Evaluation HIV/AIDS module


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Evaluatie HIV/AIDS lesmateriaal in Zuid-Afrika

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Evaluation HIV/AIDS module

  1. 1. )RUPDWLYH HYDOXDWLRQ RI WKH 5DLQERZ %LRORJ +,9$,'6 PRGXOH Luc Sluijsmans, University of Twente, luc_sluijsmans@hotmail.com Jenny Page, University of Pretoria, jennypag@global.co.za John Rogan, University of Pretoria, jrogan@scientia.up.ac.za Jan van den Akker, University of Twente, akker@edte.utwente.nl RQWH[W RI WKH VWXG 7KH 5DLQERZ %LRORJ 3URMHFW Government and non-governmental organisations in South Africa are trying to develop successful HIV/AIDS programmes (UNAIDS, 2002). The HIV/AIDS module, that is the subject of this study, is an example from one of these initiatives. The module was drafted in 2001 by the Rainbow Biology Project, part of the Centre for Science Education, at the University of Pretoria in South Africa. The aims of the Rainbow Biology Project have included the design of biology modules for the teaching of challenging topics in secondary schools in South Africa, and to promote excellence in the teaching of biology, keeping with the aims of C2005, the new curriculum for South African education (DoE, 1997). The Rainbow Biology HIV/AIDS module is designed for grade 11 learners. Many current HIV/AIDS programmes are aimed at children in the 12 -14 age range (Wolff Schoeberlein, 1999). The Rainbow Biology module therefore aims to fill the gap in the senior high school level by focusing on the 15 -17 age range. The approach aligns with outcomes based education (DoE, 1997), as the module does not simply seek to transmit information but encourages the learner to take on the role of active researcher. The module supports biology educators in teaching the science of HIV/AIDS and the factors that influence its transmission. In this way, learners are empowered to make informed decisions about behaviour. $LPV RI WKH VWXG The initial design of the Rainbow Biology HIV/AIDS module was completed at the end of 2001. The processes of formative evaluation, revision and preparing for implementation were scheduled for 2002. The aim of this study has been to evaluate the design and pilot implementation of the Rainbow Biology HIV/AIDS module, in order to arrive at a first revision, advise on a second revision and generate recommendations for further implementation and research. Evaluation of the design, and the pilot implementation of the Rainbow Biology HIV/AIDS module led to a first revision, advised the second revision and generated recommendations for further implementation and research. The aim of this study is to contribute to answering the following question: ‘:KDW LPSURYHPHQWV WR WKH 5DLQERZ %LRORJ +,9$,'6 PRGXOH PLJKW RSWLPL]H LWV HIIHFWLYHQHVV¶ The conceptual framework presented in Table 1 (after Goodlad, 1979 cf. van den Akker, 1998) was used to divide this question into six specific research questions: 1. What are the ideals of, and challenges faced by the developers of the HIV/AIDS module? 2. How does the HIV/AIDS module relate to the designers’ intentions, and to instructional design standards? 3. What were educators’ initial perceptions of the HIV/AIDS module? 4. What is the actual practice of the HIV/AIDS module in the classroom? 5. How do learners experience the HIV/AIDS module? 6. How are learners able to demonstrate their understanding of the science of HIV/AIDS before and after experiencing the HIV/AIDS module? 7DEOH )UDPHZRUN RI FXUULFXOXP UHSUHVHQWDWLRQV XUULFXOXP UHSUHVHQWDWLRQV ([SODQDWLRQ RI WKH VL[ FXUULFXOXP UHSUHVHQWDWLRQV 1. Ideal curriculum Describes the ideals and foundational tenets Intended curriculum 2. Formal curriculum Reflects the curriculum as a written document 3. Perceived curriculum Interpretation of the curriculum by the users Implemented curriculum 4. Operational curriculum Presents itself in the actual learning situation 5. Experiential curriculum Experiences and the perceptions of the learner Attained curriculum 6. Learned curriculum Presents the performances of the learners
  2. 2. 0HWKRG The first stage in this research consisted of an exploration of the intended curriculum (ideas and material). Data were gathered in two studies to address research questions 1 and 2. Designers who drafted the module were questioned and the module was analysed. The second (major) stage involved the collection of empirical information on the implemented and attained curriculum. Two educators with different backgrounds, from two secondary schools, of different settings, conducted a trial of the draft module in their classrooms. The data from these two studies were used to answer research questions 3 and 4. The last two specific research questions were addressed by questioning the learners from the classrooms of the two participating educators. Although the 6 studies provided a wealth of data to answer the specific questions, it was necessary to also consider other HIV/AIDS education evaluation studies. The literature review could only be conducted after the data collection in South Africa, due to practical timing opportunities. The literature review explored the factors that may influence the implementation of HIV/AIDS education. The findings of this exploration resulted in a framework of relevant variables that supported the interpretation of the evaluation results. 