E d i t o r : - C.J. E ales, PhD U niversity o f the W itw atersrand E d i t o r i a l A s s i s t a n t E d i t o r : - A. Stew art, M Sc U niversity o f the W itw atersrand E d i t o r i a l B o a r d : N a t io n a l M e m b e r s - S.L. A m osun, PhD U niversity o f the W estern C ape - P. G o unden, PhD U niversity o f D urban-W estville - M . Papadoupolos, M Sc U niversity o f P retoria - M . F aure, M P hil U niversity o f Stellenbosch - N. M bam bo, M S c M E D U N S A I n t e r n a t io n a l M e m b e r s - A. A k inpelu, PhD U niversity C o llege H ospital, Ibadan, N igeria - T.H .A . K olobe, PhD U niversity o f Illinois, C h icago - K. S hepard, PhD T em ple U niversity, P h ilad e lp h ia - C. Partridge, PhD U niversity o f K ent, C anterbury R e v i e w P a n e l : - A m o su n , D ele - B e ster, R ia - B o w e rb a n k , P at - C ro u s, L y n ette - D a v id , H e len - D e C harm oy, Sue - D ie n er, Ina - E k ste e n , C a rin a - E te en b e rg , M a sh e - F a u re , M ary - F e a rn h e a d , L ynn - F rie g , A n n e tte - F o rtu n e , Je ss ic a - G ira u d , Jill - H u n te r, L in d a - Irw in -C a rru th e rs, S h e e n a - K e m p , S te p h a n ie - M b a m b o , N o n c e b b a - M ’k u m b u z i, V y v ie n n e - M o th a b e n g , Jo y c e - M p o fu , R atie - P a p a d o p o u lo s , M a g d a - P a u lse n , Tom - P o tte rto n , Jo a n n e - P u c k re e , L in a - S m ith , E ls a - S w artz , A lm a - U ys, M a rie tta - Van R o o ije n , T anya C h a l l e n g e s F a c in g P h y s i o t h e r a p y E d u c a t i o n P h y sio th e ra p y e d u c atio n is fac in g in te restin g ch a lle n g e s d u e to the so c io -p o litic al c h a n g es that have taken p la c e in S o u th A fric a sin c e 1992. C h an g e in e d u c atio n is d ep e n d en t as s u p e rfic ia l in w h ic h te a c h in g ta k es place. S u ch a w ay o f c h a n g e is usually ch a n g e fo r the sake o f ch an g e. H ow ever, ch a n g e can also be a fu n d am e n tally d ifferen t w ay o f im p lem e n tin g stra te ­ gies, b ased on a p ara d ig m shift d u e to a d iffe re n t p e rsp e c tiv e o f th e w o rld aro u n d you. T h is la tte r ty p e o f c h a n g e is d ifficu lt to p u rsu e b ec au se it co n stan tly re q u ir e s r e - e v a lu a tio n o f th e new d irectio n , ad ju stin g an d im p lem en tin g the actio n plans, en s u rin g th a t th e new d irec tio n ad h eres to scien tifically and fu n d am e n tally sou n d p rin cip les o f the ch a n g es / new p arad ig m . T h e ch a n g es in p h y sio th erap y e d u c a ­ tion d escrib ed in the literature encom pass a c h a n g e in th e c o m p ila tio n o f th e trad itio n al c u rricu lu m into a p ro b lem b ased cu rricu lu m , as w ell as ch a n g e in th e te ac h in g ap p ro ach , n am ely fro m an em p h asis on lectu rin g to the p ro b lem b ased learn in g ap proach. P ro b lem -b a sed L ea rn in g (P B L ) h a s b ec o m e a lm o st a “b u zzw o rd ” in p h y s ic a l th era p y e d u c a ­ tion in recen t years. Thus, a literature review a n d d isc u ssio n are im p o rta n t a n d sa lie n t a t th is tim e w h en m any d ev elo p in g e d u c a tio n a l p ro g ra m s are em b ra cin g th is m e th o d o f in stru ctio n (H ay es, 1998). A lb an e se an d M itch ell (1 9 9 3 ) su g g e st th at a P B L p ro g ra m m ay n o t