore and describe teaching and learning support received by teenage mothers during the COVID-19 lockdown in the Vhembe district, Makhado municipality, Limpopo province. Research methodology: The study employed qualitative, participatory action reseach (PAR) through community engagement since the latter is community driven, ensuring that teenage mothers and stakeholders are included in an enquiry that seeks to promote social justice. The participatory arts-based action research created a safe space for the teenage mothers to share their stories. Data were generated from 11 participants through unstructured individual and group interviews. Findings: The study revealed that teenage mothers were supported by families, community members and teachers during the coronavirus school closures and rotational classes. However, the support was not adequate and consistent to promote the continuity of teaching and learning. The teenage mothers were further supported emotionally thus promoting their self-concept. Remote learning has proven to be a challenge to most teenage mothers due to the inaccessibility of online resources. It was difficult for teenage mothers to balance motherhood and learning due to frequent interruptions such as taking care of the baby resulting in poor concentration. Conclusion: The teenage mothers were socially, emotionally and financially supported by their families and some teachers, however, the support provided was insufficient and inconsistent to promote continuity of teaching and learning, resulting in teenage mothers not having access to quality education. Due to the frequent interruptions by crying babies, teenage mothers had difficulty balancing motherhood and learning.