3DUWLFLSDQWV The participants for the research in South Africa were: œ Two members of the module’ s development team. œ Two biology educators, from two secondary schools situated in district Gauteng, South Africa. One educator is also the designer of the initial module. Both educators are skilled in teaching about HIV/AIDS. Trial School 1 is a modern private school. Trial School 2 is a government school with a lack of physical resources. œ 63 learners, from three grade 11 classes, at the two trial schools, see also Table 2. 7DEOH /HDUQHUV¶ GHWDLOV 7ULDO 7ULDO Learners 46 learners (2 classes of 21 and 25) 17 learners (1 class) Age 15 (9%) 16 (67 %) 17 (24%) 16 (18 %) 17 (65 %) 18 (17 %) Male / Female 46% male 54% female 41% male 59% female Boy- or girlfriend 35 % 60 % All learners received HIV/AIDS education in 16 learners received HIV/AIDS education in Pre-knowledge previous grades previous grades Mother tongue English Setswana 3URFHGXUH DQG LQVWUXPHQWV The methods and instruments used were: interviews, document analysis, observation, questionnaire, and a pre- and post-test. 6WXG A pre-structured interview was conducted with two members of the module’ s development team The objective of the interview was to gain accurate insight into perceptions regarding HIV/AIDS education, and the aims of the development team. The result was a summary of the of the Rainbow Biology Project’ s development team’ s aims and challenges. 6WXG The Rainbow Biology HIV/AIDS module was critically studied. Information was gathered to find out the extent to which the module reflects the ideals of the curriculum designers. The module was also analysed in relation to instructional design standards. As a result, a summary was produced of the elements that were found in the module.
  3. 3. 6WXG Two educators were interviewed to gain a better understanding of their perceptions regarding HIV/AIDS education. These interviews were semi-structured; they contained questions linked to the module’ s objectives. A summary of the perceptions of biology educators towards HIV/AIDS education, as described in the module, was developed from this data. 6WXG The selected educators conducted a trial of the module in their grade 11 classes. The trials did not occur simultaneously – Trial 2 was scheduled after the completion of Trial 1. Observation was used to assess how the learners responded to the HIV/AIDS lessons. 7ULDO The primary author of the module conducted the first trial. She presented the HIV/AIDS draft materials over a period of five weeks to her two grade 11 classes (a total of 46 learners), as part of the biology curriculum. The module was taught separately in each class. The implementation process in both classrooms was continuously monitored [see Figure 1]. 7ULDO The second trial was conducted by an educator in a different secondary school. The educator taught the module for six weeks. In this trial, 17 grade 11 learners voluntarily participated during sessions after school [see Figure 1]. The implementation process in the classroom was also continuously monitored in this study. 6WXG All participating learners (Q=63) completed a questionnaire containing 55 Likert-type items about their experiences with the module. The responses to this questionnaire were coded for each variable and were statistically analysed. An a-select group of 14 learners (divided over the two trial schools) were also interviewed. For this purpose, a pre-structured interview was used containing 19 questions relating to how they experienced the actual implementation of the module. A summary was made of these interviews. 6WXG A One-Group-Pretest-Post-test Design (O1 X O2) was used in both trial schools, to measure the performances of the learners after experiencing the module. All learners (Q=63) were given a pre-test to measure their prior knowledge on HIV/AIDS issues. After experiencing the module all the learners were given the same test to again measure their HIV/AIDS knowledge. The questions tested the learner’ s knowledge on three topics. The responses to the pre- and post-test items were coded for each variable. The resulting data were statistically analysed. A paired-samples t-test and frequency analysis were conducted to measure the possible differences between the pre- and post-test. 5HYLVLRQ RI WKH PRGXOH Initial improvements of the module were made in a 4-week period between the two trials. Aspects of structure, lay-out and instruction were addressed. Some new elements were also added to the module. A second revision of the module will be completed in early 2003, after the second trial. This revision will be more thorough, and will be based on the outcomes of the two trials and the literature review. Figure 1 illustrates the overall design of the study and moments of revision. 7ULDO 5 7ULDO 5 2 ; 2 2 ; 2 )XUWKHU UHVHDUFK LQ )LJXUH 0RPHQWV RI UHYLVLRQ DQG WHVWLQJ O1: represents the pre-test in Trial School 1 O2: represents the post-test in Trial School 1 X1: represents the trial in School 1 O3: represents the pre-test in Trial School 2 O4: represents the post-test in Trial School 2 X2: represents the trial in School 2 R1: the first revision of the module R2: the second revision of the module
