Vol 15 No 7 - June 2016

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VOLUME 15 NUMBER 7 June 2016
Table of Contents
Special Education Administrators Perceptions of Responsibilities and Challenges .................................................... 1
Juanell D. Isaac, Teresa M. Starrett, and Jane B. Pemberton
The Impact on Absence from School of Rapid Diagnostic Testing and Treatment for Malaria by Teachers .......... 20
Andrew John Macnab, Sharif Mutabazi, Ronald Mukisa, Atukwatse M. Eliab, Hassan Kigozi and Rachel Steed
Theory of Planned Behavior: Sensitivity and Specificity in Predicting Graduation and Drop Out among College
and University Students ..................................................................................................................................................... 38
Catherine S. Fichten, Rhonda Amsel, Mary Jorgensen, Mai N. Nguyen, Jillian Budd, Alice Havel, Laura King, Shirley
Jorgensen and Jennison Asuncion
Special Education Administrators Ability to Operate to Optimum Effectiveness .................................................... 53

Juanell D. Isaac, Teresa M. Starrett, and David Marshall
Development of Teaching Plan in the Curriculum of Medical Sciences ....................................................................... 65

Forouzan Tonkaboni and Masumeh Masumi
Integrating Educational Modules for Children with Chronic Health and Dental Issues: Premise for Community-
based Intervention Framework in Developing Country ................................................................................................ 78
Ma. Cecilia D. Licuan, PTRP, MAE, Ph.D.
Recover the Lost Paradigm: Technology Guided by Teaching Methods ..................................................................... 97

Simona Savelli
Using Debate to Teach: A Multi-skilling Pedagogy Often Neglected by University Academic Staff ..................... 110
David Onen
Constructivism- Linking Theory with Practice among Pre-Service Teachers at the University of Trinidad and
Tobago .................................................................................................................................................................................. 127
Leela Ramsook and Marlene Thomas
Pupil Perception of Teacher Effectiveness and Affective Disposition in Primary School Classrooms in Botswana
............................................................................................................................................................................................... 138
Molefhe, Mogapi and Johnson, Nenty
1
International Journal of Learning, Teaching and Educational Research

Vol. 15, No. 7, pp. 1-19, June 2016
Special Education Administrators Perceptions of

Responsibilities and Challenges
Juanell D. Isaac, Teresa M. Starrett, and Jane B. Pemberton

Texas Womans University
Denton, TX, USA
Abstract. Special education administrators play a vital role in assuring

the identification and provision of services to meet the needs of students
with disabilities in the least restrictive environment (LRE). This study
examined the differences in responsibilities and challenges between
special education administrators in rural, suburban, and urban school
districts in the state of Texas. Quantitative data was collected through
surveys from 152 special education administrators in the state of Texas.
A comparative study was conducted using cross tabulation, frequency,
and percentage tables. Results of this study indicate there are significant
differences (p=<.05) in the responsibilities and level of challenges
between special education administrators in rural, suburban, and urban
school districts in the areas of collaboration between general education
and special education, contracting with outside providers for special
services (i.e. OT, PT, music therapy), monitoring staff caseloads,
providing access to appropriate materials needed for instruction,
participating in the development of district goals and objectives, serving
as a resource person in the design and equipping of facilities for
students with disabilities, and demonstrating skill in conflict resolution
with administrators, parents, teachers, staff, and community. The role
of the special education administrator requires diversified skills to
address responsibilities and challenges that are faced today.
Keywords: special education administrator; responsibilities; challenges;

perceptions; descriptive statistics
Introduction
Researchers have attempted to define the role of the special education
administrator over the past 50 years by looking at their responsibilities and the
challenges they faced (Kohl & Marro, 1971; Marro & Kohl, 1972; Hebert & Miller,
1985; Arick & Krug, 1993; Wigle & Wilcox, 2002; Thompson & OBrian, 2007). In
1971, Kohl and Marro conducted the first national study concerning special
education administrators. This study provided a baseline of information
regarding responsibilities and challenges of special education administrators in
areas such as program administration and supervision, organizational
characteristics and programming elements, and selected administrative opinions
(Marro & Kohl, 1972). Have the responsibilities and challenges of special
education administrators significantly changed since that time?
2016 The authors and IJLTER.ORG. All rights reserved.

2
With the establishment of Public Law 94-142 (Education for all

Handicapped Children Act of 1975), the responsibilities of special education
administrators have evolved and expanded as the unique needs of students with
disabilities are met in the least restrictive environment (LRE). Reauthorization
of the Individuals with Disabilities Education Improvement Act in 2004 (IDEIA
2004) brought about strengthened accountability for results, enhanced parent
involvement, use of scientifically based instructional practices, the development
and use of technology, and highly qualified staff to ensure that students with
disabilities would benefit from such efforts (Wright, 2004).
Improving educational outcomes for students with disabilities requires a
paradigm shift of the special education administrators role toward more
support of scientific and evidence-based instructional practices. Previously, the
special education administrator was responsible for ensuring compliance with
federal mandates and promoting individualized instructional programs. Now,
the special education administrator must help facilitate collaboration between
stakeholders so that all students have access to high quality educational
programs. The special education administrators effectiveness is determined by
the ability to develop, guide, support and evaluate the use of evidence-based
practices by teachers which should result in positive educational outcomes for
students with disabilities (Boscardin, 2004; Lashley & Boscardin, 2003).
Lashley and Boscardin (2003) reported that the special education
administrators responsibilities have changed from focusing on effective
interventions to concerns with litigation, accountability, inclusion, and school
reform. The diverse responsibilities of special education administrators such as
interpreting and implementing special education law, making program
decisions, supervising provision of services, empowering teachers to use
research-based strategies, and addressing parental demands make special
education administration a daunting challenge (Palladino, 2008, p. 158).
Tate (2010) noted that special education administrators have faced the
challenges of decreased funding, shortage of qualified staff, and increased
litigation while trying to meet the needs of a complex student population.
Thompson and OBrian (2007) found the most difficult aspects of being a special
education administrator were legal issues, issues with personnel, overwhelming
paperwork, budget and finance, and multiple roles while Lashley and Boscardin
(2003) reported retaining qualified staff in special education, professional
development, and recruitment as major challenges for special education
administrators.
Crockett, Becker, and Quinn (2009) reviewed 474 abstracts of articles
from 1970-2009 that addressed special education leadership and administration.
Several trends emerged that influence special education leaders: (a)
collaboration between stakeholders, (b) school improvement through
accountability measures, and (c) the use of technology. There were a
disproportionate number of data-based research studies compared to
professional commentaries (non-researched based information) in the area of
leadership roles and responsibilities (Crockett, Becker, & Quinn, 2009). From
1970-2009, Crockett, Becker and Quinn (2009) identified a total of 49 professional
commentaries and 19 data-based research studies that addressed special
education administrators roles and responsibilities. Interestingly, over half (n =

3
27) of the 49 professional v6) of the 19 data-based research studies occurred

during the same time period. The greatest number of data-based research
studies addressing roles and responsibilities occurred during the 1980s while the
greatest number of professional commentaries occurred during the years from
2000-2009. As stated by Crockett, Becker, and Quinn (2009), there is a gap in
the empirical foundation that guides the implementation of effective special
education leadership practice (p. 65). Finkenbinder (1981) noted that action
research was needed to address changes that have occurred in the
responsibilities of special education administrators especially at various
organizational levels such as rural and urban districts. This study examines
current responsibilities and challenges of special education administrators in
rural, suburban, and urban school districts in the state of Texas.
This study seeks to answer the following questions:
How have the responsibilities and challenges of special education
administrators significantly changed over time?
What are the significant differences in responsibilities in staffing,
evaluation of staff, budget, policy development, and program
development between special education administrators in rural,
suburban, and urban school districts in the state of Texas?
What are the most important challenges for special education
administrators in rural, suburban, and urban school districts in
the state of Texas?
What is the relationship between each of the 39 responsibilities
and the perceived level of challenge by special education
administrators?
Methodology
The participants for this study included special education administrators
from school districts in the state of Texas. The population sample came from the
2013-2014 Texas Council of Administrators of Special Education (TCASE)
Directory consisting of special education administrators from rural, suburban,
and urban districts. Additionally, the TCASE Directory includes twenty
Regional Education Service Center (ESC) Directors who oversee staff
development and provide support to special education administrators within
their regions. The Regional ESC Directors were excluded from the population
sample since they are not directly responsible to a school district or educational
cooperative. A total of 515 special education administrators in the state of Texas
were contacted in 2014 via e-mail to solicit input regarding the background
characteristics, responsibilities and challenges of the special education
administrator utilizing a survey.
A non-experimental research design was utilized through survey
methodology to describe perceptions of special education administrators
responsibilities and challenges. A comparative study was conducted between
special education administrators in rural, suburban, and urban districts.
The survey was modeled after the first national study of special
education administrators in public schools conducted by Kohl and Marro (1971).
In the final report by Kohl and Marro (1971), suggestions were made for further
investigations to enhance the knowledge pool regarding special education

4
administrators. This information was used to create a survey with updated

information concerning the responsibilities and challenges faced by special
education administrators. Maintaining some of the constructs of the original
survey allows longitudinal information to be obtained for comparison with the
original survey. For validity purposes, the survey was reviewed by a committee
which included individuals who had prior experience as public school
administrators for content and clarity. Statements on the survey were generated
from a collection of job descriptions that were used by school districts when
posting for open positions of special education directors in the state of Texas.
Thirty-nine statements addressing responsibilities and challenges of special
education administrators in five separate categories: (a) staffing, (b) evaluation
of staff, (c) budget, (d) policy development, and (e) program development were
included in the survey.
For each statement, the participants were asked to respond to two
separate Likert scales concerning the level of importance of the responsibility for
effectively managing the special education program and the level of challenge
for implementing that responsibility. The first Likert scale addressed the level of
responsibility as: (a) not applicable, (b) not important, (c) somewhat important,
(d) very important, or (e) essential. The choices were ranked from zero to five
respectively. The second Likert scale addressed the level of challenge. The
Likert scale choices were: (a) not a challenge, (b) a little bit of a challenge, (c)
somewhat of a challenge, and (d) substantial challenge. The choices were
ranked from one to four respectively. A determination of a mean (M) response
for each responsibility statement was calculated.
Initial contact with the special education administrators was in the form of
an e-mail that contained the following information: (a) explanation and purpose
of the study, (b) participants in the study, (c) description of procedures, (d)
instrumentation utilized, (e) potential risks, (f) participation and benefits (g) link
to survey through PsychData, (h) contact information, (i) and an opportunity to
contact the researcher if there were any questions. E-mails were grouped by
region using the blind cc to protect confidentiality. Two follow-up e-mails
were sent as reminders to complete the survey. The first reminder was sent two
days after the initial contact e-mail with the final reminder being sent one week
after the initial e-mail.
A total of 515 surveys were distributed to special education
administrators across the state of Texas. A total of 176 surveys were returned
with 24 surveys removed due to lack of completion and other factors leaving a
total of 152. Though there was an initial 35% return of surveys, 29.5% were used
in the evaluation of results. This accounts for roughly one out of three special
education administrators in the state of Texas.
Using the Statistical Package of Social Scientists (SPSS) 18 program,
results of the survey were analyzed. Frequency, percentage tables, and cross-
tabulation were used for categorical data. A comparison of responsibilities and
level of challenges was conducted through cross tabulation. The Chi-Square
value was computed to determine the statistical significance of the relationship
between each of the 39 responsibilities and the perceived level of challenge by
special education administrators.

5
Results
Of the special education administrators responding to the survey, 61.2%
were from rural school districts, 27.6% from suburban and 11.2% from urban. Of
those, 73% listed employment as the local school district, while 23.7% showed an
education cooperative unit. The remaining administrators indicated a shared
services agreement, countywide school district, State School for the Deaf and
State School for the Blind and Visually Impaired. Approximately 91% of the
special education administrators were non-Hispanic or Latino and White with
85.5% of the special education administrators being female. Those responding
overwhelmingly held a masters degree and additional courses (65.1%) or a
doctoral degree (18.4%). The majority of the individuals held mid-
management/principal certification (77.6%) while the second most common
certification was that of special education teacher (73.7%). Twenty-four special
education administrators (15.8%) had no administrative certification. Seventy-
five percent of special education administrators without administrative
certification came from rural school districts, 16.7% came from suburban school
districts, and 8.3% from urban school districts.
Responses from special education administrators were analyzed to
determine the level of importance for 39 statements of responsibility using a 5-
point Likert scale and the level of challenge for the same statements using a 4-
point Likert scale. Table 1 identifies the special education administrators mean
average for the perceived level of importance for each responsibility statement to
effectively manage the special education program. Table 2 identifies the mean
average for the perceived level of challenge for implementing that responsibility.
Standard deviations were included for each responsibility and level of challenge.
Each table provides the category of each responsibility and the responsibility
statement. The responsibility statements are ranked from the most essential to
the least important in level of responsibility and from the most substantial to the
least in level of challenge. Responsibilities and level of challenges that showed a
significant difference between special education administrators in rural,
suburban, and urban school districts in the state of Texas are noted in bold print
and starred.
Special Education Administrators Level of Responsibility
The top three responsibilities considered most essential were in the area
of policy development: (a) knowledge of federal and state special education law,
(b) implements the policies established by federal and state law, State Board of
Education rules, and the local board policy in the area of special education, and
(c) knowledge of state level assessment procedures and requirements (Table 1).
The responsibilities that were considered the least important involved
personally providing direct service to students with disabilities and evaluation
of special education and general education staff. The majority of special
education administrators (63.8%) did not consider the responsibility of
personally providing direct service to students with disabilities as applicable to
them. A higher percentage of special education administrators from rural
(19.4%) and suburban (11.9%) school districts considered this very important to
essential when compared to special education administrators from urban school
districts (5.9%). This may imply that special education administrators do not
consider personally providing direct services to students with disabilities a

6
significant responsibility unless the special education administrators are from

smaller school districts where access to qualified staff might not be prevalent.
Approximately 50% of special education administrators evaluated special
education teachers on campuses. Greater responsibility was reported by special
education administrators for evaluating general education teachers (65.8%)
itinerant staff (84.2%), diagnostic staff (98.0%), secretarial and clerical staff
(97.4%).
When comparing responses from special education administrators in
rural, suburban, and urban school districts, significant differences were noted
for six responsibility statements. Three responsibility statements from the
program development category showed a significant difference: (a) serving as a
resource person in the design and equipping of facilities for students with
disabilities, (b) providing access to appropriate materials needed for instruction,
and (c) collaboration between general education and special education. A higher
percentage of special education administrators from suburban school districts
(52.4%) considered the responsibility of serving as a resource person in the
design and equipping of facilities for students with disabilities responsibility as
essential compared to 32.3% from rural school districts and 35.3% from urban
school districts. The majority of special education administrators considered the
responsibility of providing access to appropriate materials needed for
instruction as very important (35.5%) or essential (50.7%). Special education
administrators from suburban school districts (83.3%) who considered the
responsibility of collaboration between general education and special education
as essential had a higher percentage than special education administrators from
urban (64.7%) and rural (63.4%) school districts.
A significant difference was noted for two staffing responsibility
statements: contracts with outside providers of special education services for
students with disabilities (i.e. OT, PT, music therapy) and monitors staff
caseloads. A higher percentage of special education administrators from rural
school districts (63.4%) considered contracting with outside providers as an
essential responsibility compared to 57.1% of special education administrators
from suburban school districts and 52.9% from urban school districts. Special
education administrators from urban school districts (23.5%) had a higher
percentage than special education administrators from suburban (4.8%) and
rural (1.1%) school districts that did not consider contracting with outside
providers applicable to them. This may be due, in part, to larger school districts
having the ability to hire full-time personnel to serve a large number of students.
The majority of special education administrators chose either very important or
essential for the level of responsibility for monitoring staff caseloads. A higher
percentage of special education administrators from suburban school districts
(59.5%) and urban school districts (58.8%) considered monitoring staff caseloads
as an essential responsibility compared to special education administrators from
rural school districts (43.0%).
The responsibility of participating in the development of district goals
and objectives was significant in the area of policy development between special
education administrators in rural, suburban, and urban school districts. A
higher percentage of special education administrators from urban school
districts (76.5%) considered the responsibility as essential compared to 47.6% of

7
special education administrators from suburban school districts and 28.0% from
rural school districts.
Challenges Faced by Special Education Administrators
Of the 39 responsibilities special education administrators were asked to
identify the level of challenge, collaboration between general education and
special education from the program development category was considered the
highest ranked level of challenge followed by two responsibilities in the budget
category: compiling budgets and cost estimates based upon documented
program needs and ensuring that programs are cost effective and funds are
managed prudently. The lowest rated challenges were personally providing
direct service to students with disabilities from the staffing category and two
responsibility statements from the evaluation of staff category: evaluates
secretarial and/or clerical staff and evaluates special education teachers on
campuses through the designated teacher appraisal system.
Three responsibility statements showed a significant difference between
rural, suburban, and urban school districts regarding the level of challenge as
perceived by special education administrators. Two of the responsibility
statements were from the program development category: collaboration between
general education and special education and demonstrates skill in conflict
resolution with administrators, parents, teachers, staff, and community. Special
education administrators from suburban school districts (90.4%) considered
collaborating between general education and special education as either
somewhat of a challenge (45.2%) or a substantial challenge (45.2%) compared to
special education administrators in rural (37.6%; 37.6%) or urban (35.3%; 17.6%)
school districts. Special education administrators in suburban school districts
(54.8%) considered demonstrating skill in conflict resolution with
administrators, parents, teachers, staff, and community somewhat of a challenge
(28.6%) or a substantial challenge (26.2%) compared to 51.6% of special
education administrators in rural school districts (37.6%; 14.0%) and 29.4% of
special education administrators in urban school districts (29.4%; .0%). This may
be due to the level of experience portrayed by special education administrators
in larger or urban school districts.
The final responsibility statement that showed a significant difference in
level of challenge between rural, suburban, and urban school districts was
contracting with outside providers of special services for students with
disabilities in the staffing category. The majority of special education
administrators from urban school districts (35.3%) did not consider contracting
with outside providers of special services a challenge while 11.9% of special
education administrators from suburban school districts and 7.5% of special
education administrators from rural school districts did not consider the
responsibility a challenge. The majority of special education administrators from
suburban (42.9%) and rural (35.5%) school districts considered the responsibility
somewhat of a challenge compared to only 23.5% of special education
administrators from urban school districts. This may be due to the availability
of contract providers in smaller districts. Related service personnel may be more
difficult to acquire to provide services for students with disabilities in smaller
districts without a substantial cost to the school district.

8
Table 1: Special Education Administrators Perceptions of Responsibilities

Level of
Responsibility
Type Responsibility
M SD
POD Knowledge of federal and state special education law 4.93 0.27
Implements the policies established by federal and state
POD law, State Board of Education rules, and the local board 4.84 0.49
policy in the area of special education
Knowledge of state level assessment procedures and
POD 4.74 0.54
requirements
Compiles budgets and cost estimates based upon
BGT 4.67 0.73
documented program needs
Discusses special education programs, personnel, and
PRD 4.66 0.50
students with building administrators
Ensures that programs are cost effective and funds are
BGT 4.63 0.60
managed prudently
Recommends and consults on policies to improve
POD 4.63 0.69
programs that impact students with disabilities
BGT Administers the special education budget 4.62 0.79

Collaboration between general education and special
PRD 4.52* 0.94
education
Evaluates diagnostic staff (i.e. educational diagnosticians,
EOS 4.50 0.78
LSSPs)
PRD Encourages the use of assessment to inform instruction 4.48 0.80

Ensures that student progress is evaluated on a regular,
PRD systematic basis, and the findings are used to make the 4.47 0.74
special education program more effective
Participates in recruitment, selection, and making sound
STA recommendations relative to personnel placement and 4.45 0.84
assignment
Contracts with outside providers of special services for
STA 4.43* 0.94
students with disabilities (i.e. OT, PT, music therapy)
STA Monitors staff caseloads 4.42* 0.66

Collaborates with business office on requisitions, purchase
BGT 4.41 0.67
orders, contracts, etc.
Encourages the use of effective, research-based
PRD 4.41 0.77
instructional strategies
Makes recommendations relative to retention, transfer,
EOS 4.34 0.86
discipline, and dismissal of staff
Provides access to appropriate materials needed for
PRD 4.33* 0.84
instruction
Develops and submits budgets and financial reports for
BGT 4.31 0.99
central administration

9
Table 1: Continued.
Level of
Type Responsibility Responsibility
M SD
PRD Creates supportive and safe learning environments 4.24 1.17
EOS Evaluates secretarial/clerical staff 4.16 0.91
Consults with parents regarding the evaluation and
PRD 4.11 1.04
placement of their children
Monitors professional research and disseminates ideas
PRD 4.07 0.83
and information to other professionals
Assists with alignment of student goals with standards-
PRD 4.07 1.18
based goals
Articulates the districts mission and goals in the area of
PRD special education to the community and solicits its 4.07 1.02
support in realizing the mission
Participates in the development of district goals and
POD 4.05* 1.03
objectives
Selection of instructional materials used in special
PRD 4.02 0.99
education program
Serves as a resource person in the design and equipping
PRD 4.01* 1.09
of facilities for students with disabilities
Consults with teachers regarding the evaluation and
PRD 3.97 1.07
placement of their students
Maintains a current inventory of supplies and equipment;
BGT recommends the replacement and disposal of equipment, 3.96 0.88
when necessary
Facilitates/promotes the use of technology in the
PRD 3.90 0.91
teaching-learning process
Evaluates itinerant staff (i.e. VI teacher, counselor, special
EOS 3.81 1.39
education nurse)
Participates in committee meetings to ensure the
PRD appropriate placement and development of individual 3.71 1.14
education plans for students with disabilities
Demonstrates skill in conflict resolution with
PRD 3.66 1.46
administrators, parents, teachers, staff, and community
Attends school board meetings regularly and makes
POD 3.45 1.22
presentations to the school board
Assists in general education walk-throughs and/or
EOS 2.84 1.46
evaluations
Evaluates special education teachers on campuses through
EOS 2.53 1.64
the designated teacher appraisal system
Personally provides direct service to students with
STA 1.89 1.35
disabilities (including teaching and/or assessment)
*p = <.05
Level of Responsibility:
1 = Not Applicable; 2 = Not Important; 3 = Somewhat Important; 4 = Very Important; 5
= Essential
BGT = Budget; EOS = Evaluation of Staff; POD = Policy Development; PRD =
Professional Development; STA = Staffing

10
Table 2: Special Education Administrators Perceptions of Level of Challenge

Level of
Type Responsibility Challenge
M SD
PRD 3.09* 0.88
education
BGT 3.05 0.76
BGT 2.97 0.83
managed prudently
PRD systematic basis, and the findings are used to make the 2.87 0.88
POD Knowledge of federal and state special education law 2.85 0.88
POD law, State Board of Education rules, and the local board 2.85 0.88
PRD Encourages the use of assessment to inform instruction 2.84 0.82
POD 2.82 0.85
requirements
POD 2.82 0.81
programs that impact students with disabilities
BGT Administers the special education budget 2.76 0.82
STA recommendations relative to personnel placement and 2.76 0.88
assignment
STA 2.76* 0.97
students with disabilities (i.e. OT, PT, music therapy)
PRD 2.75 0.87
instructional strategies
BGT 2.72 0.85
STA Monitors staff caseloads 2.66 0.89
EOS 2.61 0.92
discipline, and dismissal of staff
PRD 2.52 0.87
students with building administrators
PRD 2.49 0.92
based goals
PRD special education to the community and solicits its support 2.49 0.86
in realizing the mission
POD 2.45 0.88
objectives
Facilitates/promotes the use of technology in the teaching-
PRD 2.45 0.82
learning process

11
Table 2: Continued.
Level of
Type Responsibility Challenge
M SD
PRD 2.43* 1.01
administrators, parents, teachers, staff, and community
Maintains a current inventory of supplies and equipment;
BGT recommends the replacement and disposal of equipment, 2.40 0.94
when necessary
PRD 2.36 0.84
education program
Monitors professional research and disseminates ideas and
PRD 2.34 0.89
information to other professionals
PRD 2.32 0.86
instruction
Serves as a resource person in the design and equipping of
PRD 2.28 0.90
facilities for students with disabilities
PRD Creates supportive and safe learning environments 2.28 0.86

Collaborates with business office on requisitions, purchase
BGT 2.26 0.93
orders, contracts, etc.
PRD 2.21 0.85
placement of their students
PRD 2.18 0.89
PRD appropriate placement and development of individual 2.09 0.92
Evaluates diagnostic staff (i.e. educational diagnosticians,
EOS 2.05 0.87
LSSPs)
Evaluates itinerant staff (i.e. VI teacher, counselor, special
EOS 2.01 0.89
education nurse)
EOS 1.98 1.06
evaluations
POD 1.82 0.85
Evaluates special education teachers on campuses through
EOS 1.78 1.01
the designated teacher appraisal system
EOS Evaluates secretarial/clerical staff 1.72 0.83

STA 1.49 0.85
disabilities (including teaching and/or assessment)
*p = <.05
Level of Challenge:
1 = Not a Challenge; 2 = A little bit of a Challenge; 3 = Somewhat of a Challenge; 4 =
Substantial Challenge
BGT = Budget; EOS = Evaluation of Staff; POD = Policy Development; PRD =
Professional Development; STA = Staffing

12
Special Education Administrators Responsibilities vs. Challenges

A comparison of responsibilities and level of challenges was conducted
through cross tabulation. The Chi-Square value was computed to determine the
statistical significance of the relationship between each of the 39 responsibilities
and the perceived level of challenge by special education administrators. Table
3 reports the results for Chi-Square, degrees of freedom, and the significance
level for each responsibility statement. As noted in Table 3, the majority of
comparisons between responsibilities and level of challenges were significant at
the p = < .05.
The overall pattern suggests, as the importance of the responsibility
increased, the level of the challenge increased. This was applicable to 28 of the
39 responsibilities (71.7%). The remaining responsibilities followed different
patterns. The responsibility for providing direct services to students with
disabilities (including teaching and assessment) in the staffing category was
slightly different since it was only applicable to 36.2% of special education
administrators in the study. A secondary pattern was seen for certain
responsibilities in the evaluation of staff, budget, policy development, and the
program development categories. The following responsibilities showed that
special education administrators considered the responsibilities as very
important to essential but considered the level of challenge as not a challenge to
a little bit of a challenge. This pattern was applicable to the three responsibilities
in evaluation of staff: (a) evaluates diagnostic staff (i.e. educational
diagnosticians); (b) evaluates itinerant staff (i.e. VI teacher, counselor, special
education nurse); and (c) evaluates secretarial and clerical staff. There was one
responsibility in the budget category of collaborating with the business office on
requisitions, purchase orders, contracts, etc. and one responsibility in policy
development of attending school board meetings regularly and making
presentations to the school board. The five remaining responsibilities were in
the program development category: (a) consults with parents regarding the
evaluation and placement of their children, (b) serves as a resource person in the
design and equipping of facilities for students with disabilities, (c) monitors
professional research and disseminates ideas and information to other
professionals, (d) provides access to appropriate materials needed for
instruction, and (e) selection of instructional materials used in special education
program.

13
Table 3: Comparison between Special Education Administrators Responsibilities and

Challenges
Staffing X2 df Sig.
Monitors staff caseloads 29.33 9 .001*
recommendations relative to personnel placement and 66.70 12 .001*
assignment
students with disabilities (i.e. OT, PT, music therapy) 63.63 9 .001*
disabilities (including teaching and/or assessment) 116.82 12 .001*
Evaluation of Staff
Evaluates special education teachers on campuses
through the designated teacher appraisal system 97.54 12 .001*
Evaluates diagnostic staff (i.e. ed. diagnosticians, LSSPs) 18.30 12 .107
Evaluates itinerant staff (i.e. VI teacher, counselor) 68.02 12 .001*
Evaluates secretarial/clerical staff 25.74 12 .012*
discipline, and dismissal of staff 53.35 12 .001*
94.65 12 .001*
evaluations
Budget
54.38 9 .001*
63.02 9 .001*
Administers the special education budget 35.91 9 .001*
Maintains a current inventory of supplies and
equipment; recommends the replacement and disposal of 33.95 12 .001*
equipment, when necessary
37.28 9 .001*
managed prudently
Collaborates with Business Office on requisitions,
purchase orders, contracts, etc. 15.71 9 .073
Policy Development
Knowledge of federal and state special education law 7.61 6 .268
9.70 6 .138
requirements
law, State Board of Education rules, and the local board 23.22 9 .006*
programs that impact students with disabilities 50.55 12 .001*
61.35 12 .001*
objectives
60.08 12 .001*

14
Table 3: Continued.
Program Development X2 df Sig.
placement of their students 50.41 9 .001*
39.07 12 .001*
students with building administrators 9.23 6 .161
appropriate placement and development of individual 53.33 12 .001*
systematic basis, and the findings are used to make the 45.21 9 .001*
Serves as a resource person in the design and equipping
of facilities for students with disabilities 72.67 12 .001*
Monitors professional research and disseminates ideas
and information to other professionals 24.93 12 .015*
Facilitates/promotes the use of technology in the
teaching-learning process 70.59 9 .001*
instruction 27.50 9 .001*
instructional strategies 38.30 9 .001*
Creates supportive and safe learning environments
69.71 12 .001*
based goals 105.26 12 .001*
education 105.11 9 .001*
Encourages the use of assessment to inform instruction
75.51 9 .001*
education program 53.38 12 .001*
special education to the community and solicits its 59.08 12 .001*
support in realizing the mission
administrators, parents, teachers, staff, and community 163.21 9 .001*
*p < .05
Discussion
Findings from this study reveal minimal diversity in gender, ethnicity,
and race among special education administrators with the majority of special
education administrators being female, Non-Hispanic or Latino and White.
Compared to previous studies there has been no change in ethnicity or racial
composition of special education administrators yet there has been a significant
change in gender from previous studies. In the study by Kohl and Marro (1971),
75% of special education administrators were male and 25% were female. Arick

15
and Krug (1993) reported a larger percentage of male (65.5%) special education
directors than female (34.5%) as did Wigle and Wilcox (2002) with 53% of the
special education directors being male and 47% female. There were an equal
number of males and females as special education administrators in a study by
Thompson and OBrian (2007). Thompson and OBrian (2007) identified no
diversity in racial composition in their study since all participants were Non-
Hispanic and White.
The minimal degree held by special education administrators in the
current study was a masters degree with 18.4% of special education
administrators holding a doctorate degree. Due to the mandatory legislation
and the complexity of special education there is a need for highly competent and
trained administrators in the areas of special education (Forgnone & Collings,
1975). In a study by Thompson and OBrian (2007), 7.5% of 67 special education
administrators had a master's degree, 55.2% had a masters degree with
additional graduate credit, and 32.8% had a doctorate degree. Compared to the
current study, a higher percentage of special education administrators held
doctorate degrees in the Thompson and OBrian (2007) study.
The current study reflects an increase in special education administrators
with general education administrator certification and special education teacher
certification compared to previous studies. Kohl and Marro (1971) identified
43.5% of special education administrators as having a general administrator
certification, 32.0% having a special education administrator certification and
37.6% having a special education teacher certification. Arick and Krug (1993)
reported 58.3% of special education administrators having certification in special
education administration and 64.0% in special education teacher certification.
Special education administrators in the state of Texas are not required to have a
special education administration certification which may account for the
increased number in general education administration certification. State
certification requirements are one way to ensure that special education
administrators are adequately prepared as their job responsibilities increase and
become more diverse (Prillaman & Richardson, 1985).
Knowledge and implementation of federal and state special education
law at the local level continues to be a top priority for special education
administrators, as well as, a challenge. The findings in the current study support
the work by Nevin (1979) who noted interpretation of state and federal laws was
an essential competency and Prillaman and Richardson (1985) who espoused the
importance of special education administrators being able to interpret outcomes
of court cases and translating law into local policy and practice. As noted by
Tate (2010) the importance of having a good background knowledge of special
education law cannot be undermined. Thompson and OBrian (2007) reported
that legal issues were a difficult aspect of being a special education
administrator, which reflects the importance of having knowledge of federal and
state special education law, which was the highest rated challenge in the policy
development category.
Interestingly, the responsibility that was considered the least essential
and less of a challenge in the area of policy development was attending school
board meetings regularly and making presentations to the school board. In the
current study, 19.7% of special education administrators considered attending

16
school board meetings regularly and making presentations as essential with

34.9% of special education administrators considering it very important and
28.3% considering it somewhat important. Marro and Kohl (1972) noted that
relationships with the school board and central administration are important for
special education administrators. Kohl and Marro (1971) found 35.2% of special
education administrators frequently attended school board meetings, 31% only
attended school board meetings for special presentations, and special education
administrators from small education systems usually did not attend school
board meetings. Approximately 96% of special education administrators in the
current study were involved in policy development compared to 63% of the
special education administrators surveyed by Kohl and Marro (1971) who
reported they felt encouraged to recommend new policies and present their
viewpoint to the school board or through the superintendent.
The current study reflects limited involvement by special education
administrators in providing direct services to students with disabilities and the
evaluation of special education staff at the campus level was only somewhat
important which is different from previous studies. Kohl and Marro (1971)
reported that special education administrators desired to spend more time
supervising and coordinating instruction, yet 37% of special education
administrators did not formally evaluate beginning teachers and continuing
teachers. In the study by Arick and Krug (1993), 85% of special education
administrators were solely responsible for evaluating special education staff or
shared the responsibility in their district. As noted previously, the current study
showed greater responsibility toward evaluating staff that are not typically
located at the campus level such as special education secretarial or clerical staff,
diagnostic staff, and itinerant staff.
Even though special education administrators considered evaluation of
special education staff at the campus level as somewhat important,
approximately 98% of special education administrators rated discussing special
education programs, personnel, and students with building administrators as
very important (30.9%) or essential (67.8%). The results in the current study
were higher than those reported by Kohl and Marro (1971) where 70% of special
education administrators considered improving the special education program
through supervision and instruction their primary responsibility.
The current study reflects the importance of collaboration between
general education and special education administrators as well as a challenge for
special education administrators. In a study by Arick and Krug (1993), special
education administrators indicated a need for training to facilitate collaboration
between general education and special education. Boscardin (2005) advocated
the use of collaboration to develop professional bonds with teachers.
Compiling budgets and cost estimates based upon documented program
needs and ensuring that programs are cost effective while funds are managed
prudently continue to be a very important responsibility of special education
administrators and somewhat of a challenge. This supports the findings of
Thompson and OBrian (2007), that budget and finance can be a difficult aspect
of being a special education director.

