1. 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

2. 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

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

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

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

6. 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 ). London: Routledge & Kegan Paul.

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

8. 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

9. 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 ). London: Taylor & Francis.

10. 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