  4. 4. )UDPHZRUN IRU +,9$,'6 HGXFDWLRQ The input for the framework (see Appendix) is based on the outcomes of several evaluation studies. The structure of the framework is based on three educational models (van den Akker, 1998; Fullan, 2001; Norton Dawson, 2000). The framework is divided into four blocks: 1. The first block summarises the factors that have influenced, and continue to influence, the implementation of HIV/AIDS education. Successful policy must be innovative, and must support its implementation, overcome difficulties, and empower others to take effective action against the HIV/AIDS epidemic. Implementing HIV/AIDS education should be multi-sectoral, involving the government, schools and the community. Policy development, together with the provision of financial and/or technical support from national institutions, government authorities, local communities, school environments and partners are essential for successful implementation. 2. The second block details four elements of the profile of a HIV/AIDS educator. Teachers are the leaders to implement HIV/AIDS education and so also a role model. Educators will be well-positioned to lead the development of HIV/AIDS education when HIV/AIDS educational programmes are successfully implemented. Teachers must be up-to-date towards the teaching methods and HIV/AIDS issues and there must be clarity about the HIV/AIDS programmes. The aims, objectives and implementation strategies of HIV/AIDS programmes must be made clear and accessible to educators, who, in turn, should be up-to-date with current teaching methods to be able to use the programmes effectively. 3. The third block describes the outcomes of HIV/AIDS education. The outcomes address the need for the encouragement of active learners, and the transfer of the HIV/AIDS information. 4. The characteristics of a HIV/AIDS learners’ book are summarised in the fourth block. The learner’ s book should address skills, knowledge, attitudes, and methods of gaining understanding of the information. 5HVXOWV The six studies on the intended, implemented and attained curriculum, combined with the background and literature study, proved to be valuable. From the findings, it can be concluded that the HIV/AIDS module would assist the implementation of HIV/AIDS education in secondary schools by improving the learners’ knowledge, skills, attitudes and understanding. The specific results of the six sub-studies are: 6WXG The development ideals are ambitious, aiming to change the participants from passive to active learners and researchers. The approach is in line with the intended approaches and outcomes of the new curriculum in South Africa (OBE C2005). 6WXG The module deals with peer and other social pressures, and provides many opportunities to practise skills. It uses a variety of teaching/learning methods that involve and engage learners to help them to personalise the information. The module is appropriate to the learner’ s age, experience and cultural background. The activities range from discussions, role-plays, to experiments and simulations. 6WXG Both educators are trained to teach the subject of HIV/AIDS, and are willing to implement the module in their classes. The educator teaching in the township area emphasised the impact of the lack of resources and time on the implementation of the module. The private school educator has easier access to HIV/AIDS materials, and was able to support the module with these extra resources. Support (such as slides, videos and simulation tools) obviously optimizes the learning effect of the module. 6WXG Generally the learners were enthusiastic about the module, despite the fact that some information had been positioned to the learners in HIV/AIDS programmes in previous grades. Learners wanted to learn more about the scientific aspects of the HIV. It was remarkable that learners started vivid discussions during life skills sessions, and matters such as relationships, sexuality and the risks of drug use were openly discussed, especially in the township school. The role-playing, dialogues and drama-activities personalised the risks for learners. In a few cases, scientific activities such as the condom test were regarded as a fun activity.