17
Conclusion
Though the face of the special education administrator has changed from
primarily male to female, there are some facets of being a special education
administrator that has remained the same. Policy development which
encompasses knowledge and implementation of federal and state law
concerning special education continues to be the primary responsibility for
special education administrators. However, there is an increased number of
special education administrators who are involved in the development of
policies at the local level.
The importance of collaboration between general education and special
education continues to be a very important to essential responsibility but
somewhat of a challenge for special education administrators. Interestingly,
there appears to be a decrease in the evaluation of special education staff at the
campus level by the special education administrator and personally providing
direct service to students with disabilities as the importance of administrative
responsibilities have increased such as compiling budgets and legal issues.
Overall, as the level of responsibility has increased for special education
administrators, the level of challenge has increased.
Differences were noted in level of responsibility and level of challenge
for special education administrators in rural, suburban, and urban school
districts. A higher percentage of special education administrators in suburban
school districts considered collaboration between general education and special
education an essential responsibility when compared to rural and urban school
districts. Contracting with outside providers of special services was a greater
responsibility and challenge for special education administrators from rural and
suburban school districts than special education administrators from urban
school districts. Special education administrators from suburban and urban
school districts are more concerned about monitoring staff caseloads than special
education administrators from rural school districts. Special education
administrators from urban school districts were more involved in the
development of district goals and objectives than rural and suburban school
districts while a greater percentage of special education administrators from
rural and suburban school districts had more responsibilities for program
development than special education administrators from urban school districts.
A higher percentage of special education administrators from suburban school
districts considered demonstrating skill in conflict resolution with
administrators, parents, teachers, staff, and the community as a substantial
challenge when compared to rural and urban special education administrators.
It is clear that the role of the special education administrator requires
diversified skills to meet the responsibilities and challenges that are faced today.
It is essential for todays special education administrator to have a clear
understanding of federal and state special education law for the implementation
of special education programs. One of the challenges for the future will be to
increase the diversity of special education administrators.
Limitations and Future Research
There were limited research studies that involved responsibilities and
challenges of special education administrators. Reviews of literature noted the
lack of research available (Finkenbinder, 1981; Crockett, Becker, & Quinn, 2009).

18
The length of data collection for survey responses covered a two week
period. Most responses occurred within six hours of notification. This was
applicable to the initial notification and the two reminders seeking participation
in the study.
Use of an electronic survey may have excluded some special education
administrators from participation in this study. Though all special education
administrators on the TCASE list had access to e-mail, some may prefer a pencil
and paper format as opposed to an electronic format. Establishing rapport with
an individual is more difficult through an electronic format, which may have
resulted in reduction of respondents.
The sample population was limited to special education administrators
within the state of Texas. Therefore, results may not be generalized across other
states but only representative of the population in the state of Texas.
Future research is needed to identify the difference between actual
responsibilities of special education administrators and job descriptions. Are
there factors that influence a special education administrators contract days
such as a difference between responsibilities during the school year and during
the summer? Additionally, factors should be identified that influence a special
education administrators decision to remain in the field of special education or
leave the field of education.
References
Arick, J. R., & Krug, D. A. (1993). Special education administrators in the United States:
Perceptions on policy and personnel issues. Journal of Special Education, 27(3), 348-
64. Retrieved from
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Boscardin, M. L. (2004). Transforming administration to support science in the
schoolhouse for students with disabilities. Journal of Learning Disabilities, 37(3), 262-
269. Retrieved from
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special education leadership and administration from 1970-2009. Journal of Special
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Finkenbinder, R. L. (1981). Special education administration and supervision: The state
of the art. Journal of Special Education, 15(4), 485-95. Retrieved from
Forgnone, C., & Collings, G. D. (1975). State certification in special education
endorsement. Journal of Special Education, 9(1) 5-9. Retrieved from

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direct=true&db=ehh&AN=4726553&site=ehost-live&scope=site
Hebert, E. A., & Miller, S. I. (1985). Role conflict and the special education supervisor: A
qualitative analysis. Journal of Special Education, 19(2), 215. Retrieved from
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Kohl, J. W., & Marro, T. D. (1971). A normative study of the administrative position in special
education. (Grant no. OEG-0-70-2467(607), US Office of Education). University Park,
PA: The Pennsylvania State University.
Lashley, C., & Boscardin, M. L. (2003). Special education administration at a crossroads:
Availability, licensure, and preparation of special education administrators. (Document
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Marro, T. D., & Kohl, J. W. (1972). Normative study of the administrative position in
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Nevin, A. (1979). Special education administration competencies required of the general
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files/2008-
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Texas Council of Administrators of Special Education (TCASE). (n.d.). Mission, vision,
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Thompson, J. R., & O'Brian, M. (2007). Many hats and a delicate balance. Journal of Special
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20

Vol. 15, No. 7, pp. 20-37, June 2016
The Impact on Absence from School of Rapid

Diagnostic Testing and Treatment for Malaria by
Teachers
Andrew John Macnab

Stellenbosch Institute for Advanced Study
Wallenberg Research Centre
Stellenbosch, South Africa
Sharif Mutabazi, Ronald Mukisa,

Atukwatse M. Eliab, and Hassan Kigozi
Health and Development Agency (HEADA)
Mbarara, Uganda
Rachel Steed
Hillman Medical Education Fund
Vancouver, BC, Canada
Abstract. Malaria is the principal preventable reason a child misses

school in sub-Saharan Africa and the leading cause of death in
school-aged children. We describe a model for teachers to use rapid
diagnostic testing (RDT) for malaria and treatment with
Artemisinin-based combination therapy (ACT) to enhance education by
reducing school absence due to malaria. Conduct: A 2-year pilot
program in 4 primary schools in rural Uganda. Year 1, Pre-intervention
baseline evaluation (malaria knowledge; school practices when pupils
become sick; monitoring of days absent as a surrogate for morbidity and
teachers trained to administer RDT/ACT as the Year 2 intervention.
Findings: Teachers identified malaria as a barrier to education,
contributed to logistic design, participated willingly, collected accurate
data, and readily implemented/sustained RDT/ACT program.
Pre-intervention: 953/1764 pupils were sent home due to presumed
infectious illness; mean duration of absence was 6.5 days (SD: 3.17). With
school-based teacher-administered RDT/ACT 1066/1774 pupils were
identified as sick, 765/1066 (67.5%) tested RDT positive for malaria and
received ACT; their duration of absence fell to 0.6 days (SD: 0.64)
(p<0.001) and overall absenteeism to 2.5 (SD: 3.35). The RDT/ACT
program significantly reduced days of education lost due to malaria and
empowered teachers; this model is applicable to schools globally.
Keywords: Absenteeism; Community-based education; Health

promoting schools; Malaria.

21
Introduction
Malaria is the principal reason why a child will be absent from school where
the disease is endemic and the main reason a school-aged child will die in
sub-Saharan Africa. The burden of malaria and negative impact on education is
greatest amongst children in low resource settings and rural areas (Brooker, et al.,
2000; Jukes, et al., 2008; Kimbi, et al., 2005). The duration of malaria-related
absence from school, frequency of absence due to repeated infection, compromise
to learning due to residual malaise after sub-optimal treatment or when
permanent neurological complications occur with falciparum malaria all
negatively impact childrens education (Kihara, et al., 2006; Kimbi, et al., 2005;
Snow, et al., 2003). To minimize the adverse effects (morbidity) of malaria the
WHO advocates early, accurate diagnosis of infection and prompt, effective
treatment within 24 hours of the onset of illness (WHO, 2014).
Schools promoting health using the WHO Health Promoting School (HPS)
model provide opportunities within the formal curriculum to improve
knowledge and conduct a range of activities to educate pupils about healthy
practices (Macnab, et al., 2013; St Leger, et al., 2009; WHO, 1997). But, while
many schools in Africa do this in the context of malaria (Macnab, et al.; 2014), the
impact of such programs is limited because it is difficult to make a diagnosis of
malaria as symptoms are not specific, and diagnostic blood tests are often not
readily available. In addition, a lack of knowledge about appropriate treatment
and limited access to care in the community commonly contribute to malaria
morbidity (Kallander, et al., 2004). Hence, simple, accurate and inexpensive
diagnostic tools and wider availability of effective therapy are recognized as
urgently needed to reduce the impact of this disease on children (Mutabingwa,
2005).
The combined use of Rapid Diagnostic Test (RDT) kits to diagnose malaria
with administration of Artemisinin-based combination therapy (ACT) in those
testing positive meets this need. RDT/ACT use has improved the accuracy of
diagnosis and efficacy of treatment for malaria, but deployment of RDT and ACT
has been slow, especially in low resource settings. This is because the social
engagement necessary to spread the knowledge that this approach is effective
and make it accessible to rural populations has been missing (Mutabingwa, 2005).
Our hypothesis was that if school-based rapid diagnostic testing for malaria by
teachers was made available, all sick children usually sent home with a
presumed infectious illness would be screened using RDT, and be given ACT
when they tested positive. Educational benefit would accrue from a significant
reduction in days absent from school; less absence being a surrogate measure for
reduced morbidity from malaria. Also, in addition to improving school
attendance, better health outcomes should translate into an enhanced ability to
learn and better educational attainment in the long-term. An improvement in
childrens knowledge and community practices related to malaria would be a
secondary outcome.
Importantly, RDT kits are now available in Uganda and the feasibility of using
them has been demonstrated in rural clinics (Guthmann, J, et al., 2002; Kilian, et
al., 1999), and most recently in shops selling medicines (Mbonye, et al., 2010).
However, training low cadre health care workers, including school nurses, to use
these simple kits has not been done. Artemisinin-based combination therapy has

22
been adopted as a first line treatment for malaria, but while village health
workers have been taught home-based management of fever and ACT
administration, school nurses have not been trained comparably (Presidents
Malaria Initiative, 2005).
Malaria RDT kits provide a diagnosis in minutes by detecting the presence of
malaria parasites in human blood. RDT kits vary, but the principles of how they
work are similar (WHO, 2015; Wongsrichanalai, et al., 2007). Most are packaged
for individual use and include a lancet to obtain blood from a finger-prick. A
drop of blood from a potentially infected individual is put onto a strip of
nitro-cellulose housed in a plastic cassette to test for the presence of specific
proteins (antigens) produced by malaria parasites. If malaria antigens are
present, they bind to the dye-labeled antibody in the kit, forming a visible
complex in the results window. A control line confirms the integrity of the
antibody-dye conjugate. The sensitivity and specificity of RDTs are such that they
can replace conventional testing for malaria (Abba, et al., 2011; Murray, et al.,
2008).
ACTs are the best anti-malarial drugs available nowadays, and the first-line
therapy for P. falciparum malaria recommended by WHO for use worldwide
since 2001 (International Artemisinin Study Group, 2004; Malaria Consortium,
2016; WHO, 2016). Natural Artemisinin is sourced from Artemesia annua; the
herb, native to China, has a long-standing reputation for efficacy in treating
fevers; Artemisinin is now also made synthetically. ACTs combine Artemisinin,
which kills the majority of parasites within a few hours at the start of treatment,
with a partner drug of a different class with a longer half-life, which eliminates
the remaining parasites (Benjamin, J, et al., 2012). Several preparations combining
these two components in a single fixed-dose tablet are now available. Benefits of
ACTs include high efficiency, fast action, few adverse effects and the potential to
lower the rate at which resistance emerges and spreads; to make best use of ACT
issues related to access, delivery and cost have to be addressed (Malaria
Consortium, 2016).
Since 2006 we have used the WHO Health Promoting School (HPS) model to
engage communities in rural Uganda and deliver low cost health education in
schools (Kizito, et al., 2014; Macnab & Kasangaki, 2012; Macnab, et al., 2014).
From dialogue with teachers in these communities we learned that absence from
school due to malaria is high and most children sent home due to febrile illness
do not subsequently access clinics where RDT/ACT are used, due to factors
including distance, cost, and lack of awareness of the importance of treatment.
Hence the logic of our initiative to offer school communities teacher training and
support to enable school-based RDT and ACT to be provided. The incentive for
teachers was the potential to improve the education of their pupils by reducing
the length of time they are absent from school due to malaria, and decrease the
negative impact that sub-optimal management of this disease is known to have
on childrens ability to learn.
This intervention was designed as a logical and medically expedient response
to the concern voiced by teachers in Uganda. However, the same barriers to
childhood education exist worldwide where malaria is endemic, hence the broad
relevance of the health promotion model we describe, particularly for schools
serving children in rural resource-poor settings.

23
Methodology/Approach
This initiative was delivered as a community outreach project conducted in 4
newly established health promoting schools by the Health and Development
Agency (HEADA) Uganda. HEADA is a non-governmental agency funded by
the Hillman Medical Education Fund to implement comprehensive health
education, treatment, and support programs in Western Uganda. The project
employed the principles of participatory action research and followed
recommended steps for achieving participation and trust in communities
engaged in health promotion. Action research is problem-centered,
community-based and action-oriented. It is an interactive process that
co-develops programs with the people who use them and balances collaborative
problem-solving action(s) with data collection and validation of efficacy (Baum,
et al., 2006). Community trust comes via conscientious dialogue, synergistic
engagement, joint decision-making, and feedback that shares what does and does
not work (Laverack & Mohammadi, 2011; Macnab, et al., 2014b). Figure 1
summarizes the steps taken to implement this project.
In the school communities dialogue established how absence from school due
to malaria has a negative impact on the education of a large number of pupils.
The teachers described that their current practice was to send children home who
were sick or had fever; they assume many have malaria but it is left to the parents
to decide whether action to diagnose or treat their child occurs. Many children
are absent for more than a week, and often those returning clearly remain unwell
and unable to participate fully in class for several days, or even weeks.
The communities identify the problem.

HEADA initiates dialogue and active learning amongst the teachers, parents,
elders and village health teams in the 4 communities.
The Communities decide on a school-based problem solving action.
HEADA defines the logistics of delivery, data collection and evaluation of
safety and efficacy.
The school communities engage parents and provide written consent.
The teachers in the 4 school communities introduce the action within the
schools supported by HEADA.
Year 1. Pre-intervention. Year 2. Intervention.

Data collection on children identified as Teachers evaluate the children
sick at school and sent home, their identified as sick at school,
subsequent management in the conduct RDTs and immediately
community and duration of absence treat all children positive for
from school. malaria with ACT.
HEADA trains teachers to conduct

Figure 1. HEADA provides
RDTs, administer ACT and document support/supervision.
Flow chart of sequence of steps involved in this project. Data
data. collection continues.
HEADA and the 4 communities maintain dialogue to sustain the school-based

action and promote new knowledge and behavioral change community wide.
Figure 1.
Flow chart of the sequence of steps involved in the implementation of this project.

24
Public forums were initiated by HEADA to generate dialogue and active

learning about malaria causation, diagnosis, and treatment amongst the teachers,
parents, elders and village health team members. These took the form of
presentations with question and answer sessions that summarized current
knowledge about the benefits of interventions available elsewhere in Uganda and
the practicalities of delivering them, particularly the use of RDT kits for prompt,
accurate diagnosis in government clinics and the importance of early treatment
with ACT.
The communities decided that they wanted a school-based program;
problem-solving discussions were used to explore the options available and
potential hurdles the schools would face. These included if teachers would want
to invest the time to take the training required and to run a school-based
program, and be prepared to conduct testing involving collection of a blood
sample by finger prick. HEADA then defined the logistics of a teacher delivered
RDT and ACT program and a data collection strategy to evaluate safety and
efficacy. The teachers engaged parents in community-wide sessions to invite
participation, allow dialogue with HEADA regarding the process and pros and
cons of involvement, and obtain consent (Okello, et al, 2013).
Ethical considerations were addressed as follows: It was explained to parents
that in Year 1 data on absenteeism would continue to be recorded as usual by the
school for evaluation purposes, and in Year 2 those children who became sick
with fever or had signs suggestive of an infectious illness would be assessed by a
trained teacher, the use of RDT /ACT considered, and additional data collected.
Each school signed an agreement to follow the co-developed action protocol. The
school obtained consent from parents for all pupils participating; no parents
wanted their child excluded; separate informed consent was obtained from
parents prior to follow up visits conducted by HEADA in the community. Each
child identified as sick and needing assessment at school was required to give
verbal assent for conduct of an RDT, and treatment with ACT if the RDT was
positive. Pictographic information sheets on how the RDT is conducted were
used to aid education of parents and children in this context. A young
investigator was included in our team to facilitate the comprehension and
engagement of pupils.
The teachers in the 4 school communities introduced the action protocol into
the schools routine supported by HEADA staff who visited the schools weekly
to assist and respond to queries, and where necessary make adjustments to
accommodate community-driven needs.
In Year 1 the protocol involved data collection related to sick pupils sent home
and subsequently absent. School absence for reasons other than presumed
infectious illness was excluded; e.g. injury, bad behavior, caring for a sick sibling,
domestic work or failure to pay school fees. HEADA trained the teachers to
conduct RDT and administer ACT in one-day interactive workshops supervised
by a physician and run by trained laboratory staff (2) and nurses (2). These health
and education professionals trained one teacher as the primary evaluator and one
as back up for each school. After a knowledge pre-test, instruction included:
evaluation of a child for symptoms suggesting an infectious illness (headache,
malaise, nausea/vomiting, fatigue/somnolence, aches and pains +/- fever);
theory and practice related to the conduct of RDT and use of ACT; record

25
keeping; needle safety and waste disposal techniques; and post exposure
prophylaxis standard operating procedures and access to anti-retroviral therapy
in case of accidental needle pricks. Practical competency was evaluated and a
post-test administered. A refresher course was given in Year 2.
The RDT kits used were: Malaria Ag pan/Pf Malaria test kits Malarascan
(Zephyr Biomedical Systems) which targets HRP2 and Pan Aldolase of
Plasmodium falciparum and other less common Plasmodium species (P. vivax,
and P. ovale); sensitivity (96.3%) and specificity (98%) are high.
In Year 2 the protocol added screening with RDT for malaria and treatment of
those testing positive with ACT by the trained teachers. A single dose ACT
preparation was used rather than the conventional 3-day 12 hourly regimen to
ensure a full course of treatment was completed; this was to avoid the potential
for partial treatment bias if any of the five additional doses that would have had
to be given at home were missed. The ACT chosen was Arco
(Artemisinin-Napthoquine) (Midas Care Uganda, Ltd). The drug was given with
milk or juice to aid tolerance and taken under teacher supervision. Children were
observed for at least 1 hour for side effects; the protocol called for another dose to
be given if vomiting occurred.
Throughout the 2-year intervention HEADA and representatives from the 4
communities maintained dialogue to sustain the program and promote new
knowledge about malaria and encourage behavioral change community wide. In
the schools, this involved the core approaches of the WHO HPS model (Macnab,
2013): classroom education to increase knowledge and school-based activities to
develop practices and behaviors that benefited the children in the context of
malaria. Assessment of childrens knowledge preceded these activities and
post-intervention assessment followed for comparison. In the community
HEADA provided feedback via workshops on the conduct and efficacy of the
school-based intervention.
Results
Four primary schools were engaged in geographically separate low resource
rural settings in south-western Uganda; Bwizibwera Town School, Rutooma
Modern, Kaguhanzya Primary and Ruhunga Primary. Ninety kilometers
separated the 4 schools; a motorcycle and fuel costs were included in the budget;
HEADA staff travelled more than 20,000 km in the course of coordinating the
project. Total pupil enrollment was 1764 in Year 1 and 1774 in Year 2 across
classes primary 1 7.
Community-based dialogue (May September 2013) led to the collaborative
decision to introduce school-based teacher-administered RDT and ACT. Quotes
from Head Teachers include 1) This is exactly what we need, testing and
treating malaria at school. We are ready to collaborate. 2) Our children suffer
from fever and malaria, but we send them home where they are given local herbs
and paracetamol. Malaria affects childrens brains and ability to learn; it is a great
opportunity for us to be trained to prevent this from continuing to happen. 3)
Our teachers are enthusiastic about being involved in testing and treating
children after they have undergone training. Our School Board Chairman has
endorsed the idea. We are grateful for this initiative.

26
Baseline assessment, logistic planning, teacher training and inquiry of how sick
children sent home were managed by parents took place in Year 1 (September
2013 - August 2014), and RDT/ACT intervention with ongoing evaluation
followed in Year 2 (September 2014 - August 2015). This allowed a 2-year
evaluation where pre and post intervention data were collected over comparable
3 term periods during 2 consecutive school years, recognizing the seasonal nature
of malaria.
Childrens knowledge and awareness about malaria causation, transmission,
prevention, diagnosis and management were assessed in classroom sessions.
Pre-intervention, less than 20% of children knew mosquitos transmitted the
disease, the relevance of bed nets as a preventive measure, how diagnosis is
made and the importance of prompt and effective treatment. By Year 2
essentially 100% of children had a comprehensive grasp of these facts, knew the
symptoms and signs of probable infection and how to access appropriate
diagnosis and treatment.
Inquiry by anonymous questionnaire established that all teachers except one
wanted to be trained to do RDT for malaria, and all would administer ACT and
agree to take on the responsibility and additional work of evaluating sick
children as per the action protocol. The schools calculated that each needed 2
trained staff to conduct the duties required; one as the primary evaluator and one
to be available as back up throughout the intervention. A total of 11 teachers were
trained in interactive workshops over 2 years; performance at school and
refresher course evaluation confirmed all had good knowledge retention and
practical competency. Safe waste disposal was ensured by use of sharps boxes
for used blood lancets and biohazard bags. No adverse events requiring
anti-retroviral treatment occurred; every 50th positive RDT was checked by a
laboratory and all proved accurate.
Figure 2.
Management by parents of a subset of 104 febrile children with symptoms compatible
with malaria after they had been sent home from school.
In Year 1 the management of 104 febrile, sick children was evaluated once they
were sent home from school. All had symptoms compatible with malaria,
however, parental management of the majority was not in keeping with WHO

27
recommendations (prompt assessment, accurate diagnosis and comprehensive

treatment within 24 hours of the onset of illness) (WHO, 2014). Only 1 out of
every 4 (26%) was taken for any form of conventional diagnostic measure or
clinic-based anti-malarial treatment; 42% were only given an anti-pyretic (e.g.
paracetamol); 19% received a local traditional herbal remedy; 8% were taken to
church; and 5% were cared for by a traditional healer. Figure 2 summarizes these
data.
Table 1 shows the demographic and study data from Year 1 (pre-intervention)
and Year 2 (intervention). The number of children identified by their classroom
teachers as being sick with a potential infection and needing to be sent home
using the schools regular criteria in the pre-intervention year was 953. In the
intervention year this number was 1066. These 1066 were evaluated by a trained
teacher, the presence of symptoms compatible with infection confirmed, and
RDTs done. The RDT was positive in 715 of the sick children (67.5%), and all
received immediate treatment with the single dose ACT preparation
(Artemisinin-Napthoquine).
The mean duration of absence from school in children sent home with a
presumed infectious illness pre-intervention was 6.5 days from onset of illness to
return to class. During intervention mean duration of absence was 2.5 days
overall (p <0.001), 0.6 days in the 715 children RDT positive for malaria treated
immediately with ACT (p < 0.001) and 4.6 days in those RDT negative. Many
treated children felt well enough to ask to return to class of their own volition
within a few hours of receiving ACT, and hence had no days of absence from
school. Some very small variations in absenteeism rates were evident over the 2
years between schools, across classes (grades) and from term to term (season).
Overall, absence from school was reduced by 60.8% during intervention with
RDT/ACT.
Also, with 67.5% of sick children RDT positive in Year 2, if the same percentage
of children sent home in Year 1 also had malaria, this equates to 1358 cases in
1775 children over 2 years; or a malaria incidence rate of 79% across the 4 schools.
No adverse events occurred in the context of RDT screening and no adverse
reactions resulted from administration of the single dose ACT preparation which
was well tolerated. No children died from malaria during the intervention year.
Post-intervention dialogue identified a consensus amongst teachers that
participating children had derived significant health and educational benefit
from provision of school-based RDT/ACT. In addition to missing less school due
to absence, those treated for malaria were reported to appear fully engaged and
able to benefit from being back in class. HEADA staff identified that in the
broader community new knowledge was affecting behavioral change over how
suspected malaria was managed. It was agreed that the 4 schools would continue
to offer RDT/ACT, but via a modified intervention where RDT positive children
would now be given a conventional 3 day ACT regimen
(Artesunate-Amodiaquine) in the interest of cost. Knowledge transfer was also
extended beyond the community, with research reporting, publication and
dialogue to engage the Health Ministry.

