This project stream features projects which research how higher education systems can become inclusive.
Peggy Kauriatjike
Supervisors: Dr Adele Ebrahim; Prof Harsha Kathard
EXPLORING THE TRANSITION EXPERIENCES OF FIRST-YEAR STUDENTS WITH DISABILITIES FROM SECONDARY SCHOOL TO UNIVERSITY IN A UNIVERSITY IN BOTSWANA
This study explores how first-year students transition into their studies at a university in Botswana. Students with disabilities often face significant challenges when transitioning from secondary school to higher education. However, there is a limited body of scientific knowledge about the experiences of students with disabilities during their first semester transitioning from secondary school to higher education in Botswana. The research question guiding this study is: How do sociocultural and institutional factors shape the academic, social and emotional transition experiences of first-year students with disabilities during their first semester? Understanding the transition experiences of students with disabilities could assist institutions of higher education and their stakeholders in Botswana and similar contexts across Africa to design and implement evidence-based transition support strategies that improve inclusion and success for students with disabilities from the beginning of their university life. This is especially important for developing countries like Botswana, which have constrained resources.
Msindo Jordan Mahlangu
Supervisors: Prof Harsha Kathard, Dr Unati Stemela
Investigating the socio-academic injustices experienced by students with disabilities at the University of Venda: modelling an integrative and collaborative approach for inclusion
Section 29(1)(b) of the Constitution of the Republic of South Africa, the Constitution of 1996, provides that:
“Everyone has the right to further education, which the state, through reasonable measures, must make progressively available and accessible”.
Notwithstanding this provision of constitutional right, students with disabilities at higher education institutions (HEIs) still experience some socio-academic injustices, which are exclusionary. Mukansi (2005) states that students with physical impairments at the University of Venda (UNIVEN) operate in a hostile environment. At the University of Cape Town, low levels of disability inclusion were recorded, and the view that disability was not regarded as an issue of social injustice (Ohajunwa, Mckenzie, Hardy & Lorenzo, 2014).
UNIVEN students with disabilities are often admitted without adequate knowledge of disability matters by the academic staff, due to a lack of prior training. This void in knowledge leads to a situation where students are inadvertently treated with indifference, which consequently results in academic underperformance, social isolation, and systemic exclusion.
This study aims to investigate the causes of socio-academic injustices at UNIVEN and propose an integrative and cooperative model, involving various University units, for meaningful inclusion.
Elma De Vries
PhD completed Health Sciences Education
How can the process of professional identity formation of a gender-affirming practitioner inform medical curriculum change?
Background
Transgender and gender diverse people experience significant health disparities. Health professionals are generally not adequately prepared by current curricula to provide gender-affirming, holistic care that is respectful of patients’ gender identity. Therefore, this study asks the question: How can the professional identity formation of a gender-affirming practitioner inform medical curriculum change?
Methodology
The objectives of the study were to:
a. Analyse the process of professional identity formation of gender-affirming health care practitioners and students, using narrative interviews.
b. Illuminate how medical curriculum change can enable gender-affirming professional identity formation.
A critical research paradigm using the conceptual lens of professional identity formation was adopted. Case study design and narrative inquiry were the complementary methodological frameworks used. The study was conducted in two phases. In Phase One, six health care practitioners and nine medical students described their shared their experiences of becoming gender-affirming practitioners through narrative interviews. A narrative analysis was conducted and represented as stories. In phase two these stories were shared with medical educators in a group engagement to facilitate their reflections on gender-affirming curriculum change. Reflexive thematic analysis was used to analyse this discussion. Regulatory policy and university curriculum documents were analysed. Other data sources were participant reflective journals from phase one and the researcher’s reflective journal. Findings from each phase were combined for the case study analysis using a critical lens.
Findings
The process of professional identity formation is described as a journey of becoming over time rather than a destination. Being gender-affirming entails providing holistic care, confronting pathologising perspectives, seeing the human first, and shifting power to enable patient participation. The present learning environment at medical schools is not conducive to the development of a gender-affirming practitioner, given the gap between the intended and experienced curriculum.
Conclusion
A gender-affirming approach offers a new perspective of how power dynamics may shift to create a more enabling environment for the development of a gender-affirming professional identity. Curriculum change can facilitate this approach by integrating gender-affirming healthcare into the medical curriculum with a focus on attitudes, cultural humility and incorporating the voices of transgender and gender diverse people.