  5. 5. 6WXG The findings from the experiential curriculum showed that the learners were very positive about the module. They saw it as a great educational experience. Learners indicated that the module increased their knowledge, and that it might have had some influences on their behaviours. Learners made critical comments that were very useful for the revision. Although there were some differences in the trials at the two schools, there were also general similarities. 6WXG The results of paired sample t tests show that the learners participating in both trials performed significantly better on the post-test t (46)= 6,81; p .05 for trial 1, and t (17)= 2,2; p .05 for trial 2. Table 3 compares the overall results of the pre-test with post-test. It is remarkable that learners in both trials had prior knowledge on HIV/AIDS, probably due to exposure to HIV/AIDS education in previous grades. Learners’ performance in trial 2 (township school) was weaker than learners’ performance in trial 1 (private school). Most progress was made on knowledge acquisition relating to transmission. Most errors occurred in the answers to questions relating to HIV statistics. Trial 2 learners showed a lack of awareness of the statistics of the epidemic. 7DEOH 3HUFHQWDJH RI TXHVWLRQV DQVZHUHG FRUUHFWO LQ SUH DQG SRVW-WHVW ¤ 21¦ )) ' ¦%£ %%$£ ¦¤ © §¨¦£¤¢  £ 3 § £#£ 0 © ( §# # ! £ ¥ ¥ ¥ ¡ 7ULDO 7ULDO Pre Post Pre Post 1. Questions on HIV/AIDS facts 66 85 46 54 2. Questions on awareness on HIV statistics 60 68 39 37 3. Questions on the transmission of HIV 79 88 56 70 0HDQ 68 80 47 54 RQFOXVLRQ From the findings of the six studies and the framework, the question ‘:KDW LPSURYHPHQWV WR WKH 5DLQERZ %LRORJ +,9$,'6 PRGXOH PLJKW RSWLPL]H LWV HIIHFWLYHQHVV¶ can be answered. Ten suggestions for improvements have been formulated to optimize the effectiveness of the HIV/AIDS module. (PEHGGLQJ +,9$,'6 HGXFDWLRQ SROLF The module may be more effective when and if it is embedded within the biology curriculum, with compulsory weekly lessons as per trial 1. A supportive and enabling policy document for programming this module into the curriculum is recommended. 6WUHQJWKHQ FRQWDFW ZLWK FRPPXQLW The community-based activities in the module would be more effective if the objectives are clearer and the activities are better designed for learners to become HIV researchers in their communities. The activities must be designed so that learners can work directly with target members of the communities affected by HIV/AIDS. ,PSURYH VFKRRO HQYLURQPHQW Communicating what is being taught to learners’ parents would improve the effectiveness of the module. The module could be a catalyst for dialogue at home. Educators would benefit from intra- and inter school networks, as well as community, private and governmental networks, which could assist educators to constantly question and improve safety, support and open communication in the school environment. These networks would also be able to advise on the use of other resources (e.g. stories and activities), which would supplement the module. %URDGHU VXSSRUW IRU LPSOHPHQWDWLRQ Materials such as slides and an educator guide would support the module. It is recommended that in-service training should be designed, developed and provided. ,PSURYLQJ WHDFKLQJ A HIV/AIDS training programme may help to prepare educators for teaching HIV/AIDS. Some specific elements for such training include the organisation of classroom activities on sensitive issues, the use of peer educating, the use of several methods and materials to transfer HIV/AIDS information effectively, and knowledge about the theories of the behaviour changes of adolescent learners. It is also vital that educators are aware of their status as role-models to learners.