28
Table 1. Demographics and Study data: Year 1 Pre-intervention and Year 2

Intervention with school-based RDT/ACT administration by teachers.
Pre-intervention Year 1
Children (total) 1764
Age range / years 5-13
Gender M/F % 49/51
Schools Bwizibwera Rutooma Ruhunga Kaguhanzya
Children by school. 412/424 451/451 189/185 712/715
Year at start/at end
Sick/sent home Total 953
Sick/per school 221 200 218 314
Sick/per term
Tested RDT n/a
Positive RDT n/a
MALARIA
Positive vs Negative n/a
RDT
Treated ACT n/a
Absence (Days) Sick 6.5 (3.17) 6.2 6.5 6.7 6.6
sent home TOTAL
Absence (Days) Sick n/a
sent home RDT =
MALARIA
Absence (Days) Sick n/a
sent home RDT =
NEGATIVE
Intervention Year 2
Children (total) 1774
Age range / years 5-13
Gender M/F % 49/51
Schools Bwizibwera Rutooma Ruhunga Kaguhanzya
Children by school. 422/422 451/451 189/188 712/712
Year at start/at end
Sick/sent home Total 1066
Sick/per school 263 201 300 302
Sick/per term 56/127/80 27/97/77 55/135/110 70/133/99
Tested RDT 1066
Positive RDT 715 27/92/49 20/74/57 28/68/106 35/98/62
MALARIA
Positive vs Negative 168/263 151/201 202/300 195/302
RDT
Treated ACT 715 27/92/49 20/74/57 28/68/106 70/133/99
sent home TOTAL p< 0.001
sent home RDT = p< 0.001
MALARIA
sent home RDT =
NEGATIVE
Discussion
This study shows that the education of children in rural Uganda can be
advanced by training teachers to screen children for malaria using RDT and
provide immediate ACT treatment at school for those infected. This intervention

29
significantly reduced the number of days of schooling missed due to malaria, and
prompt effective treatment is known to reduce long-term complications that
negatively impact a childs ability to learn.
Amongst sick primary school children, who teachers would otherwise just
have sent home, 67.5% tested positive for malaria and received ACT. Within
hours, many of these children felt well enough to rejoin their class rather than go
home, presumably due to the promptness of treatment relative to their symptoms
beginning, and rapid parasite clearance rate achieved by Artemisinin (Benjamin,
et al., 2012). Overall, the duration of absence from onset of malaria symptoms to
return to class for the children teachers treated fell 60.8% when compared to the
duration of absence in the pre-intervention cohort sent home with a presumed
infectious illness.
This translates to a reduction from more than a week of absence to less than 1
day of education lost in children diagnosed and treated with our school-based
intervention. With prior research emphasizing that up to 50% of preventable
school absenteeism is due to malaria (Brooker, et al., 2000), RDT /ACT use by
trained teachers offers an effective means to combat morbidity from malaria
amongst school children.
Importantly, while children diagnosed and treated in this initiative missed less
school because they recovered quickly, from what teachers reported it is also
probable that they recovered more completely. The observation that they
interacted and behaved normally on return to class suggests that having malaria
which was diagnosed and treated promptly had little or no long-term
consequences on their ability to learn. Hence, although not directly measured, it
is likely that school-based RDT /ACT programs can improve overall learning
potential and educational outcome.
In this context it is relevant that malaria in Uganda is predominantly caused by
Plasmodium falciparum (cerebral malaria). Such infection is often associated
with loss of cognitive and fine motor function when diagnosis and treatment are
delayed or absent. Educational compromise often results because the resulting
loss of function may be permanent and can involve all cognitive spheres
(language, attention, memory, visuospatial skills and executive functions)
(Birbeck, 2010; Fernando, et al., 2003; Jukes, et al., 2008; Kihara, et al., 2006; White,
et al., 2013; WHO, 2015).
The potential for school-based RDT/ACT to provide important educational
benefits through the early diagnosis and effective treatment it affords is endorsed
by studies in schools where children take prophylactic chloroquine to prevent
malaria. In these children improved educational attainment is evident in addition
to reduced absence from school, when they are compared to children given a
placebo (Fernando, et al., 2010; Jukes, et al., 2006).
With any school-based intervention teacher participation and the feasibility,
sustainability and validity of what is done are clearly relevant. It was the teachers
in the participating schools who identified that malaria was a barrier to their
pupils education. They participated willingly in the required skills training,
successfully delivered RDT and ACT at school, consistently collected the data
necessary to evaluate efficacy and sustained the intervention. The broader
community (parents, elders, health teams) endorsed a school-based intervention,
reported seeing benefits for their children as it was implemented and felt better

30
educated themselves about how to manage malaria. Importantly, in addition to

being feasible, our approach of making RDT and ACT use accessible to school
children is valid; prior research has shown RDT/ACT can provide rapid,
accurate diagnosis and efficient treatment, is simple enough to adopt outside
health care facilities, and improves the health of those least able to withstand the
consequences of illness (Amexo, et al., 2004; Moody, 2002; Mutabingwa, 2005).
From an educational standpoint, childrens knowledge and awareness related
to malaria also improved. Children now knew how malaria was caused,
symptoms suggesting infection, that diagnosis and effective treatment are
available and the importance of both. Parents also learned first-hand that malaria
can be rapidly diagnosed and that there are benefits from early treatment with
ACT. This later change is significant as the schools were all in low resource rural
settings, where prior to our initiative we identified that only 1 in 4 febrile
children sent home from school received management for malaria that met WHO
recommendations (WHO, 2014). These findings match prior research (Uganda
Bureau of Statistics, 2010); and the school-based RDT/ACT model used by our
trained teachers met the WHO criteria for managing malaria with prompt,
accurate diagnosis and comprehensive treatment within 24 hours of the onset of
illness (WHO, 2014).
Although use of RDT kits and ACT treatment is endorsed at government level,
their use in a school-based program by appropriately trained teachers is novel as
far as we are aware. Importantly, our experiences are broadly in agreement with
previous studies on a), the logistics of RDT/ACT use that indicate that RDT kits
can be stocked and used appropriately outside formal health facilities (Mbonye,
et al., 2015), and b), that training comparable to our instruction of teachers
enables diagnostic kits to be used reliably (Mbonye, et al., 2010). Our diagnostic
rate for malaria of 67.5% in children with presumed infectious illness is directly
comparable to the 72.9% of patients with fever who tested positive in a recent
trial where RDT was introduced into registered drug shops (Kyaabayinze, et al.,
2010). The authors of this trial (designed and implemented by the Ugandan
Ministry of Health) stated their results demonstrated that when introduced as
part of a comprehensive intervention, RDTs can serve to guide better diagnosis of
malaria, and, that there is evidence to support scale up of RDT and ACTs
(Mbonye, et al 2010); this indirectly endorses our school-based approach.
Importantly, we believe our results and the benefits we describe can be
generalized to schools in most areas of Uganda with a similar endemic setting, as
our intervention took place in 4 geographically separate rural schools and all
children identified as sick due to a presumed infectious illness were included.
Also there is the potential for our school-based model for diagnosis and
treatment to be explored in other regions in Africa and elsewhere, as malaria is
the most prevalent parasitic disease that affects human beings worldwide. It is
endemic in 108 countries, estimates indicate that >3 billion people are at risk,
>85% of cases and 90% of deaths occur in sub-Saharan Africa, and that the
burden of disease is highest amongst children in rural and low resource
communities (White, et al., 2013).
The cost and cost-benefit of RDT/ACT are relevant. The cost of ACTs
especially has been identified as a potential barrier to scale up of initiatives that
use them (Mbonye, et al., 2015; Mutabingwa, 2005). Our cost for RDT was about

31
US$ 0.50 per kit. But how easy it is to perform the diagnostic test and train
personnel to use a given RDT kit are additional considerations (Moody, 2002).
We chose to use a relatively expensive (US$ 2.2) single dose ACT formulation to
eliminate any partial treatment bias during our evaluation phase. Now a
conventional 3-day, 6 dose ACT preparation is being used which is considerably
cheaper (US$ 1.0).
Other school-based health promotion programs involving teachers have
already proved valuable and cost-effective, including nationwide anti-helminth
treatment in Uganda (Brooker, et al., 2008b), provision of intermittent
anti-malarial therapy in Kenya (Okello, et al 2012; Temperley, et al., 2008) and
prophylactic chloroquine in Sri Lanka (Fernando, et al., 2006). Teachers have also
administered various diagnostic and treatment protocols successfully in
Tanzanian schools (Magnussen, et al., 2001). Analysis also shows that health
program delivery costs can be reduced by having teachers implement them
(Drake, et al., 2011).
The WHO health promoting school model engages each school in the context of
the local community (Lasker & Weiss, 2003; Zakus & Lysack, 1998) with
recognition of the central role of teachers (St Leger, et al., 2009; Tang, et al., 2009).
This ensures that day-to-day realities and local imperatives are reflected in the
design and conduct of programs developed to address any health problem
(Laverack & Mohammadi, 2011; Macnab, et al., 2014b). In our four project schools
teachers input was central to the development of a realistic school-based strategy
for RDT/ACT, and ongoing active participation by the staff was integral to the
success of the intervention. Interestingly, two funding submissions were
unsuccessful as reviewers stated that teachers would not be prepared to conduct
RDT, not be willing to invest the additional time required to evaluate the
children, and be unable to sustain the intervention over time. Inquiry in Year 1
found the first 2 assumptions incorrect and 3 years later all 4 school communities
continue to provide RDT/ACT, and teachers, pupils and parents all report
benefits to learning in parallel with better health in participating children.
No complications were reported from teachers performing RDTs or giving
ACT. We did follow recommendations to deploy RDT expertise by conducting
our teacher training using good visual aids and ample opportunities to practice
practical skills (Murray, et al., 2008). Neither the refresher training provided
midway through the project nor the confirmatory checks by a laboratory on
every 50th positive RDT sample identified any concerns; both were considered
important for quality assurance.
We recognize limitations in what we report. Principally, we recognize that the
outcome measure encapsulating educational compromise and malaria morbidity
that we used was absence from onset of illness to return to school. Using this
measure we can only compare Year 2 data for children RDT positive for malaria
with Year 1 data from the overall cohort sent home with presumed infectious
illness. This is because in Year 1 it was not feasible to follow each child in the
community to establish if parental care resulted in a diagnosis of malaria, and if
so what treatment ensued. However, the >10 fold difference in the duration of
absence between children in the intervention and pre-intervention years strongly
supports benefit from the school-based RDT/ACT model that we designed and
prospectively evaluated. Also, because 67.5% of sick children in Year 2 were RDT

32
positive and promptly treated according to WHO guidelines, this reflects a

significant reduction in the burden of illness from malaria, as this was a
community where the majority (74%) would not have been taken for appropriate
care by their parents had they been sent home, based on the behaviors we
documented prior to our intervention. In addition it is reasonable to assume that
the percentage of sick children in the pre-intervention year who had malaria
would have been similar to the intervention year (67.5%); in which case the
malaria incidence rate across the 4 schools for the 2 years was 79%, reflecting a
significant burden of disease.
Active learning by children during the intervention did increase their
knowledge about malaria, as by the early months of Year 2 essentially 100% of
children now knew the signs and symptoms associated with the onset of illness
and were aware that malaria can be diagnosed and treated effectively, in contrast
to < 20% having this knowledge at the start of Year 1. However, it is unlikely that
this new knowledge resulted in any substantial bias in our results, as the process
of identifying children in the classroom who were sick and needed to be sent
home was the same in both years; children did not self-select themselves, and
teachers had the same knowledge in Year 1 and 2 because of the
community-wide dialogue and active learning that led to introduction of
school-based RDT/ACT.
Our belief is that this project also benefited the broader community as
evaluation indicated new knowledge was learned and practices and behaviors
related to malaria began to change. Prior research has identified that improved
health knowledge and altered health-related behaviors are often evident in the
community as a whole where comprehensive school-based programs are
delivered (Macnab, et al., 2014b; Stewart-Brown, 2006; Tang, et al., 2009). Also, as
interventions such as ours improve diagnosis and treatment of a large number of
individuals, malaria transmission rates within the community tend to be
reduced, because each treated individuals malaria episode will be shorter, less
severe, and hence less likely to result in mosquito-borne transmission to others
(Malaria Consortium, 2016; Benjamin, et al., 2012); this is a secondary benefit of
importance.
Malaria remains a priority area for governments, aid foundations, health care
providers and educators worldwide (Brooker, et al., 2008; Mbonye, et al., 2015;
WHO Regional office for Africa, 2013). While efforts to promote preventive
measures rightly exist alongside those that advocate better diagnosis and
treatment, it must be recognized that in addition to addressing limited supplies
in low resource environments education and awareness on why and how to
employ prevention are also lacking; in Uganda, < 50% of households own a
mosquito net and 77% of children do not sleep under insecticide treated nets
(Uganda Bureau of Statistics, 2010). Novel and effective avenues for enhancing
intervention are constantly being sought, and schools are being used increasingly
as platforms for delivering simple, safe and cost-effective programs that promote
knowledge and healthy practices (Macnab, et al., 2014; Okello, et al., 2012).
Adoption of our model by national Health Ministries is logical as the same
RDT/ACT supplies provided to government clinics could be made available to
schools. Similarly, this school-based program lends itself to broad adoption by
NGOs and Agencies promoting effective malaria intervention, or expansion

33
through sponsorship of schools by philanthropic individuals or commercial

partners as has happened with our program.
The low complexity, diagnostic reliability and WHO endorsement of RDT, and
the efficacy and beneficial nature of ACT invite their use by appropriately trained
personnel without formal medical or nursing education. But the missing link
thus far has been the social engagement to educate potential users and make this
approach accessible to rural populations (Mutabingwa, 2005). Now our study
provides evidence that supports the feasibility of engaging teachers to deliver
school-based RDT/ACT, and that the negative impact of malaria on education
caused by prolonged and/or repeated absence from school can be significantly
reduced by implementing this health promotion model.
Conclusions
School-based RDT/ADT provides a valid extension of proven care entities able
to positively impact the high morbidity from malaria to a child population
known to be at significant risk.
Providing RDT/ACT in the school setting is a logical response to the global
burden of malaria on the health and educational potential of children, especially
in low resource settings.
Childrens ability to learn is enhanced by rapid diagnosis and prompt,
effective treatment because they miss significantly less school. Communities also
report their children appear healthier; probably as early intervention reduces
overall morbidity in both the short and long term.
Implementing school-based RDT/ACT is feasible. Communities who
recognize the relevance are readily engaged, and teachers have welcomed
training and sustained program delivery.
We suggest that our health promotion model of providing RDT/ACT in the
school setting is broadly applicable to other schools in sub-Saharan Africa, and in
other low resource settings globally where morbidity from malaria is high.
Acknowledgement
This paper is dedicated to the memory of Faith Gagnon who helped conceive
the concept of school-based care for children with malaria at the Stellenbosch
Institute for Advanced Study (STIAS) international colloquium on WHO Heath
Promoting Schools in 2011, and contributed throughout her life to medical
research to improve the lives of children.
This project was made possible by financial support from the Hillman Medical
Education Fund.
We acknowledge the many contributions made by the teachers and children
who participated and the collaboration and support of the parents, elders and
village health teams in the four rural Ugandan communities where the schools
were located.
The authors collaborated as a team from the Health and Development Agency
(HEADA) Uganda to plan, deliver and evaluate this health education project.
HEADA is a non-governmental agency established in Mbarara to implement
comprehensive health education, treatment, and support programs in schools
and rural communities in Western Uganda.

34
Authors affiliations: Stellenbosch Institute for Advanced Study, Wallenberg

Research Centre, Marais Street, Stellenbosch, South Africa and University of
British Columbia, Vancouver, Canada (AJM); Health and Development Agency
(HEADA) Uganda, Plot 49, Akiiki Nyabongo Road, P.O. Box 1707, Mbarara,
Uganda (SM, RM, AE, HK); Hillman Medical Education Fund, 1870 Ogden
Avenue, Vancouver, BC V6J 1A1 Canada (RS).
All authors have no conflict of interest to declare.
Correspondence to Macnab A.J. (amacnab@cw.bc.ca).
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Vol. 15, No. 7, pp. 38-52, June 2016
Theory of Planned Behavior: Sensitivity and

Specificity in Predicting Graduation and Drop-
Out among College and University Students
Catherine S. Fichten,1234 Rhonda Amsel,3 Mary Jorgensen,2 Mai N. Nguyen,2

Jillian Budd,2 Alice Havel,12 Laura King,5 Shirley Jorgensen,1 & Jennison
Asuncion2
1Dawson College, 2Adaptech Research Network, 3McGill University, 4Jewish
General Hospital, 5Cgep Andr-Laurendeau

Montreal, Canada
Abstract. We examined sensitivity and specificity when using the three

theory of planned behavior (TPB) scales (Perceived Behavioral Control,
Subjective Norms, Attitude) to predict graduation and drop-out in a
longitudinal study of 252 college and university students with
disabilities and in a separate cross-sectional study of a random sample
of 1380 junior/community college students. The results (a) show the
utility of the TPB in predicting graduation, (b) underscore that when
predicting outcome, graduation and drop-out are not polar opposites,
and (c) highlight the need to consider sensitivity and specificity
separately. We discuss the implications of using different scale cutoffs
depending on the goal of testing as well as uses of the TPB scales in
research and practice.
Keywords: theory of planned behavior, sensitivity, specificity,

graduation, college, university, prediction, longitudinal cross-sectional
Introduction.
Academic persistence and graduation are important to students (better jobs),
colleges and universities (funding issues), parents (who often pay the fees), as
well as society at large (better educated work force). Postsecondary institutions
are highly invested in improving retention and graduation rates (Selingo, 2015).
Yet, postsecondary graduation rates are typically below 55% (ACT, 2006;
Jorgensen et al., 2005; Shapiro, Dundar, Yuan, Harrell, & Wakhungu, 2014).
Prediction of graduation and drop-out has a relatively poor track record (e.g.,
Jorgensen, Ferraro, Fichten, & Havel, 2009). Models are especially poor at
predicting drop-out. This is the case even if many variables such as grades,
gender, and survey results are included (Jorgensen, Fichten, & Havel, 2008).
What is needed to identify students at risk is a brief paper and pencil measure
that correctly identifies both those likely to graduate and those likely to drop
out.

39
We recently developed a questionnaire based on Ajzens (2002, 2012) Theory Of

Planned Behavior (TPB) and tested it in a sample of 845 college students (Fichten
et al., 2016) and 611 college and university students with various disabilities
(Fichten, et al., 2014). The TPB suggests that behavior is influenced by Intention
to carry out the behavior. Intention is predicted by: Perceived Behavioral Control
(i.e., how easy or difficult it is to enact the behavior - in this case graduation),
Subjective Norms (i.e., perceived views of individuals important in the students
life), and Attitude (i.e., favorable or unfavorable evaluation of graduation).
Ajzens ( n.d.) model in Figure 1 illustrates the TPB. The model has been shown
to be highly effective and influential in numerous areas, including
postsecondary contexts (Kovac, Cameron, & Higaard, 2014; Kyle, White, Hyde,
& Occhipinti, 2014; Prentice, Caska, & McLaughlin 2009; Schuchart, 2013;
Thomas, 2014). Indeed, our studies of intention to graduate among
postsecondary students with and without disabilities show that the TPB model
predicted 44% of the variability in intention to graduate among college students
in general (Fichten, et al., 2016), and 25% of the variability among students with
disabilities (Fichten, et al., 2014).
Figure 1. Theory Of Planned Behavior
Sensitivity, Specificity, True and False Positives and Negatives. It is not

possible to examine actual graduation and drop-out rates while students are
enrolled only the intention to do so. Yet, it is during this period that it is most
important for institutions to identify individuals at risk for drop-out as this is
when colleges and universities can implement remedial or other forms of
programming to prevent drop-out.
Typically a single score obtained from a logistic or multiple regression is used

when using composite scores or a questionnaire to predict intention to graduate
- including in our own studies (Fichten, et al, 2014, 2016). Most of the time
researchers are pleased when over 25% of the variability in intention to graduate
scores is predicted. The problem with this approach, however, is that it takes
into account both students who definitely intend to graduate as well those who

40
are thinking of dropping out. What if the measure predicts one better than the
other?
In an example from medicine (cf. MedicineNet.Com, n.d.), if a test designed to

detect cancer returns a positive result, but the person does not actually have
cancer (false positive), this would be very undesirable. Similarly, it is also
undesirable for a test to return a negative result when the person actually does
have cancer (false negative). Ideally, a test has to be accurate in predicting
both true positives and negatives (i.e., correct predictions) while avoiding false
positives and negatives. The typical way to express this is through sensitivity
and specificity of a score (see Table 1 for definitions). Such concepts are
frequently utilized in medicine (e.g. Baldessarini, Finklestein, & Arana, 1983),
but rarely in social psychology or education. A notable exception is a study by
Jorgensen et al. (2008), which used predictors based on individual and
institutional factors; the results showed that the variables did a relatively good
job of predicting graduation but a poor job of predicting drop-out. This
illustrates the notion that in this context, graduation and drop-out are not simply
two poles of a continuum.
An illustrative example. The example in Table 1 illustrates this dilemma. Here, a

hypothetical sample of 1000 students complete a questionnaire intended to
predict whether they will graduate or not. Four years later 50% of the students
have graduated and 50% have dropped out. Thus it is possible to determine
actual graduation and drop-out .
Table 1. Hypothetical Example of 1000 College Students Where 500 Actually

Graduated and 500 Actually Dropped Out
Actual
Graduated Dropped Out Marginal Sum
Will Graduate a =450 c =400 850
Predicted
Will Drop Out b = 50 d = 100 150
Marginal Sum 500 500 1000
Note. Sensitivity = 90%, Specificity = 20%
Actual
Graduated Dropped Out Marginal Sum
Will Graduate a = True Positive c = False Positive a+c
Predicted
Will Drop Out b = False Negative d = True Negative b+d
Marginal Sum a+b c+d a+b+c+d
Sensitivity = a/(a+b), True Positive/All Actual Graduates; Specificity = d/(c+d) True

Negative/All Actual Drop-outs
False positive: A result that indicates that a condition is present when it is not (e.g., if a test
designed to detect cancer returns a positive result but the person does not have cancer).
False negative: A result that appears negative when it should not (e.g., if a test designed
to detect cancer returns a negative result but the person actually does have cancer).

41
Table 1 shows that our hypothetical questionnaire correctly classified 550 of the
1000 students (i.e., 55% overall correct classification): 450 of the 500 those who
actually graduated graduates (true positive) and 100 of the 500 students who
actually dropped out (true negative). But what about those who were
misclassified, including the 50 graduates who were misclassified as drop-outs
(false negative) and the 400 students who dropped out but were classified as
likely to graduate (false positive)?
Although the overall accuracy of the prediction is 55%, the sensitivity of the
measure (i.e., percentage of the 500 actual graduates who were predicted to
graduate (n = 450)) in the hypothetical example is 90%. Not bad for predicting
who will graduate! But what about the drop-outs? Specificity (proportion of 500
students who actually dropped out who are predicted to drop out (n = 100)) is
only = 20%. Thus, the questionnaire did an excellent job of predicting which
students will graduate, but a very poor job of predicting who will drop out.
Circumstances determine whether it is the sensitivity or the specificity of a test

that is more important, or if they are equally important. To predict the number
of students who will persist into the next semester, sensitivity is more important.
If an institution wishes to spend scarce resources on preventing drop-out,
however, then specificity is more important.
Present Investigation. This paper reports two studies. Study 1 evaluated, in a

longitudinal investigation, how well the three TPB components (Attitude,
Subjective Norms, Perceived Behavioral Control) predicted behavior (i.e.,
graduation and drop-out) 3-4 years later in the sample of postsecondary
students with disabilities whom we studied in 2010 (Fichten et al., 2014). We also
explore the relationship between intention to graduate and behavior (i.e., actual
graduation and drop-out) 3-4 years later in the Study 1 sample. This relationship
is important because intention to graduate is a measure often used as a proxy for
actual persistence or graduation while students are still enrolled (DaDeppo,
2009; Thomas, 2014). We hypothesize (1) that there will be a strong relationship
between intention to graduate and actual graduation and drop-out 3-4 years
later, and (2) that the three TPB components will do well predicting behavior
(graduation and drop-out) 3-4 years later. We also explore whether sensitivity or
specificity would be greater.
In Study 2, we conducted a secondary analysis of data from our study of

currently enrolled college students (Fichten et al., 2016). Here we explored
sensitivity and specificity by dividing students into two groups based on the
entire samples mean intention to graduate score. The two groups were those
who had a strong or a weak intention to graduate.
Method
Theory of Planned Behavior Questionnaire. A one page measure with 4

subscales was adapted from Davis, Ajzen, Saunders, and Williams (2002)
(available in Fichten et al., 2016). Six-point Likert scaling (Strongly Disagree to
Strongly Agree) is used to evaluate intention to graduate (e.g., All things

42
considered, it is possible that I might not complete my program of study),

perceived behavioral control over graduation (e.g., I can overcome any obstacles
or problems that could prevent me from completing my program of study if I
want to), and subjective norms related to graduation (e.g., Most people who are
important to me expect me to complete my program of study). Attitude toward
graduation is rated on 6-point Likert-type scales (e.g., very undesirable to very
desirable ). Scoring is the average value of each scale. Attitude, subjective norms
and perceived behavioral control scale means can be added together for a Total
TPB score. Fichten et al. (2014) reported acceptable psychometric properties for
the measure: Cronbachs alphas ranged from .71 to .83 and test-retest reliability
ranged from .62 to .74. Preliminary concurrent validation data were acceptable.
Higher scores indicate more positive views about graduation.
Study 1. Participants
Participants consisted of 252 Canadians with disabilities who had been enrolled
in a diploma or degree program in the spring 2010 semester and who, by the end
of 2013, had either graduated from this program (193 graduates: 126 females, 67
males) or dropped out (59 premature leavers: 38 females, 20 males, 1 did not
indicate). 175 individuals had attended a university and 77 a junior/community
college. Participants had been enrolled in 75 different Canadian postsecondary
institutions and were, on average 32 years old at follow-up. Most participants
had been pursuing a bachelors degree (n = 120). There was no significant
difference between groups on full-time (n = 204) versus part-time (n = 46) status,
or on the number of disabilities/impairments reported in 2010. Both groups
were most likely to have attention deficit hyperactivity disorder, or a learning
disability, or a mental health related disability. The only significant difference
between graduates and premature leavers was on mental health related
disability, with a larger proportion of premature leavers reporting this, X2(1,252)
= 6.99, p = .014, =.44.
Study 1: Procedure
In a protocol approved by the Dawson College Research Ethics Board in

the fall 2013 term we followed up on a sample of 611 Canadian students with
disabilities who had been enrolled in degree or diploma programs in the spring
2010 semester and on whom we reported in a previous paper (Fichten et al.,
2014). We tried contacting students through the email or postal mail they
provided in 2010. Two-hundred and fifty individuals could not be reached. Of
the 361 individuals whose mail did not bounce back, 284 responded (return rate
= 79%). Thirty-two of them were still enrolled in the same program as in 2010;
they are not of interest here. Only the 193 graduates and 59 premature leavers
are involved in the present investigation. Mean duration of the follow-up was
3.75 years. Participants were asked: Did you graduate with a (name of the
participants diploma/degree program in 2010) at (name of the participants
school in 2010)?

43
Study 1: Results
Comparing the 2010 scores of graduates and premature leavers. Results show that
while participants were still students, there were significant differences (p < .001)
between graduates and premature leavers on all TPB scales, with graduates
having more favorable scores; Cohens d scores range from .38 to .93.
Predicting graduation and drop-out. To evaluate the utility of the TPB model we
carried out a series of discriminant analyses to predict, based on the 3 TPB
predictors (i.e., Attitude, Subjective Norms, Perceived Behavioral Control)
completed almost 4 years earlier, which individuals actually graduated or
dropped-out. Table 2 shows that, overall, 74% of the sample was correctly
classified. The canonical correlation was .54, p <.001. Correlations to the
discriminant function are .899 for Perceived Behavioral Control, .640 for
Subjective Norms, and .339 for Attitude. Sensitivity (percentage of actual
graduates who were predicted to graduate) was 77%, specificity (percentage of
actual premature leavers who were predicted to drop- out) was 63%. Results for
male and female participants were very similar. Table 3 shows how TPB scores
obtained in 2010 are related to each other.
Table 2
Study 1: Classification Tables - Discriminating Graduates and Premature Leavers
Actual Group
1
Predicted by 3 TPB predictors Predicted by Intention to Graduate 2
Predicted Group Graduates Premature Leavers Graduates Premature Leavers
Count Graduates 149 22 170 28
Premature Leavers 44 37 23 31
% Graduates 77% 37% 88% 47%
Premature Leavers 23% 63% 12% 53%
1
3 TPB predictors: 74% of original grouped cases correctly classified. Sensitivity = 77%, Specificity = 63%
2
Intention to Graduate as the predictor: 80% of original grouped cases correctly classified. Sensitivity = 88%, Specificity = 53%
Intention and actual graduation and dropout. We also examined how closely
intention to graduate was related to actual graduation and drop-out. Results in
Table 2 show, similar to the analysis on the three TPB scales, that 80% of
participants were correctly classified. However, while graduates are very well
classified, premature leavers are not (sensitivity = 88%, specificity =53%). Again,
males and females had similar results.
Study 1: Discussion
Results show that intention to graduate and actual graduation and drop-out
were closely related (Hypothesis 1). In addition, although the TPB questionnaire
correctly classified 74% of the sample (Hypothesis 2), sensitivity (predicting
graduates) was 77%, while specificity (predicting premature leavers) was only
63%.

44
Study 2: Participants and Procedure

A random sample of 1380 (796 females, 576 males, 8 other/prefer not to say)
Canadian junior/community college students participated. Mean age was 20
(SD = 4, range 18-45). All students had completed a minimum of 1 semester of
studies. All completed the TPB scales in class during the first few days of the fall
2014 academic term in a protocol approved by the Dawson College Research
Ethics Board. Data on 854 of these students were reported in a previous paper
(Fichten et al., 2016).The main outcome measure was intention to graduate. This
was used both as a continuous variable in a multiple regression analysis and as a
binary score (strong and weak intention to graduate) based on the scale mean (M
= 5.673).
Study 2: Results
Comparing TPB scores of those with strong and weak intention to graduate. Results
show significant (p < .001) moderate to strong differences (Cohens d ranges
from .52 to .78) between the two groups on all TPB predictor scales, with those
with strong intention to graduate having higher scores on all three predictor
scales: Perceived Behavioral Control, Subjective Norms, and Attitude.
Predicting Intention to graduate. Pearson correlation coefficients show that the

relationships between Intention to graduate and the three TPB predictors are
quite strong (r values in Table 3 range from .369 to .568, p <.001), with Subjective
Norms being most closely and Attitude least closely related to Intention to
graduate. Results of a multiple regression to predict Intention to graduate based
on the three TPB predictors (Attitude, Subjective Norms, Perceived Behavioral
Control) in Table 4 show that together, these were able to predict 44% of the
variability in Intention to graduate; the part correlations in Table 4 document
unique variation for each predictor (i.e., all three TPB predictors make a
substantial contribution). Subjective Norms was the most and Attitude the least
important predictor. Results for males and females were similar.
Table 3. Correlations Among TPB Variables
Perceived
Behavioral Subjective
Intention Attitude
Control Norms
Intention ____ 0.417 0.568 0.369

Perceived Behavioral Control 0.442 ____ 0.282 0.208
Subjective Norms 0.417 0.280 ____ 0.193
Attitude 0.385 0.362 0.267 ____
Note. Pearson correlation coefficients.
Study 1 correlations in 2010 below the diagonal. n = 252.
Study 2 correlations above the diagonal. n = 1384

45
Table 4. Study 2. Multiple Regression: Predicting Students' Intention to Graduate

from the 3 TPB Predictors
Variables B SE B Part Pearson

Correlation Correlation
TPB: Perceived Behavioral Control .231 .020 .240 0.227 0.417

TPB: Subjective Norms .384 .018 .455 0.432 0.568
TPB: Attitude .206 .018 .232 0.224 0.369
R2 .444
To examine how well the three TPB variables predicted binary Intention to
graduate, we performed a multiple discriminant analysis. The predicted variable
was Intention to graduate divided into strong and weak Intention based on the
mean Intention score (M = 5.673). Table 5 shows that, overall, 73% of the sample
was correctly classified. The canonical correlation was .451, p < .001. Correlations
to the discriminant function are .752 for Perceived Behavioral Control, .550 for
Subjective Norms, and .642 for Attitude. Results for males and females were,
again, very similar. Sensitivity was 77% and Specificity was 63%.
Table 5. Study 2: Discriminating Those with Strong and Weak Intention to Graduate
Study 2 Classification Table: Based on Total TPB Scores

Study 2 Classification Table: 3 PTB Predictors 1
Above and Below the Sample 2 Median2
Actual Group Actual Group
Strong Intention to
Predicted Group Weak Intention to Graduate Strong Intention to Graduate Weak Intention to Graduate
Graduate
Count Strong Intention to Graduate 752 151 585 99
Weak Intention to Graduate 222 255 389 307
% Strong Intention to Graduate 77% 37% 60% 24%
Weak Intention to Graduate 23% 63% 40% 76%
Note. Predicted and Actual Group (i.e., Strong and Weak Intention to Graduate) is based on the Sample 2 Intention mean of 5.67. Weak =<5.67; Strong >5.67.
1
3TPB predictors: 73% of original grouped cases correctly classified. Sensitivity = 77%, Specificity = 63%
2
Total TPB Scores Above and Below the Sample 2 median of 16.21 as predictor: 65% of original grouped cases correctly classified. Sensitivity = 60%, Specificity = 76%
Using the Total TPB score. The Fichten et al. (2014) study on students with
disabilities used ROC (Receiver Operating Characteristic) curves1 to establish a
cutoff score based on the sum of the 3 TPB scales (Total TPB) to use in predicting
graduation and drop-out. It was suggested that a score of 15.15 could be used as
a tentative cutoff where sensitivity and specificity are roughly equivalent and
1
The ROC curve is a plot of the true positive rate against the false positive rate for the different
possible cutpoints of a diagnostic test. It shows the tradeoff between sensitivity and
specificity. Tape, T.G. (undated). Plotting and interpreting an ROC curve. In Interpreting
Diagnostic Tests. Retrieved from http://gim.unmc.edu/dxtests/roc2.htm

46
will identify 2/3 of both those who are likely to graduate and those who are
likely to drop out. To evaluate the utility of this cutoff in determining which
individuals could be targeted for remediation and which could not, here we
conducted a multiple discriminant analysis using the binary score as the
predictor variable. The predicted variable was again Intention to graduate
divided into strong and weak intention based on the mean intention to graduate
score (M = 5.673). This resulted in specificity of 89% but a very poor sensitivity
(46%).
To examine whether the present samples median total TPB would result in
better specificity, we used the Study 2 median score of 16.21 and again predicted
binary Intention to graduate. Table 5 shows that, overall, only 65% of the sample
was correctly classified. The canonical correlation was .325, p < .001. However,
sensitivity was 60% and specificity was 76% Thus, raising the Total TPB cutoff
score resulted in better specificity but poorer sensitivity.
Study 2: Discussion
Results show that when we divided participants on the mean Intention to
graduate score, 73% of the sample was correctly classified. Sensitivity was 77%
and Specificity was 63%, values virtually identical to those of Study 1. Again, the
three TPB predictors were better able to predict those who strongly intended to
graduate (sensitivity) from those whose intention to graduate was weaker
(specificity). Attempts to improve specificity by increasing the value of the cutoff
were successful, but resulted in poorer sensitivity.
General Discussion
Our goal was to examine the usefulness of the Theory of Planned Behavior (TPB)
scales in predicting graduation and drop-out. It should be noted that all scales of
the TPB model fit on a single page, so it is easy and fast to administer (see
Fichten et al, 2016). Some data already exist concerning its utility when
evaluating intention to graduate and actual graduation and drop-out when
measures were administered concurrently (i.e., not longitudinally) in samples of
individuals with various disabilities (Fichten et al., 2014) as well as nondisabled
college students (Fichten, et al., 2016).
What is unique about the present investigation is that here we examined, in a

longitudinal study, (a) how well responses on the TPB questionnaire (completed
while students were still enrolled), predicted graduation and drop-out several
years later, (b) how closely the intention to graduate component of the TPB
model, is related to actual graduation and drop-out, and (c) how useful the TPB
model and questionnaire are in predicting which specific students will drop out
or graduate in a large random sample of junior/community college students.
As predicted (Study 1 Hypothesis 1), we found that a strong relationship exists

between questionnaire responses concerning intention to graduate obtained
three to four years earlier, and actual graduation and drop-out. This prediction
was confirmed, as 80% of graduates and premature leavers in Study 1 were

47
correctly classified by intention to graduate scores obtained almost 4 years

earlier.
We also predicted and confirmed (Study 1 Hypothesis 2) that the three TPB
scales will be successful in predicting graduation and drop-out 3 to 4 years later
as we found that 74% of participants were correctly classified 4 years later. This
finding is consistent with the Fichten et al. (2014) results, which also examined
graduation and drop-out, but in a cross-sectional manner. Results of that study,
however, were not conclusive because the three TPB scales were completed
retrospectively. The present longitudinal study responded to this concern by
showing that TPB scores obtained three to four years earlier were successful in
predicting actual outcome. Similarly, we found that the three TPB scales were
successful in predicting intention to graduate among Study 2 students currently
enrolled, as the three TPB components predicted 44% of the variability in
intention to graduate in a multiple regression analysis, with all three TPB
predictors contributing to the prediction.
Applications of the TPB scales
The findings suggest that correlates of the three TPB components are likely to be
of interest if an institution wishes to improve graduation rates. For example,
information campaigns geared toward the entire student body about the value
of the schools diplomas/degrees in obtaining a job, getting a higher salary, job
satisfaction, and acceptance to graduate school can be used to increase the
favorability of attitudes toward graduation. Enhancing perceived behavioral
control, which combines self-efficacy and control expectations, can also be
useful. There is an extensive literature on ways to improve academic self-efficacy
(e.g., Schunk & Ertmer, 1999; Komarraju & Nadler, 2013) and to strengthen
control expectations (e.g., Stupnisky, Renaud, Daniels, Haynes, & Perry, 2008).
For example, perceived behavioral control can be manipulated by helping
students attribute success on projects, assignments and exams to effort and
ability, rather than to external factors such as chance or luck, by providing
positive feedback when students are doing well academically, and by helping
students learn that grades can be improved through effort. Letting students
know that their peers and others whom they value (e.g., famous politicians,
writers, scientists, musicians, sports figures, actors) also believe that graduation
is important could increase Subjective Norms (i.e., values of those important to
the students).
Sensitivity and Specificity
It appears that the TPB provides a good basis for predicting both intention to
graduate and actual graduation several years later. As noted earlier, however,
such a one dimensional prediction is inadequate when the goal is to find out
aspects related to graduation (sensitivity) and drop-out (specificity) separately.
Indeed, the sensitivity and specificity of the results based on the three TPB scales
in our investigation show a less successful outcome. As noted earlier, we were
unable to make predictions about sensitivity and specificity, and it is here that
the findings make interpretation difficult.