Ikechukwu Nwanze
Masters Supervisors: Prof. Harsha Kathard & Dr. Chioma Ohajunwa
How can we include Disability Issues in Undergraduate Curricula at the University of Cape Town?
This study examined how disability issues can be included into the undergraduate curriculum at the University of Cape Town (UCT). It was based on Ohajunwa’s (2012) study which looked at whether disability is included at all in UCT curricula. She found that disability issues were included but with minimal support and was done through individual effort and not a university collective effort. She also found that lecturers did not have support structures on how to even begin to think of including disability issues. This study therefore asked how disability issues can actually be included in the undergraduate curriculum at UCT.
A literature search found that institutions in South Africa have not started looking at the inclusion of disability issues in the curriculum in universities but rather have been focusing on the inclusion of students with disabilities. Inclusion of disability issues in university curricula has been happening on a small scale internationally with institutions citing a lack of support on how this can be embedded into all curricula rather than as an add-on.
The aims and objectives of this study, therefore, were to identify what content area should be the focus for the inclusion of disability issues, what teaching and assessment methods should be used, and what support structures are likely to be needed. The methodology used was a case study design and the case of disability inclusion in the University of Cape Town undergraduate curriculum. Focus group discussions, in-depth interviews, document analysis, and a reflective journal were means of data collection. Data were analysed using a thematic analysis method with an inductive approach.
The findings are reported in relation to a curriculum process framework which emphasises the links between why disability issues should be included, how, when and by what means. The findings are presented in four themes: 1. Achieving transformation through curriculum change; 2. Build and design the curriculum for diversity; 3. Creating a community of practice; and 4. Translating talk into action.
Trustworthiness and rigor were observed through member checking for credibility, reflexivity and peer-review for confirmability, and an audit trail for dependability.
The study concluded with a recommendation that with the use of the curriculum process framework that emerged from the study, disciplines may have a way to include disability issues in undergraduate curricula in order to transform these curricula. However, this should be done in an integrated way through considering various parts of the curriculum process framework.
PhD Supervisors: Prof Judith McKenzie & Dr. Kevin Murfitt
How do students and staff at the University of Cape Town understand equitable access to the curriculum for students with VIs?
Students with Visual Impairment (VI) still experience barriers to education despite the right to education stipulated in the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). Challenges such as delays in the conversion of curriculum content to accessible formats, inaccessible online course sites and teaching and learning that is mostly visual. With the University of Cape Town (UCT) going fully online due to COVID-19 pandemic, it became necessary to explore how equitable access to the curriculum is understood. The research topic is: How do staff and students at UCT understand equitable access to the curriculum for students with VIs? Four conceptual framework components were used. The hidden and enacted curriculum was used to explore hidden curriculum aspects and their effect on the enacted curriculum. Universal Design for Learning (UDL) framework was used to explore enablers such as assistive technology (AT) and challenges such as inaccessible content. Eight elements of digital literacies were used to explore access to opportunities to acquire digital literacies and the UNCRPD to ensure alignment with the right to education. A Q methodology study was conducted which is a hybrid of both quantitative and qualitative methods. It statistically groups viewpoints that are significantly similar to or distinct from each other, quantitatively into factors, then qualitatively interprets these factors thematically to reveal participant views about the research topic. Data was collected from students with VI, lecturers, staff from Disability Services, ICT Services, Library Services and the Centre for Higher Education Development using Q sorting where participants ranked sixty statements into disagree, neutral and agree. Focus group discussions were used to support the interpretation of the factors. Findings revealed that: accessible curriculum is also a technical issue which is not prioritised at UCT, and lecturers struggle with competing demands such lack of time, need for promotion and research. Accessibility design from the start both for curriculum development and support services is not valued. The right to education for students with VI is partial, varying their experience of the curriculum. Testing of a course site for accessibility and lack of AT negatively affects right to education. This study argues that students with VI do not yet enjoy full participation in the curriculum due to lack of understanding of the complexity involved. UDL can help academics move from a deficit view to an asset view of students with VI. UCT should change its operational model to accessibility from the start. Then UCT will move closer to equitable access to the curriculum for students with VI.
