Initiation of primary health care oriented problem-based, community-based learning: A study of its process. An ethnographic study

Abstract

The traditional methods of instruction such as a lecture have come under criticism lately because of their failure to induce critical thinking and self-directedness in student of nursing. Alternative constructivist methods of instruction are hailed as effective in producing the desired effects in students. Research studies have indicated that problem-based, community-based learning methods of instruction produce self-directed problem-solving skills in nurses. Yet documentation of the process of initiation of CBPBL are few. The purpose of this study was to investigate what happens in a nursing school that initiates CBPBL, using an ethnographic approach. Twenty-one first year diploma nursing students and four of their tutors were observed and interviewed over a period of eight and a half months. Included in this study were also two hospital administrators and the community members from Popopo village who worked with the school. Interviews were audiotaped and then transcribed. Observations were recorded in field notes using thick descriptions. Data were analyzed by repeated and careful study of the field notes and interview transcripts. Emerging patterns and themes were teased out as data were broken into parts. Similar parts were put together and given labels. Parts that did not fit under the labels were placed by themselves. Analysis was based on Tesch's framework. Patterns which were identified were labeled as tutors and students as learners, student interactions, and developing a new working relationship with the community. Themes that were identified under tutors and students as learners are: preparation and tension, knowledge acquisition and retention, principal learner, learning to share power, and mutual growth and empowerment. Themes that were identified under student interactions are: conflict and collaboration. Under the category of developing a new working relationship with the community establishing new working relationship and gaining community participation were identified as emerging themes. An independent theme that did not fit under any pattern was identified as perceived differences between traditional lecture methods and CBPBL.