48
The results of both studies show that sensitivity (i.e., predicting who will
graduate) was generally quite impressive, with a score of 77% in both Studies 1
and 2. However, predicting who will drop out (i.e., specificity) was weaker (i.e.,
63%) in both studies.
In summary, the model was reasonably good at predicting who will graduate,
but not who will drop out. Such results are similar to findings by Jorgensen et al.
(2008) using a very different array of predictors. Moreover, the results highlight
the importance of noting that graduation and drop-out, when it comes to
predicting these, are not polar opposites. For example, providing financial aid
may help prevent drop-out of those in financial need, but is not likely to increase
the likelihood of graduation for the entire college population (cf. Dwyer,
Hodson, & McCloud, 2013; Gentry, 2014).
Improving specificity and identifying individual students who are likely to drop
out. Using a cutoff on the Total TPB score (i.e., the sum of the three TPB
components: Attitude, Subjective Norms, and Perceived Behavioral Control) was
quite successful in improving the prediction of drop-out and in identifying
individual students who are likely to drop-out or to graduate.
This approach was also used in the Fichten et al. (2014) study, where a cutoff of
15.15 was suggested for further investigation. When we used this cutoff, we once
more obtained good sensitivity (89%) but poor specificity (46%). To try to
increase the specificity of the score in Study 2 we used the current samples
median of 16.21. This resulted in much improved specificity (75%) at the cost of
relatively poor sensitivity (60%).
See-saw. Thus, the lower the cutoff, the higher the sensitivity, while the higher
the cutoff, the better the specificity. What cutoff to use depends on the goal of
testing.
Using and Studying the Theory of Planned Behavior in Predicting Graduation

and Dropout
The one-page measure comprising the three Theory of Planned Behavior scales
is available in Fichten et al. (2016). It can be added to college and university
institutional research measures for further investigation. It is free, takes less than
5 minutes to complete, and appears to have good potential for predicting
intention to graduate as well as actual graduation. Although the three
components do not perform especially well in predicting drop-out, using the
Total TPB scale and adjusting the cutoff can result in acceptable specificity and,
thereby, predict which students are likely to drop out.
Three types of scores are typically used when predicting graduation: predicting
the percentage of the variability in scores, such as the R2 used in our
investigation; predicting an overall single score reflecting graduation/dropout
in discriminant analysis classification tables that are based on the percentage of

49
original cases correctly classified; and the use of individual students scores to
identify who is likely to drop-out and who to graduate.
The type of analysis that should be used depends on the purpose of testing. If it
is to study characteristics that predict graduation, then a single score that reflects
the variability that is explained by the three predictors, such as R2, or the overall
single score from a multiple discriminant analysis classification table, will do
quite well.
Different cut-off scores: implications of the see-saw. If the goal is to obtain an idea
about the success of the schools recruitment policies or to predict retention into
the next semester, then increasing sensitivity is likely to be most important. Our
results suggest that using the Total TPB score with a relatively low cutoff will
increase sensitivity.
If the purpose it is to determine which specific students to target in intervention

programs to prevent drop-out, then increasing specificity is most important.
This is best accomplished by using the Total TPB measure with a high cutoff.
Schools can consider using different cutoff scores depending on their needs and
resources. For example, if the goal is to identify as many of the students who are
likely to drop out as possible in order to target them for interventions such as
remedial efforts, financial aid possibilities, how to study and exam anxiety
workshops, etc., and the school has adequate resources so that false negatives
(falsely identifying students who are actually likely to graduate as potential
drop-outs) do not matter, then setting the cutoff on the Total TPB well above the
median is likely to yield the desired results. This can allow faculty and those
responsible for student services and student success to better support these
students with early interventions. If, on the other hand, resources are scarce, and
the school does not wish to spend limited resources on remediating those who
are likely to graduate anyway, then setting a lower cutoff can be the solution.
The present investigation has several limitations which can affect the
generalizability of the results. First, we must note that both Studies 1 and 2 are
correlational, and, thus causality cannot be inferred. In addition, in spite of the
relatively lengthy follow-up period, Study 1 participants constitute an atypical
group (i.e., individuals with disabilities). In Study 2 we used a random sample of
over 1000 students. However, they were enrolled in only two junior/community
colleges, and since they had not yet graduated, only intention to graduate could
be studied. Moreover, in Study 2 the TPB scales and intention to graduate were
administered concurrently, mainly in the beginning of the semester.
In future investigations we suggest that the TPB model be used to study

graduation and drop-out in large, preferably random samples of students at
different levels (e.g., college diploma, bachelor, graduate studies, etc.), and fields
of study (e.g., sciences, arts, etc.), at various levels of credential completion (e.g.,
first year vs. near completion of the credential). It is possible that students are

50
more optimistic about graduation at the beginning of the semester than at other
times (A. Havel, personal communication, August, 2014), so the timing of
administration could be varied and its impact investigated. Since students are
most likely to drop out early in their academic career (Jorgensen, Ferraro,
Fichten, & Havel, 2009) it is worthwhile to examine TPB scores during the first
or second semester of studies. Persistence from one semester to the next, rather
than graduation, can be used as the outcome variable. The generalizability of the
model to students with different backgrounds, both ethnic and socioeconomic,
as well as different individual differences, including disability, gender, and age
needs further evaluation.
Future research should examine different ways of extending the model (cf.
Stone, Jawahar, & Kisamore, 2010) to improve the sensitivity and specificity of
predicting graduation and drop-out. One possibility includes examination of
reasons for drop-out (Jorgensen, Ferraro, Fichten, & Havel, 2009) and exploring
how these are related to the three TPB predictors.
We also suggest that future research examine the impact of different cutoff
scores, with the possibility of ranking students on intention to graduate and
evaluating whether this ranking works to predict actual behavior. If so, then it
can be possible to determine the nature of effective interventions to increase
intention to graduate among these students by the school, government, families,
and the students themselves.
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53

Vol. 15, No. 7, pp. 53-64, June 2016
Special Education Administrators Ability to

Operate to Optimum Effectiveness
Juanell D. Isaac, Teresa M. Starrett, and David Marshall

Texas Womans University
Denton, TX, USA
Abstract. The current study attempts to identify the reasons that special
education administrators are able to operate to optimum effectiveness
and barriers that prevent this in the current educational climate.
Quantitative data was collected through surveys from special education
administrators in the state of Texas. Descriptive statistics and the
Friedman Test were used to analyze the data. The top three reasons
special education administrators were able to operate to optimum
effectiveness are sufficient knowledge concerning special education,
support from central administration, and professional background and
education while the barriers were insufficient number of staff, lack of
time, and insufficient financial resources.
Keywords: special education administrator; perceptions; effectiveness;

quantitative; Friedman Test
Introduction
Special education administrators have a diverse and complex role in
overseeing the individualized educational programs for students with
disabilities. Decisions made by special education administrators impact every
aspect of the special education program within a school district (Gore, 1995) and
every decision made by special education administrators is subject to challenge
unlike other administrative decisions (Tate, 2010). Increasing demands on
special education administrators to meet the complex needs of students with
disabilities, extensive budget cuts, accountability requirements of No Child Left
Behind (NCLB), severe shortages of qualified staff, and possible litigation
regarding the Individuals with Disabilities Education Improvement Act (IDEIA)
calls for effective practices in the administration of special education programs
(Tate, 2010). Gore (1995) described effective special education leadership as a
balancing act, advocating for the best possible services, empowering staff,
acknowledging the needs of parents, and collaborating with other
administrators (p. 3). Various factors have been identified through past
research that can influence special education administrators ability to operate to
optimum effectiveness.

54
In a seminal study conducted by Kohl and Marro (1971), special education

administrators were asked to identify roadblocks that kept them from using
their time effectively in the administration of special education. Administrators
considered central office demands as the primary roadblock followed by lack of
administrative assistance, finances, clerical help, program facilities, and office
space or facilities. As noted by Kohl and Marro (1971), five of the six reasons
dealt with resources while the primary reason focused on organizational
demands. An additional question asked by Kohl and Marro (1971) concerned
effectiveness, If you could wave a magic wand, what one thing would you
want to have to increase your effectiveness as a special education
administrator? The responses inherently identified nine areas of concern by
order of frequency: insufficient staff; limited time to consult, supervise, and
develop new programs; limited financial resources for instructional materials,
staff, and new programs; need for development of adequate knowledge base in
the areas of supervision, placement and identification of students with
disabilities, general administrative practices, and self-improvement; improved
communication between parents, community, staff and administrators; the need
for line authority vs. staff status to facilitate more control of programs,
participation in policy decisions, and effective supervision; inadequate
equipment and facilities for special education programs; organizational issues
regarding student services and placement, identification, and coordination of
services; limited opportunities to conduct field research and lack of research
upon which to base decisions; and miscellaneous reasons (Kohl & Marro, 1971;
Marro & Kohl, 1972). Kohl and Marro (1971) reported that prior to their study
little evidence exists that effectiveness has been a research concern in special
education administration and the answers provided to the question on
administrative effectiveness in this study do little to compensate for this lack of
research data (Kohl & Marro, 1971, p. 301).
Prillaman and Richardson (1985) reported that special education
administrators must develop a thorough understanding of the rules and
regulations associated with special education since they are responsible for
interpreting outcomes of court cases, which can impact the school districts local
policy and practice. The importance of being able to interpret the law, assess the
impact of court cases on special education services and ensure compliance with
the law cannot be understated (Crockett 2002; Valesky & Hirth, 1992; Palladino,
2008). Without this knowledge, decisions may lead to costly and time-
consuming litigation (Valesky & Hirth, 1992; Tate, 2010). Evidence-based
leadership practices can be enhanced by increasing special education
administrators knowledge base and skills which should improve educational
outcomes for students with disabilities (Boscardin, 2005; Boscardin, Weir &
Kusek, 2010).
Collins (2007) noted special education administrators need to be
resourceful and display interpersonal skills that include risk-taking, building
relationships, communication, and humor. Effective communication skills are
needed in the areas of negotiation and mediation with the ability to see the big
picture and to think out of the box. Special education administrators who are
effective leaders collaborate with others to achieve success and assure
accessibility to quality educational programs for all students (DiPaola &

55
Walther-Thomas, 2003; Lashley & Boscardin, 2003). Effective special education

administrators support ongoing progress monitoring, thorough academic
planning, data-based decisions and the use of evidence-based practices by
teachers (Boscardin, 2004; DiPaola, Tschannen-Moran, & Walther-Thomas, 2004).
Consistently, the reported challenge for special education administrators is
the recruitment and retention of highly qualified special educators since they
directly impact educational outcomes for students with disabilities (DiPaola,
Tschannen-Moran, & Walther-Thomas, 2004; Lashley & Boscardin, 2003;
Palladino, 2008; Seltzer, 2011; Tate, 2010). Concerning the selection of staff,
Ebmeier, Beutel, and Dugan (2010) noted no other single activity is as critical to
operating an efficient and effective school (p. 84). A critical component for
retaining qualified staff is administrative support (DiPaolo & Walther-Thomas,
2003; Lashley & Boscardin, 2003).
Due to the numerous responsibilities assigned to a special education
administrator such as general administrative tasks (i.e. managing a budget,
supervising and evaluating staff, compiling local, state, and federal reports),
making program decisions, supervising provision of services, empowering
teachers to use research-based strategies, and addressing parental demands,
special education administration can be seen as a daunting challenge (Arick &
Krug, 1993; Palladino, 2008, p. 158; Tate, 2010). There have been significant
changes in the roles and responsibilities of the special education administrator
since the initial study by Kohl & Marro (1971) which raises the question of what
roadblocks exist for todays special education administrator to operate
effectively. Patterned after the Kohl and Marro (1971) study, the purpose of the
current study was to identify the reasons that special education administrators
are able to operate to optimum effectiveness and the barriers that prevent this in
the current educational climate.
Methodology
In order to examine the perceptions of special education administrators
ability to operate to optimum effectiveness, the 2013-2014 Texas Council of
Administrators of Special Education (TCASE) Directory was used to determine
the population sample. The TCASE Directory is a comprehensive list of special
education administrators in the state of Texas currently serving in school
districts and Regional Education Service Center (ESC) Directors who provide
support to special education administrators and oversee staff development
within their regions. Since Regional ESC Directors are not directly responsible
to an educational cooperative or school district, they were not included in the
population sample for this study.
The TCASE Directory was used to compile a list of e-mail addresses for
special education administrators in the state of Texas. Special education
administrators were initially contacted in the form of an e-mail that contained
the following information: (a) explanation and purpose of the study, (b)
participants in the study, (c) description of procedures, (d) instrumentation
utilized, (e) potential risks, (f) participation and benefits (g) link to survey
through PsychData, (h) contact information, (i) and an opportunity to contact the
researcher if there were any questions. E-mails were sent using the blind cc to
protect confidentiality and grouped by region. Two follow-up e-mails were sent

56
as reminders to the special education administrators asking them to complete

the survey. The first reminder was sent two days after the initial contact e-mail
and the second reminder was sent one week from the initial contact e-mail.
In the Kohl and Marro (1971) study, two questions were asked of special
education administrators, What is the main condition or roadblock that keeps
you from attaining the ideal time distribution? and If you could wave a magic
wand, what one thing would you want to have to increase your effectiveness as
a special education administrator? In the final report by Kohl and Marro
(1971), suggestions were made for further investigations to enhance the
knowledge pool regarding special education administrators. This information
was used to create a survey with updated information. In the current study,
special education administrators were asked to Identify the top three reasons
why you feel that you can operate to optimum effectiveness and Identify the
top three reasons why you feel that you cannot operate to optimum
effectiveness. To support a longitudinal comparison, participants were
provided a list of select choice responses that were generated in the Kohl and
Marro (1971) study, as well as, the option to provide additional responses. The
survey was reviewed by a committee, which included individuals who had prior
experience as public school administrators for content and clarity.
Surveys were distributed to 515 special education administrators across the
state of Texas. A total of 176 surveys were completed online using the link to
PsychData. Twenty-four surveys were removed from analysis due to lack of
completion leaving a total of 152. The initial return rate for surveys was 35%
with only 29.5% of total surveys used in the evaluation of results. Roughly one
out of three special education administrators in the state of Texas responded to
the survey request.
Seventy-three percent of respondents were special education
administrators employed by a local school district and 23.7% were employed by
an educational cooperative unit. The remaining special education
administrators were employed by a countywide school district, in a shared
services agreement, State School for the Deaf, or State School for the Blind and
Visually Impaired. Of the respondents, 11.2% were from urban school districts,
27.6% from suburban school districts, and 61.2% from rural school districts. The
majority of special education administrator responses were from females with
only 14.5% from males. Approximately, 18% of special education administrators
held a doctorate degree and 65.1% held a masters degree with additional
coursework. The most common certification held by special education
administrators was mid-management/principal certification (77.6%) while the
second most common certification was that of special education teacher at 73.7%.
For purposes of this study, a non-experimental research design was
utilized through survey methodology and quantitative data collected to identify
existing background characteristics and obtain perceptions of special education
administrators ability to operate to optimum effectiveness in the state of Texas.
The Statistical Package of Social Scientists (SPSS) 18 program was used to
analyze results of the survey. Frequency, percentage tables, and cross-tabulation
were used for categorical data. Descriptive statistics and the Friedman Test were
used to analyze the data and determine the mean rank for each reason identified
by special education administrators in school districts from the state of Texas.

57
The Friedman Test provides information regarding the difference in the ranks of
three or more independent groups. Post-hoc testing for Friedman two-way
analysis of variance on rank means was utilized to provide additional
information (Marascuilo & McSweeney, 1977).
Results
Special education administrators were asked to identify the top three
reasons they could operate to optimum effectiveness and the reasons they could
not operate to optimum effectiveness. Multiple-choice answers were provided
with an opportunity to express an additional reason that was not listed. Table 1
includes the reasons special education administrators felt they could operate to
optimum effectiveness by mean rank order. The top three reasons noted by
special education administrators to operate to optimum effectiveness were: (a)
sufficient knowledge concerning special education, state and federal laws,
budget, etc.; (b) support from central administration; and (c) professional
background and education prepared them for the job. The three reasons with
the lowest mean were: (a) opportunity to do field research utilizing innovative
studies at the local level, (b) adequate facilities and sufficient equipment, and (c)
adequate research data upon which to base decision.
Table 1: Reasons Able to Operate to Optimum Effectiveness

Mean
Reasons
Rank
1. Sufficient knowledge concerning special education, state and
9.48
federal laws, budget, etc.
2. Support from central administration 8.75
3. Professional background and education prepared you for job 7.94
4. Effective communication 7.54
5. Sufficient number of staff 7.33
6. Have authority to participate in policy decisions, better control
7.23
of programs, and more effective supervision of personnel
7. Sufficient financial resources 6.91
8. Effective organization of special service units, pupil placement,
identification of students, and coordination between general 6.69
and special education
9. Effective time management 6.28
10. Opportunities to be involved in general education activities 5.88
11. Adequate research data upon which to base decisions 5.80
12. Adequate facilities and sufficient equipment 5.65
13. Opportunity to do field research utilizing innovative studies at
5.52
the local level
Friedman Test: X2 (12) = 332.36, p = .001

58
Each reason for why special education administrators were able to work
to optimum effectiveness in Table 1 was numbered to assist in comparisons
between rank means. Numbers in Group I and Group J of Table 2 represent the
reasons listed in Table 1. Each pair of reasons from Group I and Group J was
contrasted with a confidence interval. An interval that included zero was
considered non-significant. Table 2 shows the results of post-hoc testing for
Friedman two-way analysis of variance on rank means. Only the pair of reasons
that were considered statistically significant at the .05 significance level is listed
in Table 2. When two reasons differ with p < .05, one reason ranked higher than
the other reason. Mean ranks that are in bold represent the reason that is ranked
higher than the other. The higher the mean rank the more important the reason
in allowing the special education administrators to operate to optimum
effectiveness. The primary reason special education administrators were able to
operate to optimum effectiveness was due to sufficient knowledge concerning
special education, state and federal laws, budget, etc. There was a significant
difference between this reason and nine other reasons which shows the
importance of special education administrators having a strong knowledge base
concerning special education and related topics. The second highest reason was
support from central administration which was significantly different from the
six lowest reasons identified.
Table 2: Pairwise Comparisons of Reasons Able to Operate to Optimum Effectiveness

Mean Mean
Group I Group J LL UL Result
Rank Rank
1 9.48 6 7.23 0.20 4.30 p < .05
1 9.48 8 6.69 0.74 4.84 p < .05
1 9.48 10 5.88 1.55 5.65 p < .05
1 9.48 11 5.80 1.63 5.73 p < .05
1 9.48 12 5.65 1.78 5.88 p < .05
1 9.48 13 5.52 1.91 6.01 p < .05
2 8.75 8 6.69 0.01 4.11 p < .05
2 8.75 10 5.88 0.82 4.92 p < .05
2 8.75 11 5.80 0.90 5.00 p < .05
2 8.75 12 5.65 1.05 5.15 p < .05
2 8.75 13 5.52 1.18 5.28 p < .05
3 7.94 10 5.88 0.01 4.11 p < .05
3 7.94 11 5.80 0.09 4.19 p < .05
3 7.94 12 5.65 0.24 4.34 p < .05
3 7.94 13 5.52 0.37 4.47 p < .05
5 7.33 1 9.48 -4.20 -0.10 p < .05
7 6.91 1 9.48 -4.62 -0.52 p < .05
9 6.28 1 9.48 -5.25 -1.15 p < .05
9 6.28 2 8.75 -4.52 -0.42 p < .05

59
Table 3 presents reasons special education administrators could not

operate to optimum effectiveness. The top three reasons identified by special
education administrators were: (a) insufficient number of staff, (b) lack of time,
and (c) insufficient financial resources while the three lowest reasons based on
mean rank order were: (a) inadequate preparation for the job, (b) inadequate
research data upon which to base decisions, and (c) lack of opportunity to do
field research utilizing innovative studies at the local level.
Table 3: Reasons Unable to Operate to Optimum Effectiveness

Mean
Reasons
Rank
1. Insufficient number of staff 8.88
2. Lack of time 8.71
3. Insufficient financial resources 8.54
4. Organizational problems such as ineffective special service
units, pupil placement, categorical labeling of students, and lack 7.78
of coordination between general and special education
5. Need more authority to participate in policy decisions, have
better control of programs, and be more effective supervising 6.86
personnel
6. Central administration demands 6.83
7. Need for better communication 6.72
8. Outmoded facilities and/or insufficient equipment 6.46
9. Time spent on general education activities 6.21
10. Need for additional knowledge 6.04
11. Lack of opportunity to do field research utilizing innovative
6.02
studies at the local level
12. Inadequate research data upon which to base decisions 6.00
13. Inadequate preparation for the job 5.95
Friedman Test: X2 (12) = 290.30, p = .001
Each reason special education administrators gave regarding why they

were unable to work to optimum effectiveness in Table 3 was numbered to assist
in comparisons between rank means. Numbers in Group I and Group J of Table
4 represent the reasons listed in Table 3. Each pair of reasons from Group I and
Group J was contrasted with a confidence interval. An interval that included
zero was considered non-significant. Table 4 shows the results of post-hoc
testing for Friedman two-way analysis of variance on rank means. Only the pair
of reasons that were considered statistically significant at the .05 significance
level are listed in Table 4. When two reasons differ with p < .05, one reason
ranked higher than the other reason. Mean ranks that are in bold represent the
reason that is ranked higher than the other. The higher the mean rank the more
important the reason in preventing special education administrators from

60
operating to optimum effectiveness. The primary reason special education

administrators were unable to operate to optimum effectiveness was due to
insufficient number of staff. There was a significant difference between the top
three reasons why special education administrators were unable to operate to
optimum effectiveness and the six lowest reasons identified.
Table 4: Pairwise Comparison Reasons Unable to Operate to Optimum Effectiveness

Group Mean Mean
Group J LL UL Result
I Rank Rank
1 8.88 6 6.83 0.00 4.10 p < .05
1 8.88 7 6.72 0.11 4.21 p < .05
1 8.88 8 6.46 0.37 4.47 p < .05
1 8.88 9 6.21 0.62 4.72 p < .05
1 8.88 10 6.04 0.79 4.89 p < .05
1 8.88 11 6.02 0.81 4.91 p < .05
1 8.88 12 6.00 0.83 4.93 p < .05
1 8.88 13 5.95 0.88 4.98 p < .05
2 8.71 8 6.46 0.20 4.30 p < .05
2 8.71 9 6.21 0.45 4.55 p < .05
2 8.71 10 6.04 0.62 4.72 p < .05
2 8.71 11 6.02 0.64 4.74 p < .05
2 8.71 12 6.00 0.66 4.76 p < .05
2 8.71 13 5.95 0.71 4.81 p < .05
3 8.54 8 6.46 0.03 4.13 p < .05
3 8.54 9 6.21 0.28 4.38 p < .05
3 8.54 10 6.04 0.45 4.55 p < .05
3 8.54 11 6.02 0.47 4.57 p < .05
3 8.54 12 6.00 0.49 4.59 p < .05
3 8.54 13 5.95 0.54 4.64 p < .05
Discussion
The purpose of this study was to identify the reasons that special
education administrators are able to operate to optimum effectiveness and the
barriers that prevent this in the current educational climate. Two of the primary
reasons noted by special education administrators for being able to operate to
optimum effectiveness was sufficient knowledge concerning special education,
state and federal laws, budget, etc. and having the necessary professional
background and education that prepared them for the job. Since the field of
special education leadership is multifaceted and complex, a strong knowledge
base of the numerous areas such as local and federal policies, finance, program
development, personnel, and interpersonal skills is needed. The special
education administrators in the current study appear to have a sufficient
knowledge base and educational background to meet the demands of the job.
The results of this study were different from the study conducted by Kohl and

61
Marro (1971) where special education administrators reported the need for
additional knowledge as one of the primary areas of concerns. Due to the ever
changing educational climate, there is a need for ongoing professional
development to maintain a sufficient knowledge base concerning special
education and ongoing support from central administration. Rayner, Gunter &
Powers (2002) reported individuals working in special education perceived a
high need for continuing education specifically in leadership and management.
While Pardy and Bryan (2015) indicated that the lack of functional knowledge
and expertise could lead to failure in the position.
The secondary reason special education administrators noted for why they
were able to operate to optimum effectiveness was support from central
administration. Special education administrators in the current study appear to
have greater support from central administration than reported by Kohl and
Marro (1971). When special education administrators were asked by Kohl and
Marro (1971) to identify roadblocks that kept them from using their time
effectively, the responses focused on resources such as lack of administrative
assistance, finances, clerical help, program facilities, and office space or facilities
with the primary reason being central office demands. Central administration
demands were listed in the current study as one of the reasons special
education administrators were not able to operate to optimum effectiveness
though it was not a primary reason of concern. Central administration can
provide support to special education administrators by recognizing the
importance of having sufficient staff, allowing special education administrators
the time needed to oversee special programs and staff, and providing sufficient
financial resources.
Kohl and Marro (1971) sought special education administrators opinions
regarding ways to increase their ability to operate effectively by asking what
one thing would you want to have to increase your effectiveness as a special
education administrator? Special education administrators identified nine areas
of need or concern in the Kohl and Marro (1971) study. The top three areas of
concern noted by Kohl and Marro (1971) were the top three reasons identified in
the current study for why special education administrators were not able to
operate to optimum effectiveness: (a) insufficient number of staff, (b) lack of
time, and (c) insufficient financial resources. Insufficient staff, limited financial
resources, and lack of time appear to be ongoing reasons for why special
education administrators are unable to operate to optimum effectiveness. This
will require special education administrators to find creative solutions for
meeting the unique needs of individuals with disabilities utilizing the staff and
financial resources available to them.
The reasons identified in the current study that had the least impact on
special education administrators operating to optimum effectiveness were
research data upon which to base decisions and opportunities to do field
research utilizing innovative studies at the local level. The overall pattern
suggests that the use and purpose of research have little impact on special
education administrators whether good or bad which suggests the importance of
research for the advancement of educational practices for students with
disabilities has not been realized by special education administrators.

