Teaching critical thinking about health using digital technology in lower secondary schools in Rwanda: A qualitative context analysis

Mugisha, Michael; Uwitonze, Anne-Marie; Chesire, Faith; Senyonga, Ronald; Oxman, Matt; Nsangi, Allen; Semakula, Daniel; Kaseje, Margaret; Lewin, Simon; Sewankambo, Nelson; Nyirazinyoye, Laetitia; Oxman, Andrew D; Rosenbaum, Sarah

doi:10.1371/journal.pone.0248773

Cited by 22 publications

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References 36 publications

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“…All three countries have recently or will soon implement new competence-based curricula, but they are at different stages in this process. Rwanda has come furthest in implementing its new curriculum [ 22 , 42 ]. Kenya’s new curriculum has not yet been implemented and Uganda is in the process of implementing its new curriculum.…”

Section: Discussionmentioning

confidence: 99%

Learning to think critically about health using digital technology in Ugandan lower secondary schools: A contextual analysis

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Introduction The world is awash with claims about the effects of health interventions. Many of these claims are untrustworthy because the bases are unreliable. Acting on unreliable claims can lead to waste of resources and poor health outcomes. Yet, most people lack the necessary skills to appraise the reliability of health claims. The Informed Health Choices (IHC) project aims to equip young people in Ugandan lower secondary schools with skills to think critically about health claims and to make good health choices by developing and evaluating digital learning resources. To ensure that we create resources that are suitable for use in Uganda’s secondary schools and can be scaled up if found effective, we conducted a context analysis. We aimed to better understand opportunities and barriers related to demand for the resources, how the learning content overlaps with existing curriculum and conditions in secondary schools for accessing and using digital resources, in order to inform resource development. Methods We used a mixed methods approach and collected both qualitative and quantitative data. We conducted document analyses, key informant interviews, focus group discussions, school visits, and a telephone survey regarding information communication and technology (ICT). We used a nominal group technique to obtain consensus on the appropriate number and length of IHC lessons that should be planned in a school term. We developed and used a framework from the objectives to code the transcripts and generated summaries of query reports in Atlas.ti version 7. Findings Critical thinking is a key competency in the lower secondary school curriculum. However, the curriculum does not explicitly make provision to teach critical thinking about health, despite a need acknowledged by curriculum developers, teachers and students. Exam oriented teaching and a lack of learning resources are additional important barriers to teaching critical thinking about health. School closures and the subsequent introduction of online learning during the COVID-19 pandemic has accelerated teachers’ use of digital equipment and learning resources for teaching. Although the government is committed to improving access to ICT in schools and teachers are open to using ICT, access to digital equipment, unreliable power and internet connections remain important hinderances to use of digital learning resources. Conclusions There is a recognized need for learning resources to teach critical thinking about health in Ugandan lower secondary schools. Digital learning resources should be designed to be usable even in schools with limited access and equipment. Teacher training on use of ICT for teaching is needed.

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Learning to think critically about health using digital technology in Ugandan lower secondary schools: A contextual analysis

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“…Uganda introduced its new competence-based curriculum for lower-secondary schools in 2020, and Kenya has plans to introduce a new competency-based curriculum by 2024. [18][19][20] The new curricula in all three countries include critical thinking as a core competence and they include health topics. However, critical thinking about health is not explicitly included in any of the curricula, and both critical thinking and health are taught across subjects.…”

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Prioritisation of Informed Health Choices (IHC) Key Concepts to be included in lower-secondary school resources: a consensus study

