An evaluation of a community-based interdisciplinary health promotion course in one South African University
Health professionals worldwide are currently inadequately trained to address the health issues of communities, particularly in developing countries where there are major health disparities. This study argues for an alternative and more appropriate education, one which would better prepare future health professionals to address these needs. The study draws attention to how the University of the Western Cape (UWC) responded to preparing its health professional graduates to better meet the needs of South African society. The thesis explores the rationale for a shift in health professions education to one which supports service-learning, locating the study within the broader developments in higher education within South Africa. The specific aim of this thesis was to evaluate a community-based interdisciplinary health promotion course offered to the undergraduate health sciences students from the faculties of Community and Health Sciences and Dentistry at the University of the Western Cape (UWC). It focused on evaluating the perceived effectiveness and the impact on the stakeholders of the Interdisciplinary Health Promotion course, with the aim of developing an appropriate framework to guide the teaching of health promotion at higher education institutions in South Africa. Ten primary schools in three disadvantaged communities in the Western Cape were used as the health promotion settings for the Interdisciplinary Health Promotion course. The study design was a programme evaluation that used the explanatory sequential mixed-methods design. An evaluation matrix was developed, consisting of three core concepts (curriculum, community-based learning, and university-school collaboration) against which the course was evaluated. Indicators and criteria were developed for each core concept. Questionnaires were distributed to all the stakeholders, that is, the university students, the lecturers, the supervisors and the school educators, involved in the Interdisciplinary Health Promotion Course during 2006. Focus group discussions with the stakeholders were also conducted at the UWC campus and in the Delft community. There was a good response from all the stakeholders who participated in the study (students (72.4%), lecturers (85%), supervisors (100%) and school educators (71.5%)). A main finding of the study was that the Interdisciplinary Health Promotion course was relevant and up-to-date with developments in the field of health promotion. Course topics were dealt with in sufficient depth and the assignments were clear, specific and related to the course outcomes. The interdisciplinary teaching and learning approach allowed the university students to learn and develop a better understanding of the roles and contributions that the various professions played in health promotion in a community. The course was perceived as having been of value to all the stakeholders and having a positive impact on the schools. The findings revealed that the health promotion projects implemented in the schools helped the university students to learn how to plan, implement and evaluate a project in a community setting. Furthermore, the findings suggest that the schools offered an ideal placement for university students to learn about health promotion and its application. In addressing a concern about the course not making any meaningful long-term impact on the schools and the surrounding communities, the study showed that it is important to revisit the current teaching and learning approach of the Interdisciplinary Health Promotion course. It revealed that service-learning as an alternative to the field education approach would facilitate a closer relationship between theoretical and practical knowledge, where the practical application was translated into a service that met the needs of a community. The study further revealed that the collaboration model between the university and the school also needed to be reconceptualized, to include all the stakeholders as well as their needs in relation to health promotion in the schools. It was recommended that the Health Promoting School framework should be seen as the overarching framework for the sustainability of school-based health promotion. In conclusion, this study showed that the recognition and establishment of university community partnerships and reliance upon them in the educational process, would provide many new opportunities for relevant and meaningful health professional education and training. These efforts would contribute to improving the quality of higher education delivered to students, thereby ensuring their competency to better meet the needs of the communities they will serve.