62

The data collection period for survey responses was two-weeks. Though
the majority of responses occurred within six hours of notification, additional
time to collect data may have resulted in a higher participation rate. This was
applicable to the initial notification and the two reminders seeking participation
in the study.
Only special education administrators within the state of Texas were
contacted to be a part of this study. Therefore, results may not be generalized
across other states. Each special education administrator who was contacted
had access to e-mail and the internet. However, some special education
administrators may have preferred a pencil and paper format to an electronic
format. Having the opportunity to establish rapport with an individual through
an electronic format can be more difficult and result in decreased number of
respondents.
Future research is needed in the effectiveness of special education
administrators from different career paths and the impact they have on
educational outcomes for students with disabilities, placements for students
with disabilities in the least restrictive environment, staff retention, and financial
management.
Results of this study indicate that for special education administrators to be
effective, he or she should be knowledgeable concerning special education, state
and federal laws, and budget; have central administration support; and have
sufficient education and professional background in the areas of special
education and administration. Special education administrators reported that
having the opportunity to do field research utilizing innovative studies at the
local level, having adequate facilities and sufficient equipment, and having
adequate research data upon which to base decisions contributed the least to
operating to optimum effectiveness.
Data from this study can provide information in the development of
training programs and supports that help target leadership skills that are
necessary to address accountability, evidence-based practices, and inclusion of
students with disabilities in the general education setting, as well as, other
current issues.
References
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Perceptions on policy and personnel issues. Journal of Special Education, 27(3), 348-
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Kohl, J. W., & Marro, T. D. (1971). A normative study of the administrative position in special
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PA: The Pennsylvania State University.
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archives/Preparing%20School%20Principles%20for%20Special%20Education%20A
dministration.pdf
Pardy, A & Bryan, B. (2015, September). Effective Special Education Administrators.
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MCASE 2015 Annual Fall Preconference, Bozeman, MT.
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Seltzer, M. (2011). The roundabout of special education leadership. International Journal
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Tate, A. (2010). Case in point: The changing face of special education administration.
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Retrieved from

65

Vol. 15, No. 7, pp. 65-77, June 2016
Development of Teaching Plan in the

Curriculum of Medical Sciences
(To promote social capital)
Forouzan Tonkaboni (Corresponding author) and Masumeh Masumi

Department of Educational Science,
Payame Noor University (PNU),
Tehran, Iran
Abstract: In today's world, social capital is one of the most important

factors in development of countries. The aim of this study was to
develop a teaching plan in the educational curriculum for medical
sciences students to strengthen social capital among them. To answer
the question of what is the teaching plan that can be developed for
the promotion of social capital among students of Medical Sciences?
a study based on qualitative grounded theory was conducted in 2014
in which 14 professors in the field of medical science curricula were
interviewed. Sampling was purposive and coding method was used to
analyze the data. Teaching plan was identified as the main subject for
research and teaching obstacles, strategies, and outcomes were
identified for it. After drawing a paradigmatic model, the final plan
was obtained. For the plan of curriculum for medical students,
teaching plans must be designed based on factors affecting the
development of social capital elements.
Keywords: Medical sciences students; social capital; teaching plan;

curriculum
Introduction
Light (sociologist) used the term social capital at the 1970s and Laurie
(economist) also used it to describe the problem of urban economy. In the 1980s,
this term was used in a wider sense by Coleman the sociologist, and political
scientist Putnam was the second person that raised an ethnic passionate debate
about the role of social capital and civil society in Italy and the United States.
Their research led to the formal formation of social capital and its application in
many interdisciplinary sciences (Tahghighi, 2005).

66
Social Capital as a form of capital has a large impact on the success of the
society. Many functions have been attributed to social capital by experts. Social
capital employs the similarities of people from different directions, creating a
spirit of mutual trust and functions at the service of economic interests; it creates
the space which reduces the cost of human resources, and increases interaction
between them (Woolcock, 2008)
According to Putnam (2005) social capital is composed of elements of social life

by which people can achieve their goals effectively. He believes that this form of
capital has equal importance to the other forms of capital.
Fukuyama (2006) defines social capital as a set of norms in social systems that
promote cooperation among members of the community and reduces the
exchange and communication costs.
Experts believe that increased social capital include faith, trust, hope for the
future, relying on the community and its solidarity, social justice, prosperity,
tolerance, patience, forgiveness and unity are the main strategies to achieve
sustainable development in a society. The benefits resulting from membership in
a group creates solidarity that makes it possible to obtain benefits. Hence, social
capital is a means of access to economic and cultural resources through social
communication (Saifollahi, 2005).
In a society with high social capital, the union and solidarity among members of
society and their group spirit makes them to flow their economic capital for
themselves and their society so that everyone can use its benefits (Kavianpour,
2007).
The social capital enhances the quality of life and promotes the positive social
values in order to have a good life ( Hamdan et al,2014).
According to the above, it can be said that the concept of social capital means
that the participation in community and group can have positive interests and
functions for the individual. There are many organizations that the government
helps them to develop values that support civic engagement. The educational
system is one of these organizations. In recent years, education is considered as
one of the most powerful producers of social capital.
University as one of the main sources for the formation of social groups can be
of consideration. The Scientific, cultural and religious, and professional
organizations as well as other groups can find an opportunity to emerge in
university where some networks may be formed, which can be bases for the
establishment of key and influential institutions (Dingaa,2014).
In universities the scientific spirit, criticism, creativity, ability to communicate

scientifically, reproduction ability, and also the ability to combine and integrate
the ideas should be formed in the students and at the same time, prudence,
participation, and proving ones identity in interaction with others be
strengthened in university environment. So universities are not only functioning
in education area and indeed where higher education and social capital relate to

67
each other the university should have the ability to develop social capital
(Zakersalehi, 2008).
In a study entitled "The Relationship between the Curriculum of Higher

Education and Social Capital ", it was concluded that there is a significant
relationship between educational, economic, social goals and needs assessment
with the elements of participation and trust in the social capital (Tonkaboni et al,
2014).
Theoretical Background
According to Putnam (2005) social capital refers to those features of social life,
networks, norms and trust that enable participants to pursue their common
objectives in a more effective way. In his idea, social capital is the means to
achieve social and political development in diverse political systems and the
trust between people, governors, and political elite results in political
development.
The set of norms which exist in social systems promote the level of cooperation
among society members and also reduces the level of exchange and
communication costs. In this definition, concepts such as civil society and social
institutions are associated closely with the concept of social capital (Schiff, 2004).
Eisenstadt believes that the most important issue in shaping a community with
good social capital is attention to the trust, cohesion, solidarity and social
participation and without social cohesion and participation under the shade of
confidence establishing the new order is impossible (Chalabi, 2007).
From the viewpoint of Mevish, some of the most important prerequisites of a

functional society must be emphasized when determining the aim, content and
method of education in the curriculum. Learners in the educational system must
know as members of the society in which they live how they can best play their
social role. In case of lack of knowledge and awareness of these issues among
teachers and curriculum planners, curriculum content and objectives may
conflict with the needs and social problems which might reduce the success of
programs (Yarmohammadian, 2012).
Klein introduces nine elements of objectives, content, learning activities,

teaching methods, materials and resource evaluation, time, space and grouping
as the elements of the curriculum. The most common approach in this regard,
considers for a curriculum or a particular syllabus and curriculum decisions
involving these four elements: objectives, content, methodology and evaluation
(Mehrmohammadi, 2009).
Tonkaboni et al (2013), in an article titled " Description and Recognition the

Concept of Social Capital in Higher Education System " concluded that for the
promotion of social capital, the curriculum in higher education should be based
on development of social capital components and needs of society.
Jiroux considers educators as transformational thinkers. Selecting and

implementing appropriate teaching-learning methods as a key component of the

68
curriculum, is very important in the formation and strengthening of valuable

concepts in mind. In the process of teaching, methods and materials that
teachers select should help students in their learning content (Ornstein, 2011).
Teaching is an activity, but not every type of activity, but something which is
done consciously and on the basis of a specific purpose that makes changes.
Teaching is not easy. Teachers deals with different variables in teaching and
through manipulation of different variables and results, tries to create a situation
in which learning takes place. (Shabani, 2006)
The authority teachers have to make changes in teaching conditions and make
the factors useful for teaching a lesson are teaching models that include problem
solution patterns, pre-organizers, individual tutoring, social patterns and so on.
These patterns act as plans (Joyce, 2008).
In a research entitled as "Designing a Model for Development of Social Capital

in Universities", the researcher showed that the development of social capital
can be achieved in two objective and subjective aspects, five components:
individuals, groups, organizations, structures, and management and 28
indicators (Mostafazadeh et al,2015).
Previous researches in Iran indicate that higher education despite its great
quantitative development in the last decades, has not been successful in self-
actualization and development of social capital. This is also true about teaching
practices that are considered an important part of the curriculum.
The purpose of this study is to provide a teaching plan with an emphasis on

identifying teaching barriers, methods, and strategies to develop social capital
among students of medical sciences. For this purpose, the research question is as
follows:
What kind of teaching plan enhance social capital can be developed among
students of Medical Sciences?
Methodology
The present study is qualitative and based on Grounded Theory approach which
is an exploratory research method that allows researchers to develop the theory
of him/her. The material used in this study was the collected comments from
people during interviews. In addition, these data were highly fragmented and
contained many concepts and categories. For this reason, analysis of data
required a plan which is comprehensive as well as highly resilient and
encompassing. As a result, grounded or fundamental method was used.
The population consisted of teachers with at least 10 years experience in the field
of curriculum planning, teaching and writing textbooks in the field of medical
sciences at the university and higher education institutions across the country in
2014. In qualitative method the number of interviews should be 10 at most, but
in this study science the interviewees were at different disciplines from different
universities, all data were collected through semi-structured interviews with 14
cases and after assuring saturation in the material obtained, the interview
process was stopped since no new information was obtained. In the interview,

69
eight instructors of public universities of medical sciences and six from Islamic
Azad universities across the country participated from various medical fields.
Purposive sampling method was used for the type of favorable cases; which
means that for selecting the samples the number of academic articles and
publications were examined and it was tried to select people who are dominant
on the subject and have the experience of developing curricula.
After carrying out preliminary coordination with individuals and setting a date,
meetings were held at the researchers office or at workplace of respondent. Ten
minutes before the start of the meeting a complete description about the purpose
of the study and drawing conclusions of it was explained. For having full
information, by the permission of the interviewee, all sessions were recorded
and transcribed. First, two general question of how do you see social capital
components of trust or partnership among students? and "how universities can
expand social capital among students?" then researcher entered the subject of
discussion and using responses given by the interviewee the next questions were
asked. During the meetings it was tried to prevent diversion of the subject
without sensitivity and to direct the interview just in the framework of the preset
direction. Interviews were held on an individual basis and each interview was
between one to two hours.
To analyze the data, open, axial and selective data coding were used.
In the open coding using comparison technique and asking the data related to
the phenomenon under study, data were named and categorized with scrutiny.
After removing unrelated speeches to the subject, data were classified into tens
of paragraphs and similar paragraphs were put next to each other and concepts
were drawn out.
In axial coding, the analyzed data using open coding joined each other by new
methods. At this stage the link was made among a category and its
subcategories. This was done by implementing a paradigmatic plan of
"obstacles, strategies, and results" and putting together the similar concepts.
In selective coding the core category was selected and its relation with other
categories was found. The relations were validated by finding confirming
instances. After determining the main category, the sub-categories were related
to the main categories according to the paradigmatic plan. Then, the final
research plan was developed in which the core relationship with other concepts
was shown.
To determine the accuracy of the information obtained, four factors were used:
credibility, transferability, dependability and verifiability (Burns, 2007).
Validation was done by sharing the findings with participants to review them.
For the transferability, it was tried to consider the diversity in sampling and
different fields are used. Also, in connection with the verifiability process, it was
attempted to make teachers agree on the perceptions. And finally, in reliability,
interviews were continued until data saturation. Also for the reliability of the
study, Kirk and Miller note taking methods were used.

70
The aim of the research, study procedures, risks and benefits of the research, the
voluntary nature of participating in the study, were told to the participants. The
right to quit research at any time was considered for the participants. After
providing the necessary information they were assured that the information
obtained will be kept confidential and results will be published without naming
them. During the interview process, a short break was given for the interviewee
fatigue and they were not forced to continue the interview.
Findings
In open coding 98 concept codes were obtained from all the comments of
respondents. In the axial coding, second level concepts were obtained. In this
stage the number of concepts had a sharp decline. In the end, the main category
was identified in selective coding, that is teaching plans.
To draw a paradigmatic plan 98 codes were divided to three parts: obstacles,

solutions and results.
1. Obstacles
The number of first-level concepts about the obstacles contained 40 items that at
the secondary level reduced to 5 codes including "Ease of classical and
traditional teaching practices, poor participation of students in the class, too
much emphasis on introduced resources, teachers lack of skill in using
technology, and students focus on content expressed by the teacher. In the
following, each of the sub-themes with a sample of interviewees statements is
presented.
1.1 Ease of classical and traditional teaching methods
Leaving the old standard format of instruction is usually faced with resistance
from students. We must change this mentality and a new spirit is blown in the
university system. (Interviewee No. 12)
1.2. The weak participation of students in class
Current teaching practices do not help much to strengthen the tendency of

people to do activities together. The curriculum should be designed in such a
way that the person finds morals and attitudes necessary to work in a group.
(Interviewee No. 1)
1.3. Strong emphasis on introduced resources
Introduced resources are very effective on way of teaching. Currently, the

resources that instructors introduce are not diverse and logical. Although a
number of books are published each year for the courses at curriculum but
they introduce references of 10 to 30 years old and they are reprinted
(Interviewee No. 6)

71
1.4. Teachers lack of skill to use technology
The use of audiovisual aids in universities despite technological progress

and the significant percentage of students access to the technology such as
computers and the Internet is very low. (Interviewee No. 2)
1.5. Students focus on content expressed by instructor
There is a belief among students that teachers focus on the topics set for each
session and their repetition is the easiest and best practice for teaching. This
view must be changed. (Interviewee No. 8)
2. Solutions
The number of first-level concepts in the context of the proposed strategies in

teaching were 30 items that were reduced to 6 codes of "delegating responsibility
to the students, Introduction of efficient curriculum resources, the use of active
teaching methods, teaching along with modern science, evaluation of student
activities and the use of new media ".
2.1. Delegation of responsibility to students
Using group teaching practices or even teaching by students and conducting

conferences and seminars greatly amend the curriculums impact on social
capital. (Interviewee No. 4)
2.2 The introduction of curriculum resources
Some teachers exclude training and evaluation based on limited old school
resources that have been introduced. However, if the teacher selects updated
sources for teaching and asks the students to be prepared for them at the end of
course, s/he will need more participation of the students (Interviewee No. 6)
2.3 The use of active teaching methods
The students tend toward traditional teaching methods while group method of
teaching and students' participation in seminar or teachers emphasis on
scientific practices involving the realities directly affect social capital.
(Interviewee No. 5)
2.4. Teaching along with the modern science of the world
The teaching method should be new and does not repeat the old practices. It is
also important to note that teaching method should be selected along with the
latest science of the world (interviewee No. 2)
2.5. Evaluation of students activities
Students should have a significant role in the process of teaching. Instructors

should pay attention to their class activities, participation in the teaching and
discussions (interviewee No. 3)

72
2.6. Using new media
Book is very expensive in Iran and the students are not supported to buy books.
Therefore, one cannot expect multiple sources to be presented by teacher in such
circumstances. Instructors should move towards introducing new electronic
sources which are cost-effective and the intended diversity can be achieved.
(Interviewee No. 8)
3. Results
The number of concepts which were obtained at the first level coding was 18
that were reduced to 5 items including strengthening team spirit, shaping public
space, strengthening the spirit of questioning and criticism, promoting
accountability in the students, and activating the students in the teaching
process.
3.1 Strengthening team spirit
If the teacher works in a manner in which individual action is not acceptable and
people have to do group work, teamwork is promoted. (Interviewee No. 11)
3.2 Shaping public space
If a student is involved in class exercises, s/he will practice taking responsibility

and action in groups as most important aspects of social capital. (Interviewee
No. 14)
3.3 Strengthening the spirit of questioning and criticism
The class atmosphere on time teaching should be established in such a way that
students are not afraid of criticism and ask their questions. (Interviewee No. 2)
3.4 Promoting accountability in the students
When a student takes responsibility in the class during a course and cooperates
with his classmates in his course projects, he will tend to maintain group
activities. (Interviewee No. 4)
3.5 Student participation in group activities
Instructors trust to the student and entrust some responsibilities, such as

teaching or troubleshoot classes can have a good influence on social capital.
Responsibility Practice in the classroom can boost the morale for factors such as
participation and solidarity among people. (Interviewee No. 6)
Finally the plan of study which is the combination and integration of the main
category, its obstacles, strategies, and consequences was formulated as Figure1:

73
Obstacles Solutions Results

- Ease of classical - Delegating responsibility to the - Strengthening
and traditional students, team spirit,
teaching -Shaping public
methods - Introduction of efficient curriculum
space,
-Weak resources,
participation of - Strengthening
students in class - The use of active teaching methods, the spirit of
-Strong questioning and
emphasis on - With teaching along modern science, criticism,
introduced - Promoting
resources - Evaluation of student activities and accountability in
- Teachers lack
of skill to use the students
- The use of new media
technology - Activating the
- Students focus students in the
teaching process
on content
expressed by
instructor
Social capital Social capital

Social capital
variable variable
variable
Social capital
Figure1: Teaching plan based on social capital
Discussion
Teaching method is of the things that directly affect social capital. Changes in
teaching methods can have a substantial impact on social capital of students. Of
all the elements of the curriculum teaching methods has the highest
communication with the students and is close to the concept of social capital
more than any other component.
Tonkaboni et al (2014), designed a model of teaching in Irans Higher Education

that confirms the findings of this research in medical sciences.

74
Teaching plans should be more oriented towards learning and active teaching.
Active learning, is a learning that occurs with minimal interference of external
factors. In this method of learning, the instructor is at the same level of other
factors such as the learning environment and educational resources and only
acts as a facilitator of learning. This method is considered effective on social
capital when the student is involved actively in the process of learning and
learning occurs under his/ her control. Solati et al conducted a study on the
medical sciences students and found that the more students engage in the
teaching process, it provides more utility for the students (Solati et al., 2010)
The findings suggest that current teaching plans not only does not encourage
people to attend and participate actively in class, but also damage the
relationship between society and universities and change the mutual trust
between the university and society.
Flick & Williamson (2005), research concluded that diversity in teaching

methods promote social capital among students such as group learning and
learning services.
After changing in teaching practices and student engagement is the

institutionalization of the collective spirit among students that puts them in
touch with other groups and social institutions and practices socialization of the
individual's consciously and unconsciously.
A study on the satisfaction of students of dentistry in Shiraz from two methods

of instruction based and participation based found that students are more
satisfied with the latter and their level of knowledge has increased (Momeni
Danaie et al., 2011).
Predicted changes for curriculum give this opportunity to the planners to use
other leverages to affect the socialization process of the student and accelerate it.
University can be a good platform for many activities that potentially increase
social capital. Thus, curriculum planners should not look at it apart from the
curriculum. It is better that teaching practices that promote social capital in the
form of a clear curriculum be included in syllabus to avoid personal taste in the
teaching classes.
Marjaee (2004) in a study titled as "social capital among students of universities"

examined social capital differences between people with different educational
experiences. The results showed that in many of the components there was a
significant relationship between education and social capital. In other words, by
transition from undergraduate to PhD, a significant decrease was observed in
many of the components of social capital. In addition, students' social capital has
an inverse relationship with their academic experience.
Current practices in curriculum implementation, more than anything suffers

from stagnation and recession. Necessary reforms in this area should be
designed and implemented. To make positive changes in curriculum
implementation, it is recommended that active teaching approach is used. In this
procedure, instead of providing a set of concepts and facts that are sometimes

75
unrelated, attempt to provide students with learning activities that involve them
in real problem solving situations. Merghati Khoei et al.(2013) in a study at
Tehran University of Medical Sciences concluded that educational programs
should be revised to use modern methods which enhance learning and student
satisfaction .
Moein et al(2014), in a study among medical students at dermatology course

found that, group discussion is a valuable strategy for teaching and learning
with active participation of students which results in independent learning and
deep understanding of the course material, more attention to the key points and
creating a joyful learning environment .
So when designing curriculum, teachers should be given the freedom to act

according to the knowledge and the passion and perseverance of students in
class, and to be able to instantaneously change the complete teaching program.
In addition to helping to educate people, this gives them the opportunity to play
a role in the learning process depending on their learning experiences. In this
method, the learner should be considered independent and the learning process
alternatively changes from the students to the teacher, and vice versa.
In active learning approaches based on the student's participation, if the aim is

promoting social capital group membership should have a key role. Actual
activity as a group and individual responsibility of each member about the
outcome of group will allow group members to practice the key components of
social capital such as trust, partnership and solidarity and prepare for real life.
Conclusion
hence, instructors and curriculum planners should consider the components of
social capital in the curriculum of medical sciences. The proposed plan can be
used as a map for designing teaching method based on social development for
the medical sciences universities. Teachers can carry out similar studies in other
sections for various disciplines to provide the possibility to complete this plan.
Research limitations
Addressing teaching methods on a large scale exceeded the concepts and
categories of this study. This was particularly problematic in the coding of
concepts.
Requests for interviews were very time consuming and a lot of requests were left
unanswered because of instructors occupation.
The number of concepts discussed in the interview was too much and sorting
them was time consuming. Due to the involvement of interviewees in the
process of teaching at the university, refining the answers to remove the biased
items required scrutiny and attention.

76
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78

Vol. 15, No. 7, pp. 78-96, June 2016
Integrating Educational Modules for Children

with Chronic Health and Dental Issues: Premise
for Community-based Intervention Framework
in Developing Country
Ma. Cecilia D. Licuan, PTRP, MAE, Ph.D.

De La Salle Health Sciences Institute
Dasmarinas City, Cavite, Philippines
Abstract. This paper consolidated the developmental initiatives and

principles of two major researches conducted regarding children with
disabilities in the Philippines that focused on chronic health and dental
issues using the independent studies of Licuan (2009) and Laguilles
(2008) as take-off point to recommend a Community-based Intervention
Framework in a developing country. Given the two consolidated
studies, this paper conceptualized and recommended a framework to
enhance the services for these children in the Philippines who are prone
to having health complications that are chronic and dental in nature for
application in the grassroots or primary level of the countrys health
care and educational delivery systems which is community-based and
school-based given feasibility for application at the preparatory basic
education and special education levels as well as at the smallest unit of
the Philippine community the barangay. The study looked into the
present demographics of children with chronic health and dental issues
utilizing the Province of Cavite as the micro-represented research locale.
Together with the profile review, the respondents access to health and
education services were reviewed vis a vis the nature and implications
analyses of their condition, family profile and economic status. All of
these variables were factored-in to develop the framework that included
the developmental guidelines, paradigm and new educational module
frames that will be used as recommended platform for a succeeding
study that will yield to the development and validation of completed
educational modules. This in turn will be distributed and used by the
families of children with chronic health and dental health conditions as
well as the barangay health workers and concerned teachers to better
the lives of the children with such conditions with the intent of
instructional materials utilization not later than the year 2017 using the
Province of Cavite as benchmark locale in the Philippines.
Keywords: community-based intervention framework; children with

disabilities; chronic health issues; dental issues; health school-based
intervention.
2016 The author and IJLTER.ORG. All rights reserved.

79
Introduction
Disability in a laymans perspective is the lack of ability to function thereby
affecting performance of roles. The World Health Organization defines it using
the bio-psycho-social model which looks at it in general perspectives on
elements of bodily impairments, personal activity and participation in society
that interplay on the negative impact of the persons health condition and the
environmental and personal factors of his/her life (WHO, 2011). Considering a
global and macro perspective, over a billion or less than sixteen percent of the
globe have disability and the rates are increasing due to chronic health illnesses
as one of the factors. In the Philippines alone, the National Statistics Office has
reported that for every one thousand Filipinos, sixteen will have disability. The
entire household in the Philippines will have about 1.6 per cent with disability
given the 2010 population and housing census. Among all the regions in the
country, Region IV-A has the highest where the research locale Cavite is
situated. And as of the estimated population of persons with disabilities, the
greatest number fall in the age group of 5-19 years old and 45 to 64 years old.
Children aged 10 to 14 years old comprised the largest age group among those
in the younger range.
Concurrently, oral health is also one of the most neglected aspect of life among
children especially those with disabilities. Laguilless (2008) in her paper noted
that tooth decay is even more predominant than other disease likes asthma and
other infections. Pediatricians in the United States even noted that it is a silent
epidemic and the needs related to such cases are unmet (Barnett, 2002). Poor oral
health contributes to other illnesses like pneumonia hence there is a need to
address it in advance by preventing potential problems via early parental
involvement (Norwood & Slayton, 2008). In considering such, early exposure to
proper oral health care and treatment would be beneficial in preventing
unwanted pain and suffering and eventually improving the lives of children
with disabilities. In addition, neglected oral health care can be costly and may
only complicate standard treatment procedure (Newacheck et al. 2000 as cited in
Laguilles, 2008).
The challenges of persons with disabilities face including those that children
with chronic health and dental issues experience, are also faced with lack of
access to services including health and education thereby leading to unmet
needs (Baker & Donelly, 1992; Kuper et al., 2014; WHO, 2011). Children with
disabilities experience these impact brought about by their situation placing
them as part of the marginalized sector of the community tied with
discrimination, negative attitudes of people, lack of policies and legislations to
protect them which runs into a cycle that yields to deprived rights to health care,
education, quality of life and even survival in worst case scenarios (UNICEF,
2013).
Sobe and Kurtin (2007) emphasized how much the educational system plays a
major role in the lives of children through relevant educational programs which
encompass special services and programs for children with health challenges so
they can be served appropriately in the educational system. In the Philippines,

80
the National Statistics Office report in 2010 stated that about 97% of the children
with special needs are not reached by the public education system. The
implications of this situation is explicated by Posarac (2012) which explained
that poverty increases the risk of disability through related poor health
conditions and its related determinants which may lead to the onset of chronic
malnutrition, lack or inadequate public health intervention, poor living
conditions and unsafe work environments. He further noted that this can be
aggravated by lack of services that should have been available. More than this,
chronic health problems in children will have its effects in schooling and
relationships Collaboration is needed to promote services and limit the
restrictions for these children (Licuan, 2009)
This study recognizes the importance of looking into the profile and related
factors concerning children with chronic health and dental issues and analyzing
its implications in health and education services as springboard for the
development of a community-based intervention framework. This yields to the
creation and implementation of educational modules that can be used and
applied in the grassroots or primary level of the countrys health care and
educational delivery systems primarily at the barangay level and preparatory
basic education and special education levels, respectively. This developmental
study attempted to cross the limitations posted upon by the barriers to services
that children with disabilities especially those with chronic health conditions in a
developing country, especially those with chronic health and dental issues, faces
hence help achieve optimal outcomes for their lives.
Research Design of the Study

Anchored on the studys paradigm (Licuan, 2015) presented in Figure 1, the data
gathered describes the profile and status of access of children chronic health and
dental issues as well as explains the implications of these variables in the quality
of life of the respondents through narratives. Mixed method research design was
used thereby examining real-life contextual understandings, multi-level
perspectives, and cultural influences. Magnitude and frequency of constructs are
described through quantitative arm of the design, but the meaning and
understanding of such constructs are explored by its qualitative research arm.
This mixed-method design was fundamental in gathering the holistic
interpretative framework in the generation of potential solutions or new
understanding of the problem (Creswell, 2014; Dominguez, 2014; Hesse-Biber
& Nagy, 2010; Niglas, 2009; Onwuegbuzie, & Leech, 2006; Tashakorru, A. &
Creswell, 2007; Zhanga, 2014). And since the results of the study paves the way
for the development of educational module guidelines, paradigm and
framework for practice and implementation in community-based setting (i.e.
schools and barangay), it can also be factored-in that action research design is
integral to the paper.

81
Figure 1. Paradigm of the Study (Licuan, 2015)
Significance of the Study

The studys end goal is the development of a community-based intervention
framework for a developing country like the Philippines as basis for the creation
and utilization of educational modules for children with chronic health and
dental issues which will help in promoting both health and education services
despite the impact of poverty and disability in their quality of life. The ultimate
outcomes of the research paper benefits the children with chronic health and
dental issues especially in developing countries since it promotes access to
services, both health and education in nature, that will help address their needs
at an earlier period which then aides in deterring or even lessening the negative
impact of their condition. Such will facilitate and promote activity and social
participation thereby promoting quality of life.
The parents/caregivers, teachers of children with chronic health and dental

issues as well as community workers particularly the barangay level health
advocates also benefit from this study as they learn new ways of helping the
child achieve the benefits of education through utilization of basic instructional
strategies following the educational modules that will be developed based on
the proposed framework. The educational framework and eventually the
modules developed in this study will increase health literacy as generalized in
community and educational settings hence empowering the stakeholders.
Feldman (1989) has noted how crucial education is for better health.
The Statement of the Problem and Objectives of the Study

The study aimed to find out what community-based intervention framework can
be developed for a developing country like the Philippines as basis for the
creation and utilization of educational modules for children with chronic health
and dental issues which will help in promoting both health and education
services despite the impact of poverty and disability in their quality of life.
Anchored on such general problem, the study specifically answered the research

82
questions that determined the childrens profile (e.g. health condition, family
situation and economic status) and services (health and education) access status in
the research locale which serves as micro-representation of a developing
country- the Philippines. Moreover, it aimed to analyze the implications of the
profile and access status as bases for developing the desired framework.
Method of Procedure
The study is basically a mixed quantitative-qualitative in design. Profile and
access to services survey questionnaires and interview checklist were used tools
were used to gather data. It was validated by experts in the field of rehabilitation
medicine, dentistry, special education and allied health consultants who are
clinical practitioners in the field of occupational therapy and speech and
language pathology. Descriptive statistics specifically frequency distribution,
percentage, and mean as well as thematic analysis were used to interpret the
findings of the study. The subjects of the study were children with neuromotor
disabilities with developed or likelihood of developing chronic health and
dental issues. Purposive sampling was used gathering 112 children, less than 18
years from the top three cities of Cavite province given the highest population
namely Dasmarinas, Imus and Bacoor. Conceptual mapping of information
gathered was used to scaffold and develop the framework proposal as outcome
of the study. Given the profile of the subjects, 65/112 or 58% were diagnosed of
cerebral palsy of varying kinds ranging from mild to severe presentation of
health challenges; 15/112 or 13% with genetically-related syndromes or
condition and 32/112 or 29% belong to varying undiagnosed conditions
presenting with motor; cognitive and sensory problems. Mean age of the
subjects was 10 years with the youngest age presented as 5 years old and oldest
at 18 years. The inclusion criteria for age was limited between the age 4 to 21
years covering pediatric age span whereby schooling can be started ideally at the
day care or preparatory school at 4 years and transition schooling ending at the
age of majority which is 21 years.
Collection of Data
Population screening and selection of qualified respondents were done given the
data retrieved from the offices of the local government units of the
representative cities of the research locale in-charge of persons with disability
affairs. Consent of the qualified respondents was taken. After which, data to
answer the objectives of the study were gathered by letting the respondents
answer the research instruments which dealt on determining the profile (e.g.
health condition, family situation and economic status) and services (health and
education) access status. Respondents were guided in understanding the
questions if they are not able to read. Interview method was utilized to gather
other significant information that may come out related to the study outside
what is incorporated in the survey tool. Implications of the profile and access
status as bases for developing the desired framework were also explored during
the interview process. To facilitate a more cooperative nature in the interview
process, the 112 respondents and their families or caregivers were grouped by

83
location and were also subjected to focus group discussions scheduled in series
of meetings spread in a three-month period.
Treatment of Data
The profile (e.g. health condition, family situation and economic status) and services
(health and education) access status were treated using basic statistical methods
involving frequency distribution, percentage and mean. Data gathered during
the interview process to gather implications were processed using thematic
analysis of the information used in qualitative research design whereby patterns
of the information gathered were determined through data familiarization,
codes and themes. (Braun and Clarke, 2006).
Findings
Profile of the Respondents

Results of the study showed that 78 out of 112 or 70% of the child respondents of
the study have chronic health issues associated with their condition including, but
are not limited to,frequent cough and colds (48%), asthma (34%), pneumonia
(28%), bed sores (15%), and others (10%) [i.e. accidental wound/scratches or skin
problems and insect bites; fainting/dizziness, and swallowing problems]. Dental
issues on the other hand have 96% occurrence presented as 107 out of 112 among
the respondents of the study, whereas 4% or 5/112 where uncertain of their
answers. Dental issues expressed by the respondents show that halitosis, known
in layman as bad breath (87%), was the most common complaint followed by the
personal issue of the child being afraid of the dentist (74%), dental caries (67%),
pain (46%), bleeding gums (29%) and others (14%)which included tongue or lip
injury and oral sores.
Respiratory illness is common to children and it can be acute or chronic in

nature given genetic, environmental factors or both (JAMA, 2010). Asthma is the
most common problem between children ages 5 to 14 years old (Asher, I &
Pearce N, 2014) and Pneumonia is the most common reason for death of severely
disabled children. Seddon and Khan (2003) noted that several factors lead to
such problems not limited to poor nutrition, frequent aspiration, poor coughing
and ability to clear airway. Skin problems are also common among children with
disabilities due to limited skin sensation and inactivity (Wach & Sheehan, 2013).
Oral health is no exception in terms of issues that affect children with

disabilities. Dental caries is common brought about by prolonged bottle feeding
matched with poor oral hygiene and occlusion problems (Laguilles, 2008 &
Zemani, 2006). All of these can elicit the common symptom of pain (Oliva
, Kenny , & Ratnapalan , 2008) which serves as the most common reason for
emergency dental visits (Shqair, A. et al., 2012). Tartar formation leading to
halitosis or bad breath is also a dental issue. All these validates the importance
of dental visits to keep the gums and teeth healthy (CFD, 2016), however such is
disliked by children because of fear of injection and extraction (AlSarheed, 2011).

