A curriculum framework for undergraduate studies in dental health science
This study begins with an ethnographic self-study which allows for a reflection on traditional learning experiences. This study is located in the context of the initial development of dental health professionals within those higher education institutions that endeavour to provide education and training in a rapidly changing context. This context is characterised by the simultaneous need to address the blurring of boundaries and the dichotomies that exist such as the first world and the third world, the developed and the less developed world, the rich and the poor, health and wealth, the private and the public sectors, the formal and the informal sectors, the advantaged and the disadvantaged, the privileged and the underprivileged. The definitions, concepts, theories and principles around curricula and professional development are examined in an effort to extend into discoveries of educational research usually beyond the purview of dental health practitioners, policy makers or higher education specialists involved in training these dental health practitioners. It poses key questions regarding the nature of professional competences within dental health science undergraduate studies and how the curricula are organised around these perceptions of competence. Investigative tools include participant observation, interviews and questionnaires which have included both education deliverers - the teaching staff - and education consumers - the students. The areas of access by students to programmes (input), activities whilst in the programmes (throughput) and their competences at the exit end of the programme (output) are examined. It was found that institutions and programmes are paradoxically positioned declaring missions to be globally competitive and internationally recognised and at the same time wanting to reach out to the population who are disadvantaged and who form a majority. Whilst the needs of the wider community is for basic dental services and primary health care, the resources appear to be geared for producing technologically-superior professionals who will cater for a largely urban and middle class populations. The resources available, particularly human resources, for this training, are going through a critical shortage. Simultaneously demands are being made to challenge the epistemological rationale of the curriculum practice of the training sites at both universities and technikons (now known as universities of technology). These findings reveal that the SAQA demands and the proposed transformation of higher education provided an impetus for schools and departments within universities and technikons and their institutes to look at educational concepts and to transform curricula. This shift was found to be hampered by a variety of causes which included territorial protection, lack of a deep understanding of the education and training concepts and lack of human, physical and financial resources. It was also found that traditional designs of programmes are locked into tribal boundaries which restrict movement beyond these. The boundaries are ring-fenced by historical legacies and practices which confine programmes within these borders and continue to cement the fragmented development of dental health science professionals. The education and training of the different dental health science occupational categories are fragmented between institutes, within institutes and with three separate professional regulating bodies and, seemingly, disjointed functioning national and provincial departments of health and education. This (education and training) is found to be dominated by the traditional mould of teaching, learning and assessment with pockets of change in some schools and departments. Teaching units in the form of subjects, which operate as discrete units and remain entrenched by the habituations of subjects and departments within schools, restricts movement in the competence-based direction. The framework offered by this thesis sets broader and more fluid principles and guidelines which embody the notion of knowledge, skills, attitudes and values and which course designers and educators can utilise so that renewed ways can emerge for their programmes. This allows for a cross over into each other's territories (regulatory, institutional and the health and educational services) that will allow for courses to be designed more holistically and rationally with appropriate transformatory potential.