Agaba¹,

Chesire

Mugisha

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Background The Informed Health Choices Key Concepts are principles for thinking critically about healthcare claims and deciding what to do. The Key Concepts provide a framework for designing curricula, learning resources, and evaluation tools. Objectives To prioritise which of the 49 Key Concepts to include in resources for lower-secondary schools in East Africa. Methods Twelve judges used an iterative process to reach a consensus. The judges were curriculum specialists, teachers, and researchers from Kenya, Uganda, and Rwanda. After familiarising themselves with the concepts, they pilot tested draft criteria for selecting and ordering the concepts. After agreeing on the criteria, nine judges independently assessed all 49 concepts and reached an initial consensus. We sought feedback on the draft consensus from teachers and other stakeholders. After considering the feedback, nine judges independently reassessed the prioritised concepts and reached a consensus. The final set of concepts was determined after user-testing prototypes and pilot-testing the resources. Results The first panel prioritised 29 concepts. Based on feedback from teachers, students, curriculum developers, and other members of the research team, two concepts were dropped. A second panel of nine judges prioritised 17 of the 27 concepts. Due to the Covid-19 pandemic and school closures, we have only been able to develop one set of resources instead of two, as originally planned. Based on feedback on prototypes of lessons and pilot-testing a set of 10 lessons, we determined that it was possible to introduce nine concepts in 10 single-period (40 minute) lessons. We included eight of the 17 prioritised concepts and one additional concept. Conclusion Using an iterative process with explicit criteria, we prioritised nine concepts as a starting point for students to learn to think critically about healthcare claims and choices.

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“…The objectives were to: 1) explore interest in teaching critical thinking for health, 2) map where critical thinking about health best t in the curriculum, 3) explore conditions for introducing new learning resources in schools, and 4) describe what information and communication technology (ICT) facilities and software are likely to be accessible in Kenyan secondary schools for teaching and learning purposes, as well as national plans to improve what exists. Researchers in Rwanda and Uganda carried out similar context analyses (15)(16)(17) Our ndings will inform the design, evaluation and, if the resources are found effective, implementation of the IHC secondary school resources. Further, these ndings will be relevant for policymakers, curriculum developers, and other education stakeholders who are developing or implementing digital learning resources and learning resources for critical thinking and health, particularly in low-income contexts.…”

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Contextualizing critical thinking about health using digital technology in secondary schools in Kenya: a qualitative analysis

Chesire

Ochieng

Mugisha

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Background: Good health decisions depend on one’s ability to think critically about health claims and make informed health choices. Young people can learn these skills through school-based interventions, but learning resources need to be low-cost and built around lessons that can fit into existing curricula. As a first step to developing and evaluating digital learning resources that are feasible to use in Kenyan secondary schools, we conducted a context analysis to explore interest in critical thinking for health, map where critical thinking about health best fits in the curriculum, explore conditions for introducing new learning resources, and describe the information and communication technology (ICT) infrastructure available for teaching and learning.Methods: We employed a qualitative descriptive approach. We interviewed 10 key informants, carried out two focus group discussions, observed ICT conditions in five secondary schools, reviewed seven documents, and conducted an online catalogue of ICT infrastructure in all schools in Kisumu County. Participants included teachers, curriculum experts, and policymakers. We used a framework analysis approach to analyse data and report findings.Findings: Although critical thinking is a core competence in the curriculum, critical thinking about health is not currently taught in Kenyan secondary schools. Teachers, health officials and curriculum developers recognized the importance of teaching critical thinking about health in secondary schools. Stakeholders agreed that Informed Health Choices learning resources could be embedded in nine subjects. The National Institute of Curriculum Development regulates resources for learning; development of new resources requires collaboration and approval from this body. Most schools do not use ICT for teaching, and for those few that do, use is limited. Implementation of Kenya’s ICT policy framework for schools faces several challenges which include inadequate ICT infrastructure, poor internet connectivity, and teachers’ lack of training and experience.Conclusion: Teaching critical thinking about health is possible within the current Kenyan lower secondary school curriculum but learning resources will need to be designed for inclusion in and across existing subjects. The National ICT Plan and Vision for 2030 provides opportunity for scale up and integration of technology in teaching and learning environments, which can enable future use of digital resources in schools. However, given current ICT condition in schools in the country, digital learning resources should be designed to function with limited ICT infrastructure, unstable internet access and for use by teachers with low levels of experience using digital technology.

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Teaching critical thinking about health using digital technology in lower secondary schools in Rwanda: A qualitative context analysis

Cited by 22 publications

References 36 publications

Learning to think critically about health using digital technology in Ugandan lower secondary schools: A contextual analysis

Learning to think critically about health using digital technology in Ugandan lower secondary schools: A contextual analysis

Prioritisation of Informed Health Choices (IHC) Key Concepts to be included in lower-secondary school resources: a consensus study

Contextualizing critical thinking about health using digital technology in secondary schools in Kenya: a qualitative analysis

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