84
The variable measured concerning the family situation yielded to 100% response
as compromised where 96% (108/112) responded highly compromised while the
remaining 4% moderately compromised. Majority justified their compromised
situation answer by the complexity of their life in terms of addressing the needs
of the childs health, education and finances together with other family issues
particularly the need for food, stable work and other family members daily
demands. The variable on economic status showed that 34/112 or 30% of the
respondents family belong to middle class, 45/112 or 40% within poverty line,
33/112 or 20% below poverty line.
The relationship of poverty and disability has been strongly established. The
former can cause the latter and the latter can be complicated by the former
(WHO, 2012). Children belonging to poor families are more likely to experience
the negative impact of their disability compared to families who belong to upper
societal class (World Bank, 2009; Walker, S. et al., 2007) given the risks which
Grantham-McGregor S et al. (2007) and Walker SP et al. (2011) identified.
Access to Services
The variables measured related to the status of access to services showed that
among the 112 respondents 66 or 50% have accessed and 66 or 50% have not
accessed health services. Top three reasons for non-access to health are attributed
to fear of expenses given financial limitations, transportation and lack of
knowledge on available medical experts who can render services that are
preferred by respondents to be free of charge. This can be related to the factor
that greatly influenced health access of which majority is achieved through
medical mission consultations and nearby city health hospital services giving
free consultations. Among those who have accessed health, 45/66 or 68% have
accessed it inconsistently and 21/66 or 32% consistently. Reasons for
inconsistency in health access showed barriers related to finances, transportation
and accessibility of nearby health facility as detriments.
Educational services variable on the other hand, showed that 60/112 or 54%
respondents have accessed education and 40/112 or 36% have not accessed it.
Respondents are able to access education through the free public school regular
and special education system. The top three primary reasons for non-access on
the other hand were due to the perception that education is not anymore
relevant for the condition of the child, expenses related to education, and
availability of family member or caregiver to attend to the daily demands of
bringing the child back and forth to school. Among those who have accessed
education, 35/60 or 59% have accessed it inconsistently and 25/60 or 41%
consistently. Inconsistency in access showed barriers related to finances,
availability of person to bring the child back and forth to school and lastly at
equal presentation are factors related to transportation and accessibility of
nearby school or educational facility as detriments.
Health and education services are crucial to better the lives of special children in
the community. Such children are prone to deprivation of basic treatment even
vaccinations (United Nations Childrens Fund, Innocenti Research Centre, 2007)

85
which is detrimental to their situation. Suitable health care and nutrition enables
them to live longer and helps them improve their developmental capacity (Kerac
et al. 2012).
As children with chronic health and dental issues grow older, education
introduced at an early age becomes fundamental in the success of their learning
and development (Education for all global monitoring report, 2007). The
problem, however, is that they are introduced late, sometimes denied of access
to schooling or does not stay long in the system when introduced (WHO, 2012;
Filmer, 2008). UNESCO (2009) noted that children who are not in schools are
most likely the once with disabilities. Special children in schools however are
often segregated and are receiving poor-quality learning opportunities (WHO,
2012).
Additional educational accommodations and modifications as well as related

services like therapeutic rehabilitation are also needed by these children. The
challenge however is that majority of those services are inadequate and if
available are expensive, promoting segregation and are rarely available. (Engle,
2007; United Nations Childrens Fund, Innocenti Research Centre, 2007; United
Nations Childrens Fund, 2008; McConachie , 2001).
Implications of the Profile and Access Status

Thematic analysis of the data gathered during the interview process and focus
group sessions yielded to three major themes regarding the implications of the
profile and access status as bases for the development of the community-based
intervention framework.
Theme 1: Health as a Priority

Analysis of narrative data gathered among the respondents related to the profile
and access to services showed that health, inclusive of medical and dental nature
associated with the childs condition, as a priority is considered but not apparent
in the practice and actual life situation of the respondents. Children with chronic
health and dental issues who were able to answer the interview questions realize
how important their body functioning is when they are symptomatic and the
family or caregivers also put health of the child as a priority only during such
times of symptomatic episodes. Preventive measures, however, like regular
preventive check-ups and health/dental monitoring, are not yielding as priority
where financial situation are factored-in and other basic family needs
considering the welfare of the family (i.e. food, shelter, work stability) are
prioritized. There is also a common concern for the expenses incurred and
related to medical (including therapy sessions) and dental services. Medical-
Therapeutic and dental services are perceived to be expensive with a notion that
such services specific for their child are more specialized hence more expensive
compared to regular individuals without disability. It is also apparent that
health as a priority for the child with chronic health and dental issues are also
reflective of the same priority expressed by the families of the respondents to
themselves. Even the family or caregivers who participated in the study believes
and practices that visit to health professional are only done when the situation
highly demands of it. There is no need for consultation if home remedies can be

86
done and if the finances are scarce which is still strongly subjected to the more
important priorities of food, shelter and work stability.
Successful life outcomes can happen if the parents and families of these children
experience economic security and services access (United Nations, 2010). Social
protection programs to overcome barriers will be crucial which requires
coordination between different servicing sectors (UNICEF, 2012 & Mont, 2006).
Early intervention action is a vital element embedded in the regular delivery
system (WHO, 2012).
Theme 2: Education and Family Dynamics

Education in the eyes of children with chronic health and dental issues are seen
as an enjoyable task by the majority of the child respondents. They appreciate
the social aspects attached to their school participation and integration. Such
variable, however, is not seen as a priority by the family or caregivers of the
child. The existing perspective that their children can only do so much and will
not really be able to experience the benefits of education like independence and
future work exists as a major deterrent affecting the access and participation of
the child in school. Other priorities further interfere with this perspective
considering the basic needs of the family whereby food, shelter obligations (e.g.
home rental, utilities etc.) and other more important obligations considered by
other members of the family that must be attended-to are dominantly expressed.
Given commonly expressed limitations in finances, education and its related
expenses are prioritized for non-disabled siblings or members of the family and
the child is commonly left at home as reflected in the responses given by
respondents who have not at all accessed education or were able to access it
inconsistently. The family situation whereby existing parents of the child, if
present, are commonly pre-occupied with obligations to earn for the family is
also apparent. This scenario commonly leaves the child attended-to by the
grandparents or other non-working relatives or in worse scenario by the
neighbor expressed by about 7/112 or 6% of the respondents. It was also
apparent during the interview and focus group sessions that the basic family
unit comprising of immediate family members is also challenged among
majority of the respondents. About 68/112 or 61% of the families where the child
is affiliated have extended families living in their household. This means that
more than the main family involved with the child, relatives connected as in-
laws given expansion of the family are still living in the same household which
complicates the family dynamics given financial and social demands.
Bonding of family members and children with chronic health and dental issues
are vital for the protection, development and welfare of these children. Bonding
starts with acceptance of own family members which later transcends to the
community level. It is important that services are made available to help parent
and family members gain proper and accurate knowledge and skills
(Simeonsson , 2000) to support and advocate the need of their child with

87
disability. Service providers must work closely with the families of these
children in coming up with culturally appropriate and effective programs
(Gabarino & Ganzel, 2000; Garcia & Magnuson , 2000; Lynch, & Hanson, 2004).
Family expectations and adjustment is challenged in a life-long period for

children born with disabilities. Pleasant expectations become a serious challenge
when a child is born with unexpected disability (Ritchie, 2013). Priorities change
and the life that awaits the family as they have envisioned it becomes confronted
with challenging decisions and situations. Extended and multi-leveled family
structure also poses complication in the household set-up and priorities.
Research yield to evidence that extended families well-being is challenged and
the need for effective programming is vital. Further, studies show that
grandparents on paternal side are more likely to undervalue the impact of health
promotion on intervention. (Malde et al.,B., Scott M., & Vera-Hernndez,
M.,2015)
Theme 3: Job Stability and Resource Provision for the Child

Given the members of the childs household, about 40% or 45/112 have a parent
or family members having a stable job and 80% (36/45) of them are identified in
middle class families and 20% (9/45) among those within poverty line. The
sourced finances, however, are prioritized for spending on families needs for
food, shelter, transportation, utilities, education and health as needed. About
60% or 67/112 of the respondents families declared instability in job where a
permanent source of income is apparently challenged in almost all periods of the
year. Finances sourced from such families are primarily spent on basic needs for
food and shelter and they are represented among those identified within (21/67
or 31%) and below (46/67 of 69%) the poverty line. The job stability factor
consistently appeared as a dilemma in nearly all of the focus group discussions
and this has well connected itself to the provision of resources for the child.
Directly connected with job stability is the consistent and reliable source of
income which was noted as 90% (110/112) not sufficient and 5% (6/112) sufficient
to address the needs of the family as a whole. About 5% (6/112)of the
respondents were uncertain of answers to probing question on sufficiency of
financial resources. The health needs of the child with chronic health and dental
issues are regarded as important but not as a priority unless the health problem
is symptomatic and perceived as life threatening. Priority given to the education
of the child with chronic health and dental issues is not as high compared to the
level of priority given to non-disabled siblings or members of the family also
needing education. The basic provisions of food, shelter and safety particular to
having someone look after the child ensuring he/she is not in danger, however,
are prioritized specific to the child compared to health and education services
provision.
The most dominant call to spend for the services needed to help support
children with chronic health and dental issues alarm parents and family
members. Expenses will demand regular source of income and it will be
favorable if it is readily accessible. Financial stability and long-term career goals

88
are noted to be attained by family members who are working. All these factors
stress the importance striving for job security (Heibutzki, R., n.d.).
Community-based Intervention Framework

The needs of the special children who are subjects of this study are established
following the data gathered on the profile and implications of variables related
to the health condition and family dynamics and economics. Developing
countries like the Philippines are faced with members of its community where
the primary priority still falls on the addressing of basic needs of food and
shelter for the family. Expenses consumed in expressed priorities leave health
and education for the child compromised hence, the need to integrate
educational modules that would empower the families through health
promotion and further understanding of the childs condition uplifting the
childs quality of life is needed delivered through a Community-based
Intervention Framework (CbIF) that crosses the financial barrier and regular
expenditure priorities of the family.
Given the profile, dynamics and situation of the family engaged with the child
with chronic health and dental issues, the framework to be used as a basis for
the development of the educational modules in 2017 will follow set guidelines
on its planning, writing, validation, publication and distribution phase.
The framework development process shall proceed with the planning phase
considering the following general considerations as guidelines: (a) advocates of
the De La Salle Health Sciences Institute College of Rehabilitation Sciences
(DLSHSI-CRS) for the services and education of children with disabilities will
spearhead the leadership of the planning group and shall involve the different
stakeholders for the program which include, but are not limited to, the parents,
teachers and local government representatives involved in the administration of
health and education services to the community, barangay health workers and
most especially the children with health and dental issues themselves who can
represent the group as direct recipients of care and education; (b) the utilization
of the collaborative leadership models as presented by Ryan Estis and associates
(n.d.) illustrated in Figure 2 and the collaborative model developed by the
Center for Creative Leadership (2016) as presented in Figure 3 to guide the
people involved in the program planning and development; (c) regular and
scheduled brainstorming sessions of the detailed platform of the program and
contents of the educational learning modules with primary goal to set the
schedule of tasks and outcomes desired given a timeframe set from planning to
publication and distribution phase;(d) selection of qualified educational module
developers which will serve as core group belonging in the fields of health,
dentistry and special education, (e) accurate documentation of inputs from the
members of the planning team which are validated in succeeding meetings and
converted into workable outputs given the outcomes of each session, and (f)
identification of potential sources of funding from the private and public sectors
to sponsor the project and all its requirements until it reaches the publication
and distribution levels.

89
Figure 2. Collaborative Leadership Model (Estis and Associates, n.d.)
Figure 3. Collaborative Leadership Model (CCL, 2016)
The writing phase of the educational modules will be guided by the following
approaches: (a) selection of the members of the writing team spearheaded by
the experts identified by the core planning team to work on the contents of the
modules, (b) presentation of gratis-initiated writing offer to the identified
writing team members subject to the availability of funds for the project, (c)
official agreement among members of the planning and writing team on the
schedule of tasks and deadline of outputs given the assignments per group, (d)
use of the facilities and resources of the DLSHSI-CRS to facilitate the meeting

90
sessions and writing endeavors of the experts developing the educational

modules, and (e) conduct of regular meetings for the members of the writing
team to ensure standardization of writing format, content synthesis, critiquing
and resolution of concerns and issues related to the writing process duly
recorded in minutes of regular meetings.
The validation phase of the educational modules will cover the following
guidelines: (a.) identification of experts outside the membership of the writing
team who will validate the contents of the modules, (b.) the expert validators
will be determined by both the members of the planning and writing team, (c.)
expert validators will comply with standard schedule of review and deadlines
set by the planning team, (e.) extent of module validation will be dependent on
the decision of the experts identified as validators which can cover pilot testing,
content, face and construct validation, and (f.) depending on the availability of
funding, expert validators are subjected to gratis-initiated service.
The publication phase of the educational modules will cover the following
guidelines: (a.) DLSHSI-CRS will need to set an agreement with the local
government units on the details and technicalities related to the publication and
ownership of the educational modules, (b.) both groups may consider external
agencies that can provide funding for the publication expense subject to set
guidelines declared by the sponsoring agency, and (c.) all final arrangements
pertinent to ownership and publication shall be duly stipulated in a
memorandum of agreement signed by all parties concerned in the planning,
writing and publication phases.
The distribution phase of the educational modules will cover the following
guidelines: (a.) DLSHSI-CRS and the local government units involved, where the
educational modules will be used, will set the detailed guidelines to promote
massive use and distribution of the educational modules, and (b.) the
Department of Education in the Philippines will be tapped and communicated
with concerning the use and integration of the educational modules in the basic
and special education programs of the public schools for use of teachers situated
in the locale where the modules will be distributed.
The educational modules will proceed following the paradigm presented in

Figure 4 where the barriers identified to hinder the access to health and
education services of children with special needs, specifically those with chronic
health and dental issues associated with their condition, are eliminated using
strategies that can be implemented in the community-based settings (i.e. schools
and barangays). The attempt is to determine evidence-based strategies
incorporated in educational teaching and learning modules that can be used by
parents, teachers and community-health workers to empower them to promote
health and effective learning outcomes among children with special chronic
health and dental issues encountered in the barangay and school settings.

91
Figure 4. Paradigm of Developmental Process for Educational Modules for Children

with Chronic Health and Dental Issues using Community-based Framework (Licuan,
2015)
The educational module framework for practice and implementation in community-

based setting will proceed with the following three major basic guiding
principles throughout the program delivery in school and barangay level
settings: (a.) community participation and collaboration, (b.) stakeholder
empowerment, and (c.) evidence-based approaches to health and education
applicable to children with chronic health and dental issues.
Conclusions and Implications of the Study

The need to address the needs of children with chronic health and dental issues
are established in the study following the data gathered on the profile and
implications of variables related to the childs condition, family situation and
economic status of the family. The outcomes of having educational module
guidelines across all phases of development (i.e. planning, writing, validation,
publication and distribution); utilization of educational module paradigm; and
use of educational module framework for practice and implementation in
community-based setting is recommended as output. It is evident that children
with chronic health and dental issues are affected by health concerns related to
their condition affecting their quality of life. These children belong to families
with compromised situations affecting the childs access services. It is implicated
that medical and dental health associated with the childs condition, is not a
priority unless symptomatic and life threatening. The value placed on education
of the child is challenged by the negative perception of the family members on
its impact in the childs life and its effect in changing the childs condition. The
dynamics of the family where the child belongs to is extended (multi-leveled)
and complex creating an impact in the prioritization and needs of the family
which have direct effect in the provision of health and education services for the
child. All variables previously noted are affected by the challenges in job

92
stability of the members of the family that serves as primary predictor for the
financial resources needed not just for the childs needs but primarily for the
basic needs of the family like food and shelter which remains to be dominantly
prioritized.
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(2014): 24-35
The Author
Dr. Ma. Cecilia D. Licuan is currently the Director for Alumni
Services and Continuing Professional Education and Clinical
Preceptor for Physical Therapy Program at De La Salle Health
Sciences Institute (DLSHSI) where she is affiliated as a full-time
full professor since 1998. She also serves as one of the accreditors
of the Philippine Accrediting Association of Schools, Colleges
and Universities (PAASCU). She graduated with the degree of
Bachelor of Science in Physical Therapy in the same university in
1997, proceeded with the program Masters in Education major in
Educational Management at De La Salle University-Dasmarinas as a Highest Distinction
Awardee in 2007 and finished her Doctorate Degree in Philosophy major in Special
Education at the University of the Philippines Diliman in 2007 graduating as Academic
Excellence Awardee with her dissertation research nominated as Best Research Paper
during SY 2006-2007. Other than her full-time professor status in DLSHSI, Dr. Licuan is
also currently affiliated in other prestigious universities in the Philippines since 2006 up
to present as a graduate school part-time professorial lecturer given her expertise in the
fields of educational leadership and management as well as special education. She has
served as a part-time graduate school faculty in University of the Philippines Diliman
and St. Paul University-Manila and is currently still serving as part-time professorial
lecturer in De La Salle University Manila, De La Salle University Dasmarinas and
University of Perpetual Help System DALTA. Dr. Licuan is passionate in developing
health services and educational programs especially for children with disabilities. She is
a strong community service advocate in the Philippines and has written several
researches and scholarly works. This research paper which was presented in the
International Conference on Education and Business in January 2016 at Disney Board
Walk Conference Center in Florida, USA was awarded as Best Paper Presentation in the
cluster by Clute Institute as organizers of the event.

97

Vol. 15, No. 7, pp. 97-109, June 2016
Recover the Lost Paradigm:

Technology Guided by Teaching Methods
Simona Savelli
Universit degli studi Guglielmo Marconi
Roma, Italia
Abstract. Looking at the educational context, the paper illustrates some

multifactorial and integrated models that highlight the key role of
didactics in the teaching-learning process, even in the current
environment characterized by a high technological level.
Keywords: learning; teaching; didactics; pedagogy; technology.
Introduction
As is known, there are many factors affecting good teaching, as
versatile they are the characteristic aspects of the teaching profession.
Among them, "the subject knowledge and the pedagogical-
methodological knowledge represent two fundamental pillars [...] as the
research in the field shows", but "the current cultural scene needs to
consider a further equally essential component: the technological
knowledge " (Messina, L., & De Rossi, M., 2015, p. 86).
Technological knowledge does not refer so much to the acquisition
of technical skills necessary to use traditional and digital devices, as to the
possibilities of use of such technologies in teaching. More precisely, it
refers to how to translate the potentialities therein in solving specific
pedagogical and teaching problems situated in given contexts and how to
develop situated knowledge of what technologies are able to do for those
who use them.
Starting from these considerations, I intend to propose some
models on the educational uses of technology, in which technological
knowledge is connected with pedagogical, didactic and subject
knowledge and and that that can form the basis for an equally integrated
instructional design.
The development of integrated models

It is in 1983 that Lee Shulman, professor emeritus at the Stanford
Graduate School of Education, raises the problem of the loss of a teaching
paradigm (Shulman, 1999). In those years, he notes in particular, the lack

98
of scientific research on the interactions that occur between subject matter

content and pedagogical-didactic principles.
The author aims to highlight how the relationship between the
understanding of the contents of teaching by teachers and education that
teachers provide to students is particularly neglected (Shulman, L.,
1986a).
Therefore, in the model of pedagogical-didactic knowledge of
contents he proposed and which is related to the teaching profession (the
Pedagogical Content Knowledge model or PCK), they are represented the set
of contents (the subject matter knowledge, Content Knowledge or CK),
the set of pedagogical and didactic principles (the Pedagogical
Knowledge or PK). The PCK is the result of the merger of the previous
sets and constitutes "an understanding of how specific topics, problems or
issues are organized, represented and adapted to the different interests
and abilities of the students and presented for instruction" (Shulman,
1987, 8). These representations can arise from research or originate in the
practical experience and they include analogies, illustrations, examples,
explanations, demonstrations (Shulman, L., 1986b).
In a second step, to the model is added the set of knowledge of the
students' learning process (the Student Learning Knowledge or SLK).
This recognizes, explicitly, among the basic expert teacher's skills, the
ability to transform the content knowledge possessed in pedagogically
powerful forms and therefore adaptable to the different skills and
experiences of the learner (Shulman, L., 1987) (Figure 1).
Figure 1: Pedagogical Content Knowledge model (PCK).
To the basic PCK model many additions follow (even by Schulman

himself). Noteworthy is the Pedagogical Content Knowing model (or
PCKg) developed in the environment of teachers' training by Kathryn
Cochran, James DeRuiter and Richard King, of the University of Northern
Colorado (Cochran, K., DeRuiter, J., and King, R., 1993) (Figure 2). Here

99
the emphasis is on the dynamic and situated nature of the learning

process, which provides an integrated understanding on the part of the
teacher of pedagogical-didactic principles, contents, student
characteristics and context. The dynamism is created by the interaction of
all components with each other and is the result of the maturation of new
experiences and of participating in new learning activities.
Figure 2: Pedagogical Content Knowing model (PCKg).
Having thus outlined a framework that can give an account of the

components of the teacher's pedagogical-didactic knowledge, Professor
Shulman moves in search of the steps and actions necessary to the
transformation of personal understanding into forms that can be
understood by those who learn. The pedagogical reasoning model
resulting (Shulman, L., 1987) is cyclical in nature and includes:
understanding the purpose and structure of the subject matter content, of
the ideas inside and outside the discipline;
the transformation of content knowledge in pedagogically powerful and
adaptable forms (articulated in the phases of preparation, presentation,
selection, adaptation to students characteristics);
education, which includes several observable forms of teaching and
active learning;
evaluation, with verification of students understanding and evaluation
of teaching;
reflection, stimulated from the critical analysis of their own performance
and that of the class;
new understandings of the purpose of teaching and of disciplines, of
students, of themselves.
Conceptually linked to the studies above, the concept of didactic
transposition (transposition didactique) as used by Yves Chevallard,
professor emeritus at the Universit d'Aix-Marseille, to designate the
transition from wise knowledge, addressed to the explanation of

100
phenomena, to taught knowledge, aimed to the teaching of knowledge

(Chevallard, Y., 1981-82).
In fact, scientific knowledge, can be considered the subject, both of
a selection of contents by politicians and experts for the construction of
formal programs (external didactic transposition) and of more socially
negotiated transformations through didactic contracts within the system,
where the interactions between teacher, students and taught knowledge
take place and lead to the real and implemented educational program
(internal didactic transposition).
Even in this case, the concept is developed by various scholars
including Michel Develay (1987), professor at the Universit Lumire
Lyon 2 and Philippe Perrenoud (1998), professor emeritus at the
Universit de Genve. Starting from their contributions they are
confirmed and integrated some aspects of the didactic transposition
which result in the following key elements:
the constant dialogue between knowledge and prevailing social practices
and wise knowledge;
the occurrence of an external didactic transposition concerning the
knowledge to be taught which flows into the formal program;
the occurrence of an internal didactic transposition related to the
teaching-learning process leading to the taught knowledge and to
students' learning.
As Laura Messina, Full Professor at the Universit di Padova, says,
the conceptualizations of Shulman and Chevallard despite the dated
epistemology, retain undisputed heuristic significance and they still try
conjugations of it (Messina, L., & De Rossi, M., 2015).
In this direction, trying to highlight the dynamic interaction among
pedagogical knowledge, pedagogical knowledge of the subject matter,
didactic transposition and personal constructs, Frank Banks, Jenny Leach
and Bob Moon professors at the Open University UK elaborate the
Teacher's professional model, a model of the teaching profession (Banks, F.,
Leach, J., & Moon, B., 1999) (Figure 3). The core components that the
authors identify are defined in terms of: subject knowledge, school
knowledge (didactic transposition), pedagogical knowledge and personal
constructs. Personal constructs are made up of beliefs and prior
knowledge, learning experiences, personal views on what is good
teaching and act as catalysts of the three domains of knowledge
considered.

101
Figure 3: Teacher's professional model.
The technological dimension

The diffusion of technologies for information and communication
increases the amount of knowledge that needs to be capitalized by the
teacher. It is not just to know and master technological tools, but above
all, to reconsider the way we think about technology. We need to rethink
our relationship with technological devices and to operate an effective
integration of them in teaching through the resolution of real problems
(Mishra, P., & Koeler, M., 2003).
From 2005, Matthew Koehler and Punya Mishra, professors at the
Michigan State University, develop in this sense the PCK paradigm of
Shulman, proposing a new model, the Technological Pedagogical And
Content Knowledge model, TPCK or TPACK (Koehler M., & Mishra P.,
2005). It consists of three basic forms of knowledge (content, pedagogical
and technological) and of the interactions of these forms among them,
which result finally, in a integrated comprehensive knowledge of a
technological, pedagogical and content type (Figure 4).

102
Figure 4: Technological Pedagogical And Content Knowledge model (TPACK).
Content knowledge refers to concepts, theories, procedures,

explanatory frameworks, pursued objectives, forms of representation
within the disciplines.
Pedagogical-didactic knowledge concerns processes, methods,
teaching and learning practices, principles and educational objectives,
theories of development cognitive and socio-cognitive theories, direction
of the class, educational planning and teaching and its implementation,
evaluation.
Technological Knowledge extends from traditional media to digital
ones.
Pedagogical content knowledge questions the differences among
disciplines and the opportunity to use the same teaching strategies in
different disciplines.
Technological content knowledge deals with the way contents are
modified through the application of technology, the choice of the most
appropriate technologies to address certain topics, how arguments
determine or modify technologies.
Technological-pedagogical knowledge is to know the pedagogical
affordances and limitations of technological tools in relation to projects
and appropriate teaching strategies from a disciplinary and evolutionary
perspective.
The concept of affordance is the basis of the interesting PST model
(Pedagogical Social Technological model) proposed by Qiyun Wang, associate
professor at the National Institute of Education in Singapore, in 2008, to
complete the TPACK of Koehler and Mishra (Wang, Q., 2008).
With the term affordance you define the perceived and real property
of a thing, especially the functional characteristics that determine how
you might use that particular thing (Pea, R.D., 1993). A further definition

103
of affordance is that of signifier, indicator, signal of the physical or social

world, which can be interpreted in a meaningful way (Norman, D.A.,
2008).
In the educational field the connotation of the term tends to move
more and more on feasible uses and relationships and it is in this sense
that is used by Wang. The author distinguishes three types of affordance
in relation to the integration of technologies in the teaching-learning
process:
pedagogical affordance, concerns the characteristics of an instrument that
determine whether and how a learning activity can be implemented in a
particular educational context;
social affordance, refers to the real and perceived properties of an
instrument that can promote social interaction of users;
technological affordance, pertains to the way a tool allows to realize a set of
tasks in an efficient and effective way and in a way that satisfies the users
(Wang, Q., 2009).
The TPACK is therefore proposed as a "neutral" model that does
not indicate the contents to teach, the pedagogical approaches to use and
the technologies to adopt in teaching, but expresses a cognitive
framework whose possibilities of implementation are open to multiple
solutions.
The Conversational Framework

In that same spirit is conceived the learning model of Diana
Laurillard, professor at the London Knowledge Lab (Laurillard, D., 2014)
(Figure 5).
Figure 5: Learning model.
The author, from an extensive analysis of the existing literature,

represents in a single view, the main concepts and relationships
associated with learning seen as an active process, and takes as reference

104
the associative, cognitive, experiential, socio-constructivist, conceptual,

constructionist, collaborative modes. The structure is formulated to be
relevant in any context of learning (implicit, informal, formal) and it
consists of continuous and iterative cycles, which are summarized below.
In the learning process the student brings into play some internal
cognitive components that the teacher tries to influence and formulates
objectives, which may consist in wanting to elicit a response from the
teacher generating a conceptual network or in attempting to generate
action to elicit an outcome in the environment.
In the teaching process, the teacher, starting from its own concepts and
through the explanation, modulates the student's concepts; the student
generates new conceptual organizations that allow the teacher to
understand the situation; in turn the teacher creates a new explanation or
comment to modulate the students concepts. In these cases the feedback
that is provided from the teacher to the student is extrinsic to the action.
In a similar way, the environment generates an action pattern that
modulates the student's practice; the student's practice creates an action
that matches the pattern; the environment generates the result of such
action, which modulates the practice of the student. In these cases the
feedback that is provided to the student from the environment is intrinsic
to the action.
Starting from this basic learning-teaching representation, Laurillard
elaborates what she herself defines Conversational Framework, since
"inspired by the Conversational Theory of Gordon Pask, a cybernetic
model of teaching and learning" (Laurillard, D., 2014, p. 128) (Figure 6).
This framework provides "the most simple static visual representation
possible for capturing the complexity of collective ideas produced in the
literature on what is needed to learn and therefore what is needed to
teach" and "it shows all the ways in which the teacher and other subjects
learners activate the iterations in the internal learning cycle" (Laurillard,
D., 2014, p. 128-129).
Figure 6: Conversational Framework.