  6. 6. 6HWWLQJ SULRULWLHV LQ +,9$,'6 HGXFDWLRQ RXWFRPHV The activities in the module encourage learners to actively participate and explore information about HIV/AIDS issues. However, the development team should reconsider the outcomes expected from these activities, according to their priorities. The way in which the module addresses these outcomes should then be checked. 5HILQLQJ WKH DSSHDUDQFH RI WKH +,9$,'6 PDWHULDOV The module’ s presentation could be made more appealing if structure and lay-out is improved. This may also contribute to optimizing the learning effect. 2SWLPL]H VFLHQWLILF FRQWHQW RI WKH PRGXOH The medical and scientific information, and biological facts of HIV/AIDS could be more strongly connected to learners’ real-life situations. The development team could consider ways of increasing and/or emphasising the scientific information in the module. More information on statistics (e.g. graphs) may improve learners’ awareness of the epidemic. )XUWKHU GHYHORSPHQW RI WKH PRGXOH For the next revision, consultation with learners at an early stage of programme design may be helpful to ensure relevance. The participation of parents, community workers and people living with HIV/AIDS may help to ensure inclusion of the real-life component. This approach may also help to address any problems in a culturally and socially appropriate way. 'HYHORSPHQW RI DVVHVVPHQW DQG HYDOXDWLRQ LQVWUXPHQWV The module could include guidelines for assessment and evaluation instruments. These guidelines could assist educators to evaluate knowledge, attitudes, skills, and behaviours at various stages while conducting the module. )XUWKHU UHVHDUFK Further research is necessary for the effective implementation of the module. The following areas have been prioritised: +RZ WR LPSURYH WKH PRGXOH The presentation of instruction and procedures can be explored further. The development team could investigate new elements that could be added to optimize the effect of the module. Implementation of this module on a large scale could be compromised - some activities will be less effective because the material does not take wider political, religious, or cultural issues into account. The condom experiments, where the learners fill the condom with lead, are an example of this. +RZ WR LPSOHPHQW WKH PRGXOH LQ WKH ELRORJ FXUULFXOXP According to Campbell and Lubben (2002), science education is the right place for learners to meet issues related to HIV/AIDS. The first task for the designers, when implementing the module within the biology curriculum, should be to conduct more research on the learners’ environment. This is important because learners may not necessarily share the developers’ attitudes on HIV/AIDS issues. The information is also necessary to establish the most appropriate grade at which introduction of the programme would be most effective. The results of such research will have a direct impact on the rest of the curriculum design. +RZ WR SURYLGH +,9$,'6 HGXFDWLRQ IRU HGXFDWRUV The Rainbow Biology Project intends to support educators by providing workshops. It is necessary to question whether or not workshops are the most effective way to support the development of skilled educators. A study conducted by Campbell and Lubben (2002) in Namibia showed that HIV/AIDS education programmes for educators were mostly unbalanced, focussing only on knowledge about the disease and the mechanisms of preventing infection.
  7. 7. 5HIHUHQFHV van den Akker, J.J.H.: 1998, ‘The science curriculum: between ideals and outcomes’ , in B.J Fraser K.G Tobin (eds.), ,QWHUQDWLRQDO +DQGERRN RI 6FLHQFH (GXFDWLRQ, Kluwer Academic Publishers, Dordrecht. Campbell B. Lubben F.: 2002, ‘Science teaching and HIV/AIDS education in Namibian secondary schools’ , proceedings SAARMSTE, pp. III - 35-40. University of Natal, Durban. Department of Education,: 1997, ‘Outcome based education in South Africa’ [online], Available from: [KWWSHGXFDWLRQSZYJRY]D] Goodlad, J. 1979, XUULFXOXP ,QTXLU WKH 6WXG RI XUULFXOXP 3UDFWLFH, McGraw-Hill, New York. Fullan, M.G.: 2001, 7KH 1HZ 0HDQLQJ RI (GXFDWLRQDO KDQJH, 3th ed., Teachers College Press, New York. Norton J. Dawson, C.: 2000, ‘Life skills and HIV/AIDS education’ , in A. Dyk , +,9$,'6 DUH RXQVHOOLQJ, D 0XOWLGLVFLSOLQDU $SSURDFK CTP Book Printers, Cape Town. UNAIDS.: 2002, ‘The report on the global HIV/AIDS epidemic’ , 14th International Conference on AIDS, Barcelona, 7-12 July 2002. Wolff, W.J. Schoeberlein, D.R.: 1999, ‘The status of middle level HIV/STD education as assessed by state and local education agencies’ , -RXUQDO RI 6FKRRO +HDOWK, vol. 69, no. 6, pp. 239-242.