Sarah Whitehead PhD in Health Sciences Education
Proposing clinician competency guidelines for the inclusion of disability in the undergraduate medical curriculum of South Africa - an exploratory study
Abstract
Introduction
Persons with disability make up the largest minority group in the world yet there is a dearth of research both internationally and nationally on how disability is included in professional training curricula for medical doctors.
Aim of the study
The purpose of this study is to add to the body of knowledge that would facilitate the inclusion of disability in the undergraduate medical curriculum in South Africa.
Methods
This is a mixed method, sequential study – Phase one followed by Phase two. Phase one, data was collected - via focus groups and in-depth interviews - from Medical Doctors, Medical Students, Physiotherapists, Occupational Therapists, Speech and Language Therapists and Persons with disability. Phase two used a modified Delphi Method with an expert panel of disabled and abled Disability Studies Academics, Medical Educators, Disability Rights Activists and Medical Doctors. The experts were asked to rate – using a 5-point Likert Scale - each competency according to its importance and language clarity. They were also asked in open-ended questions, to make any suggestions relating to the language of each competency and whether any competencies could be combined.
Findings
Four main themes emerged from Phase one data: Experience of disability, Attitudes towards disability, Knowledge about Disability and Life beyond the disability. Data from these four themes contributed to the generation of an initial competency set – 17 competencies and 13 sub-competencies. In Phase two the initial competency set was presented to an expert panel as part of a modified Delphi Method. In the first iteration consensus was regarding the importance of each competency. In the second iteration consensus was reached regarding the language of each competency and a final competency set – containing 13 competencies and 9 sub-competencies - was generated. Competencies and sub-competencies 1-6 are clustered as knowledge competencies, 7-10 as attitudes and 11-13 as skills.
Conclusion
This study sets an important precedent for the inclusion of the subject of disability in undergraduate medical curricula. It proposes an approach to teaching and learning about disability inclusion for medical students. The list of disability specific competencies set forth by this study are a steppingstone in the process of curriculum transformation. The use of this guideline to improve the understanding of disability, and as a catalyst for undergraduate medical curriculum review is recommended.
Publications
https://ajod.org/index.php/ajod/article/view/1588
Lefa Kekena-Hlatswayo Masters in Disability Studies
Acquiring a disability during the clinical years of study: Exploring the experiences of medical students using a qualitative methodology
Introduction
This study explored the experiences of medical students who acquired a disability after enrolment in the Bachelor of Medicine and Bachelor of Surgery (MBChB) program at the University of Cape Town (UCT), whilst within their clinical years of training. The purpose of the study was to add to the limited literature about the experiences of medical students with disability particularly in their clinical years of the program and again in an African context, using UCT, as the study site.
Research Question
How do medical students and graduates who acquired a disability whilst in their clinical years of study (years 4-6) navigate the clinical training platform?
Methods
A narrative study design was used, and data was collected from five participants by means of three online in-depth interviews per participant. After listening to the experiences of the participants, the analysed data was presented using a thematic analysis approach and by storytelling using diary entries and comics. The inclusion criteria was: medical students currently in their clinical years (4-6); graduates who completed MBChB at UCT and had acquired disability during their clinical years and, medical students who acquired disability in their clinical years but did not complete their degree due to deregistration. The exclusion criteria was: medical students with disability, who are not enrolled at UCT; medical students with a known disability before fourth year of UCT MBChB program; postgraduate medical students; and students within other disciplines in health sciences.
Findings
The following cross-cutting themes emerged from the analysed data: Culture of Medicine, Impact of Socio-Economic Status, access and accessibility, Undergraduate support and inconsistent experiences, reintegration, curriculum flexibility, disclosure, disability education, environmental barriers, disability and mental health links and medicine as an island.
Conclusion
The study concluded that medical students who acquire disability in their clinical years of study find it difficult to navigate the clinical training platform. Challenges include issues of ableism, resistance from the culture of medicine in their institution, physical and attitudinal barriers; and difficulties of inclusion in their training sites and assessments. Questions about the assessment of competence in medical training were raised in consideration of students with disability’s diversity, the application of equity and reasonable accommodations. The need for disability education and introspection of the current culture of medicine is also raised.