105
The communication cycle with teacher's revision allows each learner to

modulate his conceptualizations connecting them with those of the
teacher (activity 1 of the model); the teachers extrinsic feedback
motivates each student to ask questions or to articulate knowledge and
practice (activities 2 and 1).
In the practice cycle with teacher's revision the extrinsic feedback
provided by the teacher motivates each learner to modulate his practice
by generating the actions suggested (activities 4 and 1).
The modeling cycle with teacher's revision motivates each learner to
modulate his practice by generating actions suggested by the intrinsic
feedback provided by the modelling environment (activities 4 and 3).
The peers communication cycle allows each learner to modulate his
conceptualizations comparing them with those of his peers (activity 6);
activates each learner to produce a conceptual network with extrinsic
feedback from his peers (activities 5 and 6).
In the peers modeling cycle each learner generates actions in a
practice environment, while sharing the results of his practice (activities 4
and 7); it allows each learner to modulate his practice, using as a model
the results obtained by peers (activity 8).
Exploring the specific learning activities that can take place in an
educational context, the author distinguishes those typically individual
(appropriation, research, practice, production) from those typically social
(discussion, collaboration) and outlines their features.
In individual learning the learner conducts an internal dialogue,
while he thinks about what he is trying to learn. He reflects on what he is
listening or reading, or receiving through feedback and reviews and
inspects his own theoretical and practical knowledge in a coordinated
mode:
through appropriation, the learner, reads, listens or witnesses a teacher's
explanation or observes a teacher's pattern of action and reshapes his
own personal knowledge, but does not generate action or thought;
through research, the learner is encouraged to select resources that reflect
the knowledge and ideas that are taught; the learner has more control
over the path, but is guided in comparing knowledge and information, in
investigating and using resources and data; he reshapes its conceptual
organization thanks to the researches carried out and the exposure of
what was found;
through practice, the learner uses his actions, puts theory into practice
while working for a purpose, performs an action to reach it and uses the
feedback to modulate action and knowledge; teaching offers a modeling
environment that requires an action and provides an intrinsic feedback;
through production the learner is motivated to consolidate what he has
learned, to articulate the knowledge acquired and the ways to use it in
practice; the exposure of the learner's thought allows the teacher to
106
respond with extrinsic feedback, directions and further explanation.

In learning through discussion the teacher provides some stimuli
and learners produce ideas and questions that set in motion the need to
remodulate personal ideas, this generating additional ideas and
questions.
In learning through collaboration (which includes discussion,
practice and production), the teacher provides means to create shareable
results, identifies a task aimed at creating a common product and an
environment for the modeling and practice, aimed at developing
personalized results. Students exchange the products or the results
obtained from their practice and are thus motivated to remodulate their
actions and to produce a discussion on the reasons that have determined
their choices.
Each activity can be based on technologies, from the most
traditional to the most advanced (Table 1). In the case of research teachers
can use a set of materials and digital resources, make a field work, visit
sites and virtual reality environments. In the case of practice they can refer
to type-answers, examples of work, interactive games, simulations, micro-
worlds and adaptive models. In the case of production they stimulate the
learner to realize an essay or a representation, but also to undertake the
solo exposition of his own thought. In learning through discussion they
can be employed work in small groups, seminars, asynchronous on-line
discussion forums and synchronous chats. In learning through
collaboration they can make use of group projects, group work in modeling
environments, wikis and other online environments for the construction
of knowledge.
Table 5: Learning types and types of activities that can be performed with traditional and
digital technologies.
LEARNING ACTIVITIES WITH TRADITIONAL

TECHNOLOGIES AND DIGITAL
TECHNOLOGIES
Appropriation Reading of texts and documents; listening
to the teacher's presentations in person;
lessons; participation in experiments,
expert classes.
Reading of multimedia content, web sites
and digital resources;
listening/watching podcasts, webcasts,
animations and videos.
Research Use of study guides based on texts;
analysis of multiple materials and
resources to search for information and
ideas; use of conventional methods for

107
collection and analysis of data;

comparison of texts for research and
evaluation of information and ideas.
Use of online tips and guides; analysis of
a wide range of digital resources
searching for information and ideas; use
of digital tools for collection and analysis
of data and for comparison of digital texts
in research and evaluation of information
and ideas.
Practice Conducting exercises; realization of
projects based on practice; participation in
laboratories, study visits, on site role
playing.
Use of models, simulations; participation
in micro-worlds, experiments and study
virtual tours, online role-playing games.
Production Production of articulated thoughts using
documents, essays, reports, projects,
performances, artifacts, animations,
models, videos.
Production of digital documents, projects,
performances, artifacts, animations,
models, resources, slideshows, photos,
videos, e-portfolios.
Discussion Participation in tutorial classes and
seminars; discussions in groups, forums,
classroom; comments in blogs.
Participation in on-line tutorials and
seminars; discussions by e-mail, in group,
in forum; participation in synchronous
and asynchronous videoconferencing.
Collaboration Implementation of projects in small
groups, discussion of the results of the
class mates, joint creation of products.
Implementation of projects in small
groups using online forums, wikis, chats;
discussion of the results of other
participants; joint creation of products in
digital format.
Conclusion
A similar lack of paradigm in teaching, as that found by Lee
Schulman in the 80s, is perceived nowadays. Scholars who take a closer
inspection can see how, today, technologies for communication and
education themselves remember their own role in learning: that of new

108
particularly brilliant companions next to their solid older colleagues. The

studies treated in these lines, resulting in some modeling, give an account
of this type of approach.
Technologies, due to their social penetration, consequence of their
versatile utility and thanks to that sense of urgency that they impose on
their use in teaching, are making it inescapable a further reflection on
what is didactics itself, what are the meanings that it assumes, which are
exactly the educational values it promotes and how to concretely realize
all this in the learning-teaching process. In the end, I think it will be
through the knowledge of itself that it will take that leading role that is
widely hoped-for.
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Vol. 15, No. 7, pp. 110-126, June 2016
Using Debate to Teach: A Multi-skilling

Pedagogy Often Neglected by University
Academic Staff
David Onen
Makerere University
Kampala, Uganda
Abstract. This paper describes both qualitative and quantitative studies

that addressed the use of debate as a pedagogical strategy in a graduate
level course at Makerere University (Uganda). The investigation was
triggered by persistent complaints from students who had participated
in international exchange programmes where they were taught using
different pedagogical methods including debate. They wondered why
they were hardly taught using debate; yet, its use would equip them
with extra skills. Using a descriptive cross-sectional survey design, the
study established that: a whole 20 percent of the student participants
had never been taught using debate; the academic staff respondents
acknowledged their limited use of debate due to hurdles; and all
respondents reportedly perceived the use of debate as an effective
pedagogical strategy for enhancing class participation, oral
communication, research, and critical thinking skills. It was concluded
that members of academic staff were aware of the benefits of using
debate as a pedagogical tool; though they were unable to use it,
regularly. The author recommends academic staff in universities to
consider using debate since it is perceived not only to encourage active
learning, but to equip learners with additional competences.
Keywords: academic staff; debate; graduate students; multi-skilling;

pedagogy
Introduction
World over, the call for effective teaching and learning at all levels of education
is on the increase. Practically, the concern about ineffective teaching is not only
being raised by parents, but virtually all stakeholders in education including
school administrators, civil society as well as scholars. In higher education in
particular, the apprehension about using poor methods of teaching has equally
been raised by students. Yet, effective teaching requires making choices from a
repertoire of pedagogical strategies that do not only enhance learning, but also
promote the development of additional competences such as communication,

111
critical thinking as well as interpersonal skills among others. But choosing an

appropriate teaching strategy, even for the most accomplished teacher, is no
easy feat. The case of academic staff at the College of Education and External
Studies (CEES) of Makerere University does not seem to be an exception. In this
study, the researcher looked at how often the graduate students at CEES were
taught their courses through debate and whether the students perceived the use
of debate as a pedagogical strategy to enhance their class participation, oral
communication, research, and critical thinking skills. In this section, the author
presents the statement of the background, the research objectives, and questions.
Historically, while several scholars seem to agree that the use of debate as a
pedagogical strategy occurred many years ago, there appears to be controversy
over who developed it and when it was first used. According to Vo and Morris
(2006), the use of debate might have been pioneered by Sophists and Aristotle.
But Darby (2007) and Hall (2011) believe that it is Protagoras of Abdera who
initiated using debate as a pedagogical technique around the 5th century.
Nonetheless, there is consensus that the use of debate as a pedagogical strategy
emanated from ancient Greece well before it spread to other parts of the world.
However, as a pedagogical method, debate flourished during the 19th and early
20th century, before it somehow lost popularity and its use in schools actually
diminished (Zare & Othman, 2013). But the curiosity to use debate as a
pedagogy across the world again started in the 1980s. According to Darby
(2007), this renewed interest was premised on the philosophy that debate helps
to promote critical thinking, logic, and oral communication skills. This belief still
persists amongst educators up to the present day. As a result, the author
hypothesised that the use of debate to teach graduate students in education
courses is a worthy pedagogical tool to consider by those who teach (or lecture)
such students; thus, the genesis of this study.
Over the years, a number of scholars have investigated the role debate plays in
teaching, and how it can be successfully used to teach different disciplines in
different contexts. According to Shen (2015), debate has been successfully used
as a pedagogical strategy to teach several disciplines. For instance, while Fallahi
and Haney (2011), revealed that debate has been successfully used in teaching
psychology, Healey (2012) and Combs and Bourne (1994) respectively reported
the successful use of debate to teach geography, and marketing. In addition,
debate has also been found to be effectively used in teaching sociology (Green &
Klug, 1990), and more recently, in on-line teaching (Park, Kier & Jugdey, 2011).
However, many of these studies were conducted in the context of developed
nations. Moreover, most of these studies focused on investigating the use of
debate in teaching undergraduate students. This study, however, was focused
on examining the benefits of using debate in teaching graduate students
pursuing education-related programmes. Besides, the context of this study is
that of a developing nation; therefore, the researcher expected that the study
findings would fill this knowledge gap.
According to Vargo (2012), the results of several previous studies have revealed
that using debate to teach allows students to take responsibility for their own

112
learning since it grants the students the opportunity to prepare and present their
work to other fellow students. As such, its use as a pedagogical tool is in line
with the pedagogic theory which states that individuals learn well when they
study together and interact. But Zare and Othman (2013) add that using debate
to teach helps the students in many ways - including in how the students can
make use of library resources, think, analyse issues, and be able to present their
arguments in a logical manner. These imply that the use of debate as a
pedagogical strategy can help in developing other additional skills like research,
critical thinking and communication skills (Brown, 2015). This study was thus
intended to verify these claims in the context of graduate education.
In this study, three key concepts were focused on, namely: debate, pedagogy
and multi-skilling. Debate, according to Darby (2007, p.1), is an old teaching-
learning strategy that presupposes an established position, either pro or con, on
an issue, assertion, proposition, or solution to a problem. But Hall (2011, p.1)
defines debate as an education strategy that fosters clinical reasoning and
thinking skills as well as heightens awareness of attitudes, values and beliefs.
However, as a pedagogical method, debate enables students to express their
opinions over an issue from two different perspectives. This is done in order to
contradict one anothers argument (Chang & Cho, 2010). In this study, the
researcher focused on investigating formal debate organised for the purpose of
teaching a topic in a course in a classroom setting. The second major concept of
interest in this study was pedagogy. According to the Merriam-Webster
Dictionary (2016), the word pedagogy is used to refer to the method and practice
of teaching. It may also be looked at as the art or profession of teaching. In this
study, pedagogy was used to refer to the use of debate as a teaching method.
Finally, the study also focused on the concept of multi-skilling. The term multi-
skilling has different meanings depending on the context in which it is used.
According to Macquarie Dictionary (2016), multi-skilling refers to the situation
where individual workers are made to possess several skills that make them
versatile in a work situation. In that regard, a multi-skilled worker is one who
possesses or acquires a wide range of skills and knowledge that he/she can
apply to accomplish tasks well beyond the original training. In the context of this
study however, the term multi-skilling was used to refer to a range of skills that
a student was expected to acquire when taught using debate including class
participation, oral communication, research, and critical thinking skills.
In terms of context, the researcher investigated the use of debate as a

pedagogical strategy at CEES. This College is one of the nine colleges that was
established by the University Council in 2011 when the University adopted the
collegiate system of administration and management (Makerere University,
2011). The College is comprised of three schools, namely: the School of
Education (SoE), School of Distance and Life-long leaning (SoDLL), and the East
African School of Higher Education Studies and Development (EASHESD). Each
year, the College enrols approximately 100 students on its different masters and
taught-PhD programmes (Makerere University, 2014a). The College employs 119
academic staff of different ranks ranging from teaching assistants to professors
(Makerere University, 2014b). Of recent, the College has experienced some cases

113
of student unrest. One source of student discontent has been over the manner in
which they are allegedly taught. Some groups of graduate students of the
College who had participated on different international exchange programmes
in which they reportedly were taught using diverse teaching methods including
debate, wondered why at CEES they were hardly taught using such techniques.
Yet, they claimed that debating would make their lessons interesting and could
improve on their presentation, public speaking and critical thinking skills. This
kind of complaint was amongst the factors that prompted the researcher to
conduct this study in order to verify what the rest of the other students and
academic staff think about such claims; hence, the genesis of this paper.
Study objectives. Overall, the study investigated the use of debate as a

pedagogical strategy in graduate level course in education courses at CEES.
However, the study intended to achieve the following specific objectives: (1) to
find out how often the graduate students at CEES were taught their courses
through debate; and (2), to establish the perception of the graduate students and
the academic staff (or faculty) of the benefits of using debate as an effective
pedagogical strategy in enhancing: (a) class participation, (b) oral
communication, (c) and (d) critical thinking.
Research questions. The study sought for answers to the following research
questions: (1) how often are you taught your courses through debate as a
pedagogical strategy? (2) What is your perception about the benefits of using
debate as an effective pedagogical strategy to enhance your: (a) class
participation, (b) oral communication, (c) research, and (d) critical thinking
skills?
Literature Review
Theoretical Review. Theoretically, this study was underpinned by the social
theory of learning. The theory is attributed to the work of scholars such as Albert
Bandura, and the Russian teacher and psychologist, Lev Vygotsky (Bandura,
1977; Vygotsky, 1962). According to the theory, people often learn in a social
context (learn from each other); therefore, educators (or teachers) should learn to
construct a social environment where active learning can occur (Bandura, 1977).
In that regard, the main role of the teacher is to create an active community of
learners by enhancing social interactions and engagements. In addition, the
theory stipulates that culture is an important factor for knowledge creation
because it is through the cultural lens that individuals learn through their
interaction with one another (Vygotsky, 1962). In this study, the social theory of
learning was preferred because the researcher looked at using debate to teach as
an opportune moment for the teacher to create a social environment within
which individuals learn from each other through imitations, interactions and
engagements. It was therefore hypothesised by the researcher that through using
debate, a teacher would create an active learning environment and community
which should enhance not only the understanding of the concepts and issues
being taught and learnt, but also facilitate the development of additional
competences in the learners such as participation, oral communication, research
and, critical thinking skills, among others.

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Related Literature. Several scholars have already written about the

importance of using debate as a pedagogical strategy. Many of these
writings have covered studies on how to use debate to teach in different
contexts and disciplines. According to Berdine (1984), for instance, there
are different types of debate that a teacher can conduct to enhance
learning. Shen (2015) identifies some of these as: dividing students into
opposing groups that present in turn or discuss in a relatively
unstructured way, free-flowing form, as well as role-playing or
simulations of media and court debates (p.1). Vargo (2012) meanwhile
classifies debate in form of: four corner, role-play, fishbowl, think-pair-
share, and meeting house debates (p.5). However, much as the format of
debate can vary, Shen (2015) contends that:
a classroom debate that serves effective teaching and learning is
encouraged to incorporate four conceptual components: (a) development
of ideas with description, explanation, and demonstration, (b) clash of
opinions supported by reasons and evidence, (c) extension or arguments
against criticisms, which again are refuted by the opponent, and (d)
perspective, the process of weighing ideas and issues to conclude with a
logical decision is made, either about the issue or about the presentation
of arguments. (p.1)
This implies that when planning and conducting a debate as a pedagogical
strategy, the teacher (or faculty or lecturer) must ensure that the exercise would
lead to the development of ideas; that there would be differences in opinions
supported by evidence; that the arguments raise would be countered, and that
the arguments would be weighed against each other. As a result, apart from
gaining new knowledge, participants would be able to strengthen their oral
communication as well as critical thinking skills.
Regarding the roles that debate plays when used as a pedagogical strategy,
several studies have already revealed significant correlations between the use of
debate and the benefits that accrue from it. Fallahi and Haney (2011) for
instance revealed that the use of debate has been found successful in involving
in undergraduate students in the teaching-learning process. Berdine (1984)
supports that view but adds that the use of debate facilitates verbal participation
and better involves students in class. This is because, according to Snider and
Schnurer (2002), the use of debate discourages passive learning, and makes the
students play an active role in understanding what is being taught. In fact, the
benefits of using debate as a pedagogical strategy according to Green and Klug
(1990), is not only enjoyed by the debaters, but even members of audience due to
the post-debate discussions that often ensue. However, the majority of these
studies were focused on undergraduate classroom settings. This particular study
instead looked at the use of debate in the context of teaching graduate students.
According to Shen (2015), debate has also been found to improve learning
outcomes (p.1). For instance, one short-term benefit of debate has been found to
enhance knowledge acquisition because as Kennedy (2009) puts it, it enables

115
students to master what they have already been taught. However in the long-
run, debate helps students to gain better comprehension, application, and
critical evaluation skills when a controversial topic is presented for
discussion (Omelicheva & Avdeyeva, 2008, p.607). These same authors also add
that debate helps to improve students listening and public speaking skills, while
Combs and Bourne (1994) contend that it opens up opportunities to develop oral
communication skills; and Vo and Morris (2006) say it enhances creativity. All
these, and more, were some of the benefits of debate that this study intended to
re-affirm in the context of graduate education
.
Methodology
In this study, the researcher used the descriptive cross-sectional sample survey
research design, where both quantitative and qualitative methods of data
collection and analysis were used. The descriptive design was preferred because
the study was aimed at investigating how the use of debate enhances the
learning outcomes of graduate students at CEES. The study specifically used the
cross-sectional survey design. This was intended to allow the researcher to
collect data from a cross-section of the study population at one point in time in
order to avoid wasting time returning to the field to collect additional data that
would make the process rather time consuming and costly if the design was
longitudinal in nature. In addition, using the design would help to generalise the
findings obtained from the sampled population to the targeted population of
graduate students pursuing masters and doctoral programmes in education as
well as the academic staff of CEES. Data were collected from 55 students and
four members of academic staff (two female and two male staff) drawn from the
College through survey and interview methods. The survey tool was adapted
from previous studies (Darby, 2007), and data analysis was conducted using
content analysis and descriptive statistical techniques.
Results
This study looked at how often the graduate students at CEES were
taught their courses using debate and whether the students perceived the
use of debate as a pedagogical strategy to enhance their class participation,
oral communication, research, and critical thinking skills. In this section, the
results of the study are presented in accordance with the research
questions that guided the investigation. But first, a description of the
characteristics of the student respondents in terms of their gender, study
programme and year of study is presented in Table 1.
Table 1: Distribution of respondents by their background characteristics
Background Attributes Frequency Percent

Variable
Gender Female 22 40
Male 33 60
Total 55 100
Program PhD 19 34.5
Masters 36 65.5
Total 55 100

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Year of Study Year 1 21 38.2

Year 2 25 45.5
Year 3 5 9.1
Above 3 years 4 7.3
Total 55 100
The results in Table 1 indicate that of the 55 graduate students who participated
in the study, 60 percent (33) were males. The remaining 40 percent (22) were
females. This finding was in agreement with the enrolment records in the
Department of the Academic Registrar which showed that there were more male
students enrolled on the masters and PhD programmes at CEES than their
female counter-parts (Department of the Academic Registrar, Makerere
University, 2016). In terms of programme of study, masters students dominated
in the study (65.5% or 36). There were only 19 (34.5%) PhD students who
participated in the study. This was also in consonant with the enrolment data in
the Department of the Academic Registrar which revealed that there were more
masters students enrolled in the College than their PhD counter-parts. Finally, in
terms of year of study, the majority of the respondents were second year
students (25 or 45.5%). These were followed by students of first (21 or 38.2%),
third (5 or 9.1%) and more than 3 years (4 or 7.3%). The dominance of the second
and first year students respectively in the study was the result of their presence
on campus during the time of data collection. The third years and those on their
study programmes beyond three years were students who were engaged in
producing their dissertations and they were rarely on campus during such
times. Overall, the data for this study were collected from students pursuing
masters and taught-PhD programmes. Therefore, they were in position to
provide valid information regarding whether their teachers (or lecturers) use
debate to teach the different courses, and whether they perceived the use of
debate to enhance their class participation, oral communication, research, and
critical thinking skills.
Research Question One

This study intended to establish how often the graduate students at CEES were
taught their courses using debate as a pedagogical strategy. The question which
guided the achievement of this objective was stated as, How often are you
taught your courses through debate as a pedagogical strategy? Under this
question, the respondents were asked to rate the frequency with which they
were taught through debate on a scale of: 1=Never, 2=Rarely, 3=Seldom,
4=Often, and 5=Always on three different questionnaire items. The results of
their ratings are presented in Table 2 below.

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Table 2: Distribution of student respondents by their ratings on how frequently they

are taught through debate
Questionnaire 1 2 3 4 5 Mean S.D
Item N R S O A
I am taught 8 27 13 5 2 2.38 0.97

using debate (14.5%) (49.1%) (23.6%) (19.1%) (3.6%)
Our courses 12 20 16 7 0 2.33 0.96

are structured (21.8%) (36.4%) (29.1%) (12.7%) (0%)
in the format
of debate
Our courses 12 21 14 6 2 2.36 1.06
are delivered (21.8%) (38.2%) (25.5%) (10.9%) (3.6%)
through
debate
Overall Total 32 78 43 18 4 2.36 0.99
(18.29%) (44.57%) (24.57%) (10.28%) (2.29%)
The results in Table 2 indicate that the majority of the respondents

(Never=14.5% and Rarely=49.1%) reported that they were hardly taught using
debate as a pedagogical strategy with a mean response rate of 2.38, and a
standard deviation of 0.97 - implying that there was high level of agreement
over the issue among the respondents. On whether their courses were structured
in the format that allows the use of debate, the majority of the respondents
(Never=21.8% and rarely=36.4%) again rated that their courses were hardly
structured to allow the use of debate as a pedagogical strategy with a mean
response rate of 2.33, and a standard deviation of 0.96. Overall, the results in
Table 2 show that the students who participated in this study were in agreement
with the fact that they were rarely taught their courses using debate with an
overall mean response rate of 2.36, and a standard deviation of 1.06. The finding
that the graduate students at CEES are hardly taught using debate as a
pedagogical strategy was corroborated by interviewing some members of the
academic staff of the College.
During interviews, one senior lecturer acknowledged that he hardly uses debate
as a method of teaching. According to him, debating is time consuming, and
most times, it is difficult to ensure proper class control during debate. He also
reiterated that with debate, it needs a lot of prior planning on the part of both
the teacher and the students. He claimed that he has no such time to think of
and to plan for debating in his classes. Another lecturer, who said that she uses
debate to teach her students once in a while, said she does so because many of
these students are lazy. When you give them work to research on, they hardly
do a good job. According to her, this discourages me from frequently
employing debate to teach my classes. Another lecturer who teaches research
methodology also acknowledged limited use of debate to teach his course unit.
He attributed this to lack of sufficient time to enable me complete the course

118
syllabi in time. These qualitative findings therefore validated the quantitative

ones that were obtained from the students.
Research Question 2(a)

The second question that guided this study was stated as, What is your
perception about the benefits of using debate as an effective pedagogical
strategy to enhance your class participation skills? The researcher asked the
respondents to rate their responses on a scale of: 1=Not at all true (NAT), 2-
Slightly true (ST), 3=True about half the time (THT), 4=Mostly true (MT), and
5=Completely true (CT) on seven questionnaire items. The results of the ratings
of the student respondents on the issue of class participation are presented in
Table 3.
Table 3: Distribution of respondents by their ratings on how true using debate
enhances their class participation
Item NAT ST THT MT CT
Debate
increases my
Class 0 3 13 25 14 3.90 0.84

participation (0.0%) (5.5%) (23.6%) (45.5%) (25.5%)
Interaction 0 2 15 24 14 3.91 0.82
with course (0.0%) (3.6%) (27.3%) (43.6%) (25.5%)
mates
Interaction 1 2 16 19 17 3.89 0.96
with teachers (1.8%) (3.6%) (29.1%) (34.5%) (30.9%)
Class 2 8 7 28 10 3.65 1.06
attendance (3.6%) (14.5%) (12.7%) (50.9%) (18.2%)
Engagement 0 3 19 21 12 3.76 0.86

with study (0.0%) (5.5%) (34.5%) (38.2%) (21.8%)
materials
Ability to get 1 1 12 30 11 3.89 0.81
more subject (1.8%) (1.8%) (21.8%) (54.5%) (20.0%)
content
Attention 0 1 13 21 20 4.09 0.82
during (0.0%) (1.8%) (23.6%) (38.2%) (36.4%)
lessons
Overall Total 4 20 95 168 98 3.87 0.88
(1.04%) (5.19%) (24.68%) (43.64%) (25.45%)
The results in Table 3 indicate that on the item debate increases my class
participation, the majority of the student respondents (Mostly true=45.5% and
completely true=25.5%) agreed that use of debate enhances their participation in
class with a mean response rate of 3.90, and a standard deviation of 0.84. But on
the issue of whether debate increases my interaction with course mates, the
majority were also in agreement with 43.6 percent rating themselves as mostly
true, and 25.5 percent as completely true with a mean response rate of 3.91, and

119
a standard deviation of 0.82. On the issue of whether debate increases my

interaction with my teachers, again the majority of the respondents rated
themselves as mostly true (19 or 34.5%), and completely true (17 or 30.9%) with a
mean response rate of 3.89, and a standard deviation of 0.96. On the issue of
debate increases my class attendance, the majority of the respondents agreed
that it is mostly true (20 or 50.9%), and completely true (10 and 18.2%) that
debate increases their class attendance with a mean response rate of 3.65, and a
standard deviation of 1.06. On the statement on whether use of debate increases
my engagement with study materials, the majority of the respondents agreed
that it is mostly true (21 or 38.2%), and completely true (12 or 21.8%) that the use
of debate increases their engagement with study materials with a mean response
rate of 3.76, and a standard deviation of 0.86. On the statement on whether the
use of debate "enables me to get more subject content, the majority of the
respondents indicated that this is mostly true (30 or 54.5%), and completely true
(11 or 20.0%) with a mean response rate of 3.89, and a standard deviation of 0.81.
Finally, on the issue of whether the use of debate makes my lessons interesting
and I pay more attention, the majority of the respondents agreed that it is
mostly true (21 or 38.2%), and completely true (20 or 36.4%) with a mean
response rate of 4.09, and a standard deviation of 0.82. Overall, the majority of
respondents rated that it is mostly true (43.64%), and completely true (25.45%)
that the use of debate increases their class participation with a mean response
rate of 3.87, and a standard deviation of 0.88. This implies that the students
perceived the appropriate use of debate to enhance their class participation
skills, other factors held constant. These findings were triangulated by
interviewing some members of the academic staff who expressed similar views
about the role of debate in enhancing class participation skills.
During the interview with members of academic staff, a respondent who is at

the rank of senior lecturer pointed out that the use of debate compels some
students to engage in the teaching-learning process. He said this happens when
the usually quiet students are assigned active roles in debating. Moreover, the
senior lecturer added that debating would force such quiet students to bring
out what they have researched on thereby making them active in class.
However, one lecturer observed that for a debate to enhance class participation,
the teacher must take care of the roles that are assigned to the different students,
otherwise some students may dodge to participate in the debating activity. All
in all, there was consensus between the students and their teachers on the role
debate plays in enhancing active learning in the classroom environment.
Research Question 2(b)

The third question that guided the study was stated as, What is your
strategy to enhance your oral communication skills? The researcher asked the
respondents to rate their responses on a scale of: 1=Not at all true (NAT), 2-
Slightly true (ST), 3=True about half the time (THT), 4=Mostly true (MT), and 5=
Completely true (CT) on five questionnaire items. The results of the ratings of
the student respondents on the issue of oral communication are presented in
Table 4.

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Table 4: Distribution of student respondents by their ratings on how true using

debate enhances their oral communication skills
Questionnaire 1 2 3 4 5 Me S.D
Item NAT ST THT MT CT an
Debate
Develops my 0 1 9 23 22 4.20 0.78
public speaking (0.0%) (1.8%) (16.4%) (41.8%) (40.0%)
skills
Builds my 0 2 9 26 18 4.09 0.80
confidence to (0.0%) (3.6%) (16.4%) (47.3%) (32.7%)
speak in public
Helps me 0 0 9 23 23 4.25 0.73
communicate (0.0%) (0.0%) (16.4%) (41.8%) (41.8%)
fluently with
others
Enables me to 0 2 13 20 20 4.05 0.87
persuade others (0.0%) (3.6%) (23.6%) (36.4%) (36.4%)
Enables me to 0 0 6 31 18 4.22 0.63
arrange (0.0%) (0.0%) (10.9%) (56.4%) (32.7%)
logically my
arguments
Overall Total 0 5 46 123 101 4.16 0.76
(0.0%) (1.8%) (16.7%) (44.7%) (36.7%)
The results in Table 4 indicate that on the item debate helps to develop my
public speaking skills, the majority of the student respondents (Mostly
true=41.8% and Completely true=40.0%) agreed that debate develops their
public speaking skills with a mean response rate of 4.20, and a standard
deviation of 0.78. On the issue of whether the use of debate helps to build my
confidence to speak in public, the majority of the respondents were also in
agreement that using debate helps them build confidence in public speaking
with 47.3 percent rating their feelings as mostly true and 32.7 percent rating as
completely true with a mean response rate of 4.09, and a standard deviation of
0.80. On the issue of whether using debate enables me to communicate fluently
with others, again the majority of the respondents rated that it is mostly true
(23 or 41.8%), and completely true (23 or 41.8%) that debate enhances them to
communicate fluently with other people with a mean response rate of 4.25, and a
standard deviation of 0.73. On the issue of whether the use of debate enables
me to persuade others to support my argument, the majority of the
respondents agreed that it is mostly true (20 or 36.4%), and completely true (20
or 36.4%) that debate helps them to persuade others with a mean response rate
of 4.05 and a standard deviation of 0.87. On the question of whether the use of
debate enables me to logically arrange my arguments, the majority of the
or 32.7%) that debate helps them to arrange their arguments with a mean
response rate of 4.22, and a standard deviation of 0.63. Overall, the majority of
respondents rated that it is mostly true (36.72%), and completely true (44.7%)
that debate enhances their oral communication skills with a mean response rate

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of 4.16, and a standard deviation 0.76. This implies that appropriate use of
debate would make learners acquire better oral communication skills, other
factors notwithstanding.
During interviews with the academic staff, a respondent who is at the rank of
senior lecturer pointed out that the use of debate practically engages students
in the teaching-learning process and since debating involves talking, it must
induce students to learn how to speak in public. Frequent participation in
debate therefore can enable individuals learn how to speak in public, the
interviewee added. Another lecturer who was also interviewed observed that
since debate makes students discuss issues from different perspectives, it helps
them learn how to persuade others to look at an issue from their perspectives.
This, the interviewee added, can be helpful in developing persuasion and
negotiation skills. Moreover, the interviewee also said, frequent use of debate
should help to reduce fears and anxiety that many individuals face when they
are made to speak in public especially to a large audience. In that regard, use of
debate as a pedagogical strategy makes students gain confidence in themselves
and in their ability to convince others.
Research Question 2(c)

The fourth question that guided the study was stated as What is your
strategy to enhance your research skills? The researcher asked the respondents
to rate their responses on a scale of: 1=Not at all true (NAT), 2-Slightly true (ST),
3=True about half the time (THT), 4=Mostly true (MT), and 5=Completely true
(CT) on six questionnaire items. The results of the ratings of the student
respondents on the issue of research skills are presented in Table 5.
Table 5: Distribution of respondents by their ratings on how true using debate

enhances their research skills
Item NAT ST THT MT CT
Debate
enhances my
Literature 0 2 14 24 15 3.94 0.83
search skills (0.0%) (3.6%) (25.5%) (43.6%) (27.3%)
Organization 0 4 21 22 8 3.62 0.83
skills (0.0%) (7.3%) (38.2%) (40.0%) (14.5%)
Data collection 0 7 14 27 7 3.62 0.87
skills (0.0%) (12.7%) (25.5%) (49.1%) (12.7%)
Analytical skills 0 3 18 24 10 3.75 0.82
(0.0%) (5.5%) (32.7%) (43.6%) (18.2%)
Discovery skills 0 1 17 24 13 3.89 0.79
(0.0%) (1.8%) (30.9%) (43.6%) (23.6%)
Discussion 0 1 9 24 21 4.18 0.78
skills (0.0%) (1.8%) (16.4%) (43.6%) (38.2%)
Overall Total 0 18 93 145 74 3.83 0.82
(0.0%) (5.45%) (28.18%) (43.94%) (22.43%)

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The results in Table 5 indicate that on the item debate enhances my literature
search skills, the majority of the student respondents (Mostly true=43.6% and
completely true=27.3%) agreed that debate enhances their literature search skills
with a mean response rate of 3.94, and a standard deviation of 0.83. But on the
issue of whether the use of debate enhances my organization skills, the
majority were also in agreement with 40.0 percent rating as mostly true and 14.5
percent rating their feelings as completely true with a mean response rate of
3.62, and a standard deviation of 0.83. On the issue of whether the use of debate
enhances my data collection skills, again the majority of the respondents rated
that it is mostly true (27 or 49.1%), and completely true (7 or 12.7%) with a mean
response rate of 3.62, and a standard deviation of 0.87. On the issue of whether
the use of debate enhances my analytical skills, the majority of the
or 18.2%) with a mean response rate of 3.75, and a standard deviation of 0.82. On
the question of whether the use of debate enhances my discovery skills, the
majority of the respondents agreed that it is mostly true (24 or 43.6%), and
completely true (13 or 23.6%) with a mean response of 3.89, and a standard
deviation of 0.79. On the question of whether the use of debate increases my
skills for discussion, the majority of the respondents indicated that this is
mostly true (24 or 43.6%), and completely true (21 or 38.2%) that the use of
debate enhances their discussion skills with a mean response of 4.18, and a
standard deviation of 0.78. Overall, the majority of the respondents rated that it
is mostly true (43.94%), and completely true (22.43%) that the use of debate
enhances their research skills with a mean response rate of 3.83, and a standard
deviation 0.82. This implies that an appropriate use of debate should make
students acquire different research skills including the skills to review literature,
collect and analyse data and make concrete discussions.
During interview with members of academic staff, a respondent who is at the

rank of senior lecturer pointed out that the use of debate compels some
students to do research on the topic being debated and this helps them to master
the skills not only of reviewing literature, but also to be critical and analytical in
their reviews. Such skills, the senior lecturer said can be very helpful to a
student during the time of writing his or her dissertation. However, one
lecturer observed that for debate to enhance the students research skills, the
teacher must take care of the roles that are assigned to the different students
otherwise some students may dodge to participate in the debate. All in all,
there was consensus between the students and their teachers on the role debate
plays in enhancing the learners research skills.
Research Question 2(d)

The fifth question that guided this study was stated as, What is your perception
about the benefits of using debate as an effective pedagogical strategy to
enhance your critical thinking skills? The researcher asked the respondents to
rate their responses on a scale of: 1=Not at all true (NAT), 2-Slightly true (ST),
3=True about half the time (THT), 4=Mostly true (MT), and 5= Completely true
(CT) on five questionnaire items. The results of the ratings of the student
respondents on the issue of critical thinking are presented in Table 6.

