Ted Sommerville Medical Education, NRMSM, UKZN Problem-based learning at the Nelson R Mandela School of Medicine: student and staff perceptions of a knowledge structure viewed through a Bernsteinian lens Ted Sommerville Medical Education, NRMSM, UKZN

Aim To explore factors affecting students’ engagement with the pedagogy of problem-based learning (PBL) To analyse PBL using Bernstein’s theory of classification and framing as an organising framework

Method Quantitative study Extracts from ITS v class test results 2007 1st year MBChB class → 3rd year Qualitative study Interviews 19 students and 6 staff members Stratified as to demography Analysed using Nvivo™

Results – Demographics ‘Race’ Language Age Financial need Sex NS High school quintile Previous tertiary ed. ‘Year of study’ (test marks) Matric points

Conclusions – Demographics Socio-economic ‘class’ ? School → university transition School-leaving performance Composition of individual tests

Classification & Framing Boundaries Everyday / Specialised Interdisciplinary Intradisciplinary Framing: Relations Content Organisation Pacing Evaluation [sic] Hierarchy Bernstein, B. (1971). On the classification and framing of educational knowledge. In Class, codes and control Volume 1 Theoretical studies towards a sociology of language (Vol. 1, pp. 202-230). London: Routledge & Kegan Paul.

Results – C&F Students: + / - - + Staff: + / - + - - / + Everyday / Specialised Interdisciplinary Intradisciplinary Content Organisation Pacing Evaluation Hierarchy

Results – “Integration” Integration of medical and non-medical knowledge Integrated teaching of cognate disciplines (horizontal integration) Combination of basic science and clinical aspects (vertical integration) Logical sequencing of disciplinary material Teachers linking their lectures with those of their colleagues Integrating structure and function, health and disease of the whole body Clinicians integrating basic science, diagnostic and other skills Students making links within their own minds

Discussion Discourse Vertical Horizontal Knowledge structure Hierarchical Knowledge structure e.g. Physics e.g. Sociology Bernstein, B. (1996). Discourses, knowledge structures and fields: some arbitrary situations. In B. Bernstein (Ed.), Pedagogy, symbolic control and identity: theory, research, critique (pp. 169-181). London: Taylor & Francis.

Conclusions Medicine is a vertical discourse, distinct from everyday discourses Medicine is largely a horizontal knowledge structure, with a number of distinct areas This requires more explicit ‘integration’ than a pure hierarchical knowledge structure PBL attempts to integrate; preferable to layered hierarchical pedagogy