d e v e lo p th e d e s ire d k n o w le d g e s tru c tu re , w h ic h is a s c ie n tific a n d th eo retica l fo u n d a tio n u pon w h ich to b u ild a b a se o f u n d ersta n d in g in o rd er to m ake so u n d d ia g n o ses an d to p ractice in d e p e n d e n tly {Ibid). T h e re a so n for this is tw ofold: firstly the fo u n d atio n al p rin cip les th at n eed to be in p la ce for im p le m e n tin g P B L h a v e n o t b een d e s crib ed fu lly and seco n d ly th e re is a lack o f ev id en c e th at o n e ed u c atio n al m ethod o r approach is better than another. F o u n d atio n a l p rin cip les th at n eed to be in p la ce w o u ld be an u n d ersta n d in g o f the su b stan tiv e an d sy n tactical stru ctu re o f the d isc ip lin e th at is b ein g learned. A m o n g s t o th e r th in g s , th e c o re o f the m atter is th a t it en tails an u n d er­ sta n d in g o f the th in k in g stru ctu re (the re la tio n sh ip b etw een the facts, co n cep ts, p rin cip les u sed in the d iscip lin e), as w ell as the sk ills n ee d ed in the p ro ce ss o f g en e ratin g new k n o w led g e in the d isc i­ plin e. T h is leads to th e situ atio n th at every in stitu tio n im p lem e n ts and ad ap ts P B L ac co rd in g to its ow n circ u m sta n ce s an d facilities. T h is ca u se s a situ atio n th at P B L p ro g ra m s can n o t be co m p ared to o n e a n o th e r d u e to fo u n d a tio n a l d iffe ren ce s in th e co m p ila tio n o f the p ro g ram s. T h e reaso n fo r the la ck o f scien tific ev id en c e th at o n e ed u c atio n al m ethod o r approach is better than another th is is th a t th e re s e a r c h d e s ig n o f e d u c atio n al p ro g ra m s o r tech n iq u es are often p oorly d ev elo p ed an d /o r described. T h is m ak es co m p ariso n b etw een the e ffec ts o f ed u c a tio n a l a p p ro a c h e s o r te c h n iq u e s im p o s s ib le . C o m p a ris o n b e tw e e n e d u c a tio n a l a p p ro a c h e s o r te ch n iq u e s to d eterm in e w h at co n stitu tes ‘b est p ra c tic e ’ is ca lle d b est ev id en ce m ed ical ed u c atio n (B E M E ), w hich is sim ila r to ev id en c e b ased p h y sio th erap y p ractice. B E M E is also b ased on a sy stem a tic rev iew o f rese arch an d is b ased on sy stem a tic rev iew o f research in education, social science, crim inology, e tc e te ra . T h e p r o c e s s o f sy s te m a tic review in h ealth ca re e d u c atio n is d ev e l­ o p ed by the C a m p b e ll C o llab o ratio n , a sim ila r o rg an iz atio n to the C o ch ran e C o llab o ratio n (B elfield , e t al 2001). A ll rese arch in h ea lth care (and also p h y sio th erap y ) e d u c atio n needs to take 2 SA J o u r n a l o f Physiotherapy 2001 V o l 57 No 4 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) p la c e o n a so u n d fu n d a m e n ta l an d scien tific fo u n d atio n , w hich serv es as p o in t o f re fe re n c e fo r d e v e lo p in g a research p rotocol as w ell as in terp retin g th e results. In this reg ard C a m p b e ll and Jo h n so n (1999) states: O ne b a r r ie r to true debate is a lack o f conceptual clarity. A u th o r s d o n o t n e e d to b e u n a n im o u s in their definition o f a concept, b u t they m ust be cle a r a b o u t th e ir co n cep tu a lisa tio n . B elfield et al (2 0 0 1 ) d escrib e five le v e ls