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Table 6: Distribution of student respondents by their ratings on how true using

debate enhances their critical thinking skills
Questionnaire 1 2 3 4 5 Me S.D
Item NAT ST THT MT CT an
Debate
Develops my 0 5 7 26 17 4.00 0.90
critical thinking (0.0%) (9.1%) (12.7%) (47.3%) (30.9%)
skills
Helps in 0 1 14 25 15 3.98 0.78
organizing my (0.0%) (1.8%) (25.5%) (45.5%) (27.3%)
thoughts
Helps me 0 3 15 28 9 3.78 0.79
prioritize (0.0%) (5.5%) (27.3%) (50.9%) (16.4%)
information
Helps me to 0 3 11 26 15 3.96 0.84
form my (0.0%) (5.5%) (20.0%) (47.3%) (27.3%)
opinions
Enhances me to 0 7 8 25 15 3.87 0.96
deconstruct (0.0%) (12.7%) (14.5%) (45.5%) (27.3%)
others opinions
Overall Total 0 19 55 130 71 3.92 0.85

(0.0%) (6.91%) (20.0%) (47.27%) (25.82%)
The results in Table 6 indicate that on the item, debate develops my critical
thinking skills, the majority of the student respondents (Mostly true=47.3% and
completely true=30.9%) agreed that debate develops their critical thinking skills
with a mean response rate of 4.00, and a standard deviation of 0.90. But on the
issue of whether the use of debate helps in organizing my thoughts, the
majority were also in agreement with 45.5 percent rating mostly true, and 27.3
percent rating completely true that debate helps to organize their thoughts with
a mean response rate of 3.98, and a standard deviation of 0.78. On the issue of
whether the use of debate helps me to prioritize information, again the
majority of the respondents rated that it is mostly true (28 or 50.9%), and
completely true (9 or 16.4%) that debate helps them to prioritize their
information with a mean response rate of 3.78, and a standard deviation of 0.79.
On the issue of whether the use of debate helps me to form my opinions, the
majority of the respondents agreed that it is mostly true (15 or 27.3%), and
completely true (26 or 47.3%) that debate helps them to form their opinions with
a mean response rate of 3.96, and a standard deviation of 0.84. On the question
of whether the use of debate enhances me to deconstruct the opinion of others,
the majority of the respondents agreed that it is mostly true (25 or 45.5%), and
completely true (15 or 27.3%) that using debate helps them to deconstruct others
opinions with a mean response rate of 3.87, and a standard deviation of 0.96.
Overall, the majority of respondents rated that it is mostly true (47.27%), and
completely true (25.82%) that debate enhances their critical thinking skills with a
mean response rate of 3.92, and a standard deviation 0.85. This implies that an
appropriate use of debate would make students think critically.

124
During interviews with the academic staff, a respondent who is at the rank of
senior lecturer pointed out that the use of debate enables students to organize
their thoughts and set out what information to give out first or later. This, he
said, is helpful in strengthening their thinking abilities. Besides, the
interviewee observed that during debate, participants on either side listen
carefully to the arguments of their opponents which they often try to counter.
This shows that debate equips the participants with the ability to deconstruct
the opinions of others, the interviewee said. Such critical thinking abilities are
generally helpful to the individuals not only during debating, but even in
different life-settings.
Discussion
In this study, five key findings were made. First, that members of academic staff
(or lecturers) at CEES hardly employ debate to teach graduate students. This
finding is not strange. According to Darby (2007), the use of debate as a
pedagogical strategy started to decline across the world at the beginning of the
19th century and it was until the 1980s that the move to revive debating began,
again. Since then, the use of debate as a pedagogical tool has remained
intermittent in many classroom settings. But bearing in mind the numerous
benefits of debate, university teachers (or academic staff) need to think about the
need to effectively employ debate as a possible means of enhancing effective
learning where students would not ordinarily learn, but acquire other additional
salient skills including communication, critical thinking and research skills.
Second, the study established that the use of debate as a pedagogical strategy is
perceived to generally enhance students class participation. This is in agreement
with the findings of many other scholars. For example, as Vargo (2012 points
out, debate engages the students in active learning because it provides them
with the opportunities to talk, listen, read, write and reflect as they approach
the course content (p. 3). In addition, earlier research has also shown that the
use of debate encourages class participation among those students that typically
do not talk in class (Darby, 2007). However, this can only happen if the teacher
(or academic staff) carefully assigns the roles different students play in debate.
Third, the study found out that using debate is perceived to help students
develop critical thinking skills. This is also in agreement with the findings of
many other earlier researchers. Darby (2007) for instance found out that debate
enhances active learning of students because according to him, debate
encourages talking, listening, and reflecting on what others say. According to
Omelicheva and Avdeyeva (2008), using debate to teach does not only enhance
the acquisition of basic knowledge on the subject content being discussed, but it
can enable students think harder and develop more critical thinking skills that
will not be used only for understanding the current subject matter, but for
solving other life-problems as well. This is because, debaters must critically
analyse the issues at hand if they are to ably oppose the other debating side. This
process of analysing issues helps to develop individuals oral communication
skills, and as Combs and Bourne (1994) put it, debating refines the listening

125
skills of the students who engage in it so that they are able to make effective
rebuttals. As a result, the use of debate enhances the development of critical
thinking skills in the participants. This, Combs and Bourne (1994) said, is true
not only for those that actively engage in debating, but even for those in the
audience. And this view is not far from that of this author.
Fourth, the study furthermore established that using debate is also perceived to
enhance students research skills. This is also in agreement with Vargos (2012)
findings where he argues that the use of debate makes participants search for
new materials (or points) from literature and other sources, and assemble them
for presentation to their opponents in a persuasive manner (Omelicheva &
Avdeyeva, 2008). As a result, debaters often acquire literature review,
organization, gathering information and discussion skills. All these skills are
very helpful to the learner when he or she later gets engaged in research work.
Finally, the study confirmed that the use of debate as a pedagogical strategy is
perceived by both students and staff to enhance the development of students
oral communication skills. This is also in consonant with the findings of earlier
researchers who pointed out that debating engages students in talking,
defending and persuading others over the issues that are debated upon (Combs
& Bourne, 1994). Besides, debating helps participants deconstruct the opinions
of others as well as form their own opinions. These competences are helpful to
the debaters for gaining self-confidence and for making effective oral
communication. The findings of this study, however, are generally in consonant
with that of several other scholars; although, this study explored the use of
debate as a pedagogical strategy in the milieu of graduate education.
Conclusions and Recommendations

On the basis of the study findings, the researcher concluded that the students at
CEES were not regularly being taught their courses using debate; yet they would
prefer it that way. Secondly, the members of academic staff at CEES were aware
of the benefits of using debate as a pedagogical tool; though they were unable to
use it regularly for diverse reasons. Finally, it was also concluded that both
graduate students and academic staff have a positive perception on the use of
debate as a teaching-learning strategy. Therefore, the author recommends that
academic staff at CEES and elsewhere should embrace the frequent and planned
use of debate as a pedagogical strategy since it is perceived not only to
encourage active learning, but also enable the acquisitions of extra competences
by learners.
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Vol. 15, No. 7, pp. 127-137, June 2016
Constructivism- Linking Theory with Practice

among Pre-Service Teachers at the University
of Trinidad and Tobago
Leela Ramsook and Marlene Thomas

University of Trinidad and Tobago
Trinidad
Abstract. In this paper, the authors investigated how the Year Two
cohort of pre-service teachers in the primary specialization at the
University of Trinidad and Tobago linked the theory of constructivism
with practice in the implementation of their lessons during practicum. A
mixed method approach was adopted and the sample included 108
participants. Data were gathered using multiple methods such as
questionnaires, focus group interviews and reflections which facilitated
triangulation of data. Findings revealed that most participants are
familiar with the tenets of the theory of constructivism. Many pre-
service teachers have applied the principles during practicum but others
opted to engage in the traditional mode of teaching and learning.
Participants experiences are demonstrated in the following themes that
emanated: active learning, sharing ideas, student centred and
interactive learning, engaged in the learning process and learning by
doing. It can be concluded that while some pre-service teachers were
able to translate theory into practice, many of them found it challenging
to change from a traditional frame of reference.
Keywords: pre-service teachers, constructivism, theory, practice
Introduction
The literature revealed multiple definitions of constructivism with variations
based on the perspectives of various authors. This research focused on
constructivism as a theory which explains how each child constructs meaning
through the learning experiences provided by the teacher. The theory
incorporates cognitive, social and radical constructivism. The research explored
whether pre-service teachers have adopted a constructivist approach in teaching
and learning during their practicum.
Situating the Study

At the University of Trinidad and Tobago all pre-service teachers in Year Two
have been exposed to mandatory foundational courses such as Student Centred
Pedagogy and Psychology of Learning, in which constructivism forms a
significant component, thus all pre-service teachers would have been
introduced to constructivist-based theory and pedagogy. The study attempted

128
to discern the extent to which the theory of constructivism was translated into
practice by pre-service teachers.
Literature Review
The Theory of Constructivism
There are multiple perspectives of constructivism such as cognitive
constructivism, social constructivism and radical constructivism. Many
definitions have been proffered including the following:
The central principles of this approach are that learners can only make sense
of new situations in terms of their existing understanding. Learning involves
an active process in which learners construct meaning by linking new ideas
with their existing knowledge. (Naylor & Keogh, 1999, p. 93)
The central focus of constructivism is that knowledge is conceptualized as a

process in which the learner actively constructs meaning and learns through
experience. Beyhan and Kksal (2013) note, What is important in constructivist
learning is how the individual makes meaning out of knowledge rather than
adopting it (p. 172).
Constructivism and Teaching

Teachers who use the principles of constructivist theory provide interesting
activities for students so that they are engaged in active learning. Chaille (2008)
maintains that constructivism is the theory that underlies the choices and
decisions you make about how you set up the classroom, choose the curriculum,
and respond to the childrens work and ideas (p. 5). As facilitators of learning,
teachers mentor and guide students to construct their own meaning (Piaget,
1970; Jones & Brader-Araje, 2002). Learning is a constructivist activity that the
students themselves have to carry out . . . the task of the educator is not to
dispense knowledge but to provide students with opportunities and incentives
to build it up (von Glasersfeld, 1996, p. 7). A similar view is expressed by
Hackthorn, Solomon, Blankmeyer, Tennial & Garczyn, 2011). Authentic
experiences that are meaningful are provided for pupils so that they may
explore, discover and solve problems based on their prior knowledge. Chaille
(2008) notes that . . . constructivism underlies all aspects of childrens activities
and experiences in the classroom (p. 3).
Teachers also encourage learning by doing (Hackthorn, Solomon, Blankmeyer,
Tennial & Garczyn, 2011) which includes problem solving activities, inquiry
based learning (Kirschner, Sweller & Clark, 2006) and cooperative learning
(Friend & Cook, 2010) so that pupils can be involved in direct engagement
(Tobias & Duffy, 2009; Taber, 2016) to share, collaborate and negotiate with each
other (Kagan, 1994; Johnson and Johnson, 1999). A conducive environment
(Tobias & Duffy, 2009) and the necessary resources are provided to support
learning for each individual student. Teachers promote cognitive and social
development by using constructivist principles as students are scaffolded to
their next level of learning (Vygotsky, 1970; Beyhan & Kksal, 2013).
Teachers function within frames of reference and they use these frameworks to
formulate their plans, interpret their experiences and respond to classroom

129
events (Kennedy, 1999). From a very impressionable age pre-service teachers

were conditioned by traditional methods of teaching and learning, thus when
they are encouraged to use an entirely different type of teaching, they are asked
to shift to an entirely different frame of reference. The literature is replete with
examples of the tendency of pre-service teachers to teach the way they were
taught as students (Fosnot, 1996; Kennedy, 1999; McCrea, 2012). The endurance
of traditional teaching practice derives in part from the fact that teachers are
highly likely to teach in the way they themselves were taught (Kennedy, 1999, p.
55). Pre-service teachers view learning as the acquisition of facts and perceive
the teachers roles as showing and telling students what they need to know
(Fosnot, 1996; McCrea, 2012). There is therefore need to promote the self-efficacy
of pre-service teachers (Flores, 2015), deconstruct their beliefs (Prawat, 1992)
through activity, reflection and discourse in both coursework and fieldwork
throughout the duration of the programme (Fosnot, 1996, p. 206). In addition,
Kennedy (1999) notes,
The apprenticeship of observation is an important omission from the

received wisdom model of teacher learning . . . This apprenticeship gives
teachers a frame of reference that allows them to interpret their experiences
and gives them some ideas of how to respond to them. (p. 55)
Cognitive Constructivism
Piagets (1970) cognitive constructivism proffers that learning is active cognizing
whereby each child constructs personal meaning through his/her experiences.
One of Piagets (1970) principles is that learning is an adaptive process whereby
children build on their previous experiences and this has implications for the
way in which information is presented by the teacher. Piaget (1970) postulates
learning by doing which suggests that teachers need to provide hands-on
experiences for students. The theorist believes that a learner assimilates and
accommodates new knowledge into his/her existing schema, thus information
is always reviewed and re-constructed in new ways (Selley, 1999; Tobias, &
Duffy, 2009).
For Piaget (1980), interaction means a cognitive subject that is dealing with
previously constructed perceptual and conceptual structures (von Glasersfeld,
1996, p. 5). Teachers must therefore provide meaningful activities which are
related to the real world, that is, students social, cultural and language
background to enhance cognitive development. However, while cognitive
constructivism has contributed substantially to effective teaching and learning,
a major critique levelled against the theory by observers such as Taber (2016) is
that it fails to address the issue of subjectivity.
Social Constructivism
Social constructivism, advanced by the theorist Vygotsky (1978) emphasized the
collaborative nature of learning and the role of the cultural and social
environment. The theory advocates that learning takes place in a social
environment in which there is dialogue, discussions and problem solving
activities. Learning is seen as a social phenomenon and teachers employ

130
collaborative teaching and learning methods (Jones & Brader-Araje, 2002), so

that teamwork and group skills are developed.
Cooperative learning, which involves positive independence, individual

accountability, equal participation and simultaneous interaction (Kagan, 1994)
forms key components of social constructivism. With cooperative learning
activities (Slavin, 1990; McCrea, 2012), children are supported by each other or
more knowledgeable others (Vygotsky, 1978; Tobias & Duffy, 2009).). Theorists
Johnson and Johnson (1999) include face-to-face promotive interaction,
interpersonal and small group skills and group processing as critically
important criteria for constructivist activities. These cooperative learning
principles are supported by commentators such as Beyhan and Kksal (2013);
Naylor and Keogh (1999) and Taber (2016).
Radical Constructivism
Radical constructivists such as von Glasersfeld (1996) believe that each
individual makes associations and constructs unique interpretations but the
process of understanding is based on the persons subjective interpretation of
the experience, thus suggesting that even though an experience may be
identical, there is no way of knowing that the understanding or meaning
constructed is the same. Knowledge is constructed from experience, . . .
because they are individual constructs, one can never say whether or not two
people have produced the same construct (von Glasersfeld, 1996, p. 5).
Researchers such as Riegler (2015) argue that for radical constructivists, the
senses, which mediate the external, may not represent the configuration of
objects or even interactions in a unified way, which makes reality very
subjective.
Co-teaching
Co-teaching has been defined in multiple ways but for the purpose of this
research it involves team work of two persons to plan and implement lessons, as
well as assess a class of students. This type of co-teaching is also referred to as
team teaching where the members of the team co-teach alongside one another
and share responsibility for planning, teaching, and assessing the progress of all
students in the class (Cook, 2004; Titus, 2013). In order to utilize this method of
teaching while using constructivist principles, pre-service teachers
communicated, collaborated, built trust and creatively constructed lesson plans
with their peers. They became involved in cooperative learning activities
(Kagan, 1994; Johnson & Johnson, 1999; Friend & Cook, 2010) to determine
teaching strategies and students activities in formulating their lesson plans. The
pre-service teachers shared responsibility, set mutual goals and ensured
combined ownership of the development and implementation of lessons.
In the process of planning their lessons they were engaged in constructivist

learning by sharing ideas with their partners (Cook, 2004), cooperating teacher
and practicum advisors. The aim was to build competency (Flores, 2015) and
collegiality among themselves as well implement effective lessons to increase
students learning. They were expected to apply constructivist learning

131
principles in their classes and refine their technique and personal style
(Kennedy, 1999; Taber, 2016) throughout the field teaching exercise in the
classroom.
Purpose of the Study

The purpose of the study was to investigate whether pre-service teachers
understand the theory of constructivism. It also attempted to determine whether
the participants applied the theory of constructivism in their practical teaching.
In addition, the research examined the experiences of the participants in the
application of the theory.
Research Questions
1. Do pre-service teachers understand the theory of constructivism?
2. Do pre-service teachers apply the theory of constructivism in the

implementation of their lessons during practicum?
3. What were the experiences of pre-service teachers in applying the theory

of constructivism in their classes?
Methodology and Design

Sample
The sample included a Year Two cohort of pre-service teachers at the University
of Trinidad and Tobago. The participants were enrolled as full-time students at
the Centre for Education programmes at the Corinth Campus, in the southern
part of Trinidad. In the second term of the academic year, the participants
engaged in co-teaching, one day per week for three consecutive weeks during
which each team planned and implemented six lessons.
Instruments
This research adopted a mixed method approach (Johnson & Onwuegbuzie,
2004) including both a qualitative and quantitative methodology and design.
Mixed method research closes the gap between qualitative and quantitative
research (Johnson & Onwuegbuzie, 2004). A questionnaire was used as the
instrument to collect data. The instrument was pilot tested to determine the
appropriateness of the items (Miles, Huberman & Saldana, 2014) and some of
the questions were reworded for clarity which increased the validity of the data
collection procedure (Creswell, 2012). The items included fifteen questions
consisting of eleven yes/ no responses and four open ended questions. The
questionnaire was administered to 130 participants and 108 responses were
received. No coercion was used in the data gathering process as participants
were informed beforehand that participation was totally voluntary.
Focus groups interviews using structured questions were conducted with five
co-teaching teams to acquire one on one information about experiences. The
interviews were audio recorded and transcribed verbatim. The transcripts were
returned to the participants for verification of the data, thereby establishing
accuracy and authenticity (Denzin & Lincoln, 2011). Pre-service teachers also

132
wrote reflections about their experiences and the practical application of

constructivist teaching. The multiple methods of data collection allowed for
triangulation as well as affirmed credibility and confirmability (Cohen, Manion
& Morrison, 2007; Creswell, 2012).
Results
From the data, 96.2 % of the participants revealed that they understand the
principles of constructivism. When asked if the theory of constructivism
influenced their personal philosophy of teaching and learning 98.1% of the pre-
service teachers answered affirmatively and 1.9 responded negatively. A total of
81.48% of them stated that they applied constructivist principles in the
implementation of their lessons while 18.52% revealed that they neglected to do
so.
The majority of pre-service teachers, 90.7%, reported that they employed hands
on activities but 9.3 stated that they did not. The data showed that 89.8% of the
pre-service teachers used cooperative learning while 10.2% mentioned that they
omitted to do so, thus implying that they would have retained traditional
modes of teaching and learning. A significant number, 75.9% explained that
they utilized problem solving activities while 24.1% stated that they overlooked
the approach during practicum.
Table 1: Responses from Questionnaire Represented in Percentages
Questions %Positive %
responses Negative
responses
1. Have you been exposed to Constructivism as a 96.2 3.8
learning theory?
2. Do you know about Cognitive and Social 87.03 12.97

Constructivism?
3. Are you familiar with Radical Constructivism 73.14 26.86
4. Have you been exposed to learning theories 97.2 2.8

and student-centred pedagogy?
5. Has the theory of constructivism influenced 98.1 1.9

your personal philosophy of teaching & learning?
6. Do you think that the constructivist theory is 95.3 4.7

useful for practicum/ classroom practice?
7. Did you use Cooperative learning during your 89.8 10.2

practicum?
8. Did you apply constructivist principles in the 81.48 18.52

implementation of your lessons?

133
9. Was your lesson student-centred? 86.1 13.9
10. Did you have constructivist problem solving 75.9 24.1

activities for your students?
11. Did you engage your students in hands-on 90.7 9.3

activities
The experiences of some pre-service teachers are outlined below as the

qualitative data cannot be quantified (Creswell, 2012). Common themes
(Lichtman, 2006) that evolved include: active learning; sharing ideas; student
centred and interactive learning; learning by doing and engaged in the
learning process. The themes are congruent with the reflections that pre-service
teachers stated in writing, also with the focus group interviews as well as the
answers to the open ended questions on the questionnaires.
The team members of the focus groups explained their experiences as follows:
Team A
Learning was effective because we did not use chalk and talk teaching strategies.
We involved the students in active learning through the use of manipulatives,
guided instructions and guided questions. We also engaged them in peer activities
to promote peer tutoring and . . . peer assessment. We also activated their schema
about the concept by eliciting their previous knowledge at the beginning of the
class which is important for the students making meaning . . . with regard to the
concept and redounds to long term memory.
Team B
Learning was indeed effective because of the level of participation and enthusiasm
shown by students . . . sharing ideas. They were able to manipulate resources . . .
engage in discussion and peer learning . . . and the assessments were completed
with a high degree of accuracy by the majority of students.
Team C
Our lessons were very student centred and interactive with the additional support
of effective age appropriate resources. The lessons were student centred, eye
catching and most important informative. When higher order questions were
asked, the students responded brilliantly . . . and you realized the importance of
involving them in group activities.
Team D
Learning was effective because the students learnt from each other by exchanging
ideas on how to do the activity . . . they were engaged in the learning process . . .
We were able to assist all students by taking them from one level to the next
according to Vygotskys zone of proximal development.
Team E:
Learning was effective as the students were able to learn by doing, not by the
teacher telling them but by actively participating . . . based on student centred
and interactive learning.

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Some reflections that students wrote, which are aligned with the themes that
emanated from the data, include the following:
1. Students collaborated . . . they came up with their responses.
2. Students were given the chance to actively engage in the lessons.
3. Students were able to do the activities and were given the experience.
4. Students were more involved due to the new methods and the activities used.
5. The problem-based learning . . . and the constructivist strategies used were effective.
The findings revealed that all pre-service teachers are familiar with the theory
of constructivism. Secondly, a significant percentage used constructivist
learning principles and activities such as cooperative learning in their teaching
during practicum. In addition, five themes about pre-service teachers
experiences which emerged are as follows: active learning, sharing ideas,
student centred and interactive learning, engaged in the learning process, and
learning by doing. However, a number of the participants indicated that they
did not use constructivist principles of teaching and learning, for instance
problem solving, in the implementation of their lessons and did not create
activities for students to construct their own meaning. An outlier that
emanated from the study can be summarized in the following statement by
one participant: Students were able to answer questions and the learning objectives
were met . . . they understood the task because they did well in the evaluation. These
responses indicate that some pre-service teachers perceive teaching and
learning as product rather than process.
Discussion
While a majority of respondents are familiar with cognitive and social
constructivism, approximately twenty five percent are not familiar with
radical constructivism. This suggests that the concept of radical constructivism
(Reigler, 2016) has to be deconstructed during practicum so that pre-service
teachers have a holistic orientation to constructivism. Most of pre-service
teachers indicated that they used constructivist activities in the
implementation of their lessons, which means that they were able to translate
theory into practice. However, a minority continued in the traditional domain.
The implication is that some of the pre-service teachers continue to be
challenged with the translation of the theory of constructivism into classroom
practice. Others may still be steeped in the ideology of traditional teaching and
have difficulty applying constructivist principles of teaching and learning.
This may be attributed to the ways in which they were taught by their former
teachers (Kennedy, 1999; Kirschner, Sweller & Clark, 2006) or their frames of
reference.
Another explanation is that pre-service teachers modelled their cooperating
teachers who utilized traditional methods of teaching and learning. A further
suggestion is that the pre-service teachers found it easier to plan and deliver

135
traditional lessons. It may also be an indication of their fears about failure or

uncertainty about changing from a traditional frame of reference to a new mode
of teaching and learning. In addition, there may be implications for self-efficacy,
self-competence, self-confidence and the emotional challenges affiliated with
being assessed by practicum advisors during the co-teaching practicum.
It must be noted that during their first year, the pre-service teachers in this study
were exposed to observation practicum which consisted of observing their
cooperating teachers in the conduct of their classes. They also experienced
campus based practical sessions in which they were given the opportunity to
teach in simulated classrooms. The lack of one hundred percent success in
transitioning to constructivist practices therefore demonstrates the power of
tradition and the difficulty associated with changing ingrained cultural patterns.
As Titus (2013) notes, practicum advisors may need to shift their current
paradigm of knowledge for practice . . . to . . . knowledge of practice (p. 13)
which is more meaningful to pre-service teachers and this suggests a
restructuring of teacher education programmes.
Conclusion
For successful constructivist practices, there needs to be continuous reflective
practice and effective mentoring of pre-service teachers by practicum advisors
in collaboration with cooperating teachers. Practicum tutors need to engage
pre-service teachers in discourse to discern the difficulties of implementation,
issues of time constraints, limitations and other individualistic concerns.
Resistance to change from one frame of reference to another must be
interrogated and the necessary intervention strategies employed. One
suggested method to mitigate concerns and heighten transformation is to
engage pre-service teachers in simulated activities on a regular basis.
Continuity is required if constructivist practices are to prevail. Those who
used constructivist principles also need reinforcement to refine their teaching
skills. For the traditionalists, a consistent reflective approach is necessary if
beliefs are to be modified. Practice, observation, modelling and coaching need
to be conducted throughout the duration of the programme to facilitate
modification of pre-service teachers perceptions, to assist those who are
steeped in the transmissionist mode of teaching in the transition process, and
to ensure the continuation of constructivist principles for teaching and
learning.
Recommendations
The findings of this study imply that other pertinent aspects of classroom
implementation of pre-service teachers need to be investigated in order to gain
a deeper understanding of the issue of translating the principles of the theory
of constructivism into practice. To this end, it may be necessary to examine pre
service teachers early experiences in teaching and learning. This investigation
may clarify reasons for the continuation of the retention of traditional methods
of teaching and learning by pre-service teachers whilst on teaching practice.
During field teaching, pre-service teachers do spend a considerable amount of
time being supervised or mentored by cooperating teachers, thus it may be

136
necessary to conduct an investigation into the methods of teaching and

learning that cooperating teachers implement in their classes.
Acknowledgement
We wish to acknowledge the contributions of all the pre-service teachers who
participated voluntarily in this research.
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Vol. 15, No. 7, pp. 138-147, June 2016
Pupil Perception of Teacher Effectiveness and

Affective Disposition in Primary School
Classrooms in Botswana
Molefhe, Mogapi and Johnson, Nenty

Educational Foundations, University of Botswana
Abstract. Teacher effectiveness, in the eyes of learners, in the classroom

is to a large extent determined by the atmosphere created by teachers
classroom behavior especially the degree to which a teacher carries the
class along during lesson. Children are leading the way in demanding
accountability from teachers and one important expectation is a
classroom which is psychologically conducive for learning. Such
classroom tends to induce from the learners desirable affective
behaviors that are conducive for teaching and learning. This study aims
at finding the relationship among pupil- perceived teacher effectiveness
and their own level of exhibition of desirable related behavior in their
classrooms. Survey data was collected from 472 learners taken from 29
primary schools drawn through stratified random sampling method
from urban private schools and rural remote areas in Botswana. The
relationship between pupil's perceived teacher effectiveness factors and
their own affective disposition in the classrooms were found using
Pearson correlation analysis. The results showed that generally pupils
perceived level of their teachers effectiveness in terms of classroom
assessment behavior, teaching strategy, provision of feedback and their
overall effectiveness in teaching English language have significant
influence on their interest in the following key areas; subject of study
(e.g., English Language) , classroom environment, perceived level
difficulty of learning English, preference for group work in the class and
general