  8. 8. $SSHQGL[ )UDPHZRUN RI IDFWRUV WKDW PLJKW LQIOXHQFH WKH LPSOHPHQWDWLRQ RI +,9$,'6 HGXFDWLRQ )DFWRUV WKDW QHHG WR EH DGGUHVVHG IRU WKH LPSOHPHQWDWLRQ RI +,9$,'6 HGXFDWLRQ 3ROLF GHYHORSPHQW /RFDO FRPPXQLW 6FKRRO HQYLURQPHQW (GXFDWLRQDO VXSSRUW œ Clear national policies to œ Work directly with œ Make a clear policy œ Education in HIV/AIDS for support HIV/AIDS target members of framework that educators who implement education the communities clearly state the HIV/ AIDS education œ Create a supportive and affected by goals on HIV/AIDS œ Learn and support the use of enabling policy HIV/AIDS education peer educating in the school environment for œ School-community œ Monitor and œ Provide quality HIV/AIDS programming HIV/AIDS partnerships evaluate regularly materials and financial and education in the œ Educators must œ Stimulate peer- technical support for its curriculum improve their educating implementation œ Support openness about status as a role- œ Safe, supportive œ Provide educator guidelines all aspects of HIV/AIDS model in the class and open school for implementing environment HIV/AIDS education 3URILOH RI D 2XWFRPHV RI +,9$,'6 HGXFDWRU +,9$,'6 HGXFDWLRQ œ Skilled in teaching ,PSOHPHQWDWLRQ RI œ HIV/AIDS education should HIV/AIDS education +,9$,'6 HGXFDWLRQ encourage learners, in a œ Skilled in using several exploring, innovative, methods and materials effective and popular way, to learn about HIV/AIDS transferring the 3URJUDPPHV WKDW SURYLGH issues HIV/AIDS information FXOWXUDOO DSSURSULDWH effectively RSSRUWXQLWLHV RI WUDQVIHUULQJ œ Knowing the theories of LQIRUPDWLRQ HIIHFWLYHO RQ œ HIV/AIDS education should behaviour change of +,9$,'6 WKURXJK H[SORULQJ transfer the learners skills, learners (adolescents) XVLQJ VHYHUDO PHWKRGV DQG knowledge, attitudes and when implementing GLIIHUHQW PDWHULDOV understanding to responsible HIV/AIDS education behaviour regarding to the œ Clarity about the problems created by HIV/AIDS programmes HIV/AIDS KDUDFWHULVWLFV WKDW QHHG WR EH DGGUHVVHG LQ D +,9$,'6 OHDUQHUV¶ ERRN 6NLOOV .QRZOHGJH $WWLWXGHV 8QGHUVWDQGLQJ œ Practical skills œ All the facts about œ Self-efficacy to be œ The HIV/AIDS epidemic œ Critical thinking skills HIV/AIDS able to develop and its impact œ Social skills œ How their bodies solid values that œ The HIV/AIDS facts œ Communication skills and minds work will guide the œ Possible future benefits of œ Decision-making skills œ What HIV/AIDS decision making HIV/AIDS education œ Skills to get access to the problems they may œ Respect to people‘s œ The connections between health services to which experience and rights and values wrong choices and risky they are entitled how to deal with œ Confrontation with behaviour œ Solving / negotiation such a problems prejudices and œ Manifestation of negative skills to be able to make œ How to prevent stereotypes and undesirable positive correct decisions HIV infection œ Discussing the consequences of risky in their lives œ Medical and issue of gender behaviour œ Generic skills for biological facts œ Dealing with the œ Links to health services community activism about HIV/AIDS HIV/AIDS stigma œ The correct information