o f e ffe c tiv e n e s s a c c o rd in g to w h ich the effectiv en ess o f ed u catio n al stra te g ie s an d in te rv e n tio n s ca n be m easu red , nam ely: i) h ig h est level im p a ct on the d eliv ery o f health care w hich in clu d es that g ra d u a te s m a k e f e w e r e rro rs in p ractice d u e to a d iffe ren ce in e d u c a ­ tio n a l strategy; ii) p ro o f o f a ch a n g e in health p ro fe s­ sio n a ls ’ behaviour, p erfo rm an ce or p ractice; iii e ffe c tiv e le a rn in g o r k n o w le d g e ac q u isitio n d u e to an ed u c atio n al strategy; iv) le a rn e rs’ reactio n to o r satisfactio n w ith the ed u c atio n al strategy; v) th e lo w es t le v el, p a rtic ip a tio n o r co m p letio n o f a learn in g task. P a rti­ cip atio n o r co m p letio n m ay at its lo w est level ev en in clu d e a financial au d it an d state th at p articip a tio n o f learn ers w as sa tisfac to ry o r not. S uch a scale an d h ierarch ical c la ssi­ ficatio n o f term s m ak es it p o ssib le to c o m p a re e v id e n c e o f e ffe c ts a c ro ss a ra n g e o f te a c h in g m e th o d s and ap p ro ach es. B e lfield et al (2 0 0 1 ) ad v ise th a t re se a rc h e rs p lan an d im p lem e n t the m e th o d o lo g y o f ed u c atio n al research p ro jects w ith the aim being to m easu re th e effectiv en ess o f a sp ecific strateg y in m o re than o n e o f th e o u tc o m e m easu res o f e ffe c tiv e n e s s in o rd e r to fo rm a b alan c ed o p in io n on the effectiv en ess o f the ed u catio n al strategy. T h e fact that the o u tco m e o f ed u c atio n al strategies o r ap p ro ach es as w ell as in stru ctio n al tech n iq u es can be m e asu red red u ces the in c id en c e o f im p lem en tin g ed u c atio n al strateg ies ju s t b ecau se it is in ‘fa s h io n ’ Im p le m en tin g such ‘fa sh io n ’ strategies w ith o u t c ritica lly ev a lu a tin g them , is d etrim en ta l to the d ev e lo p m e n t o f h ealth care e d u c atio n an d in the long run also fo r fa c ilita tin g th e d e v e lo p m e n t o f h ealth o f care p ro fessio n als. REFERENCES A lb an ese M A, M itch e ll S 1993 P ro b lem b ased learning: a rev iew o f literatu re on its o u tco m es an d im p lem e n ta tio n issues. A cad em ic M e d icin e 68 B e lfie ld C , T h o m a s H , B u llo c k A, E y n o n R, W all D 2001 M e asu rin g e ffe c ­ tiv en ess fo r b est ev id en c e m ed ical e d u ­ cation. M ed ical T each er 23(2) C am p b ell J K, Jo h n so n C 1999 T ren d spotting: fash io n s in m ed ical ed u catio n , B ritish M ed ical Jo u rn al 318 H a y e s S H 1998 P ro b le m -B a s e d L ea rn in g in P h y sica l T h erap y : A R ev iew o f the literatu re an d O v erv iew o f the M cM aster U niversity Experience. Invited C o m m en tary . P h y sical T h erap y 7 8(2) CARINA EKSTEEN Physiotherapy Department, University of Pretoria THE SOUTH AFRICAN IOURNAL OF PHYSIOTHERAPY All co rresp o n d en ce to th e ed ito r m u st be ad d ressed to: Prof CJ Eales - Editor SASP Journal, D epartm ent of Physiotherapy, Faculty of Health Sciences, 7 York Road, Parktown 2193 E-mail: 159eales@chiron.wits.ac.za ;™ ■" 159garsl@chiron.wits.ac.za r r v SA J o u r n a l o f P hysiotherapy 2001 V o l 57 No 4 3 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) mailto:159eales@chiron.wits.ac.za mailto:159garsl@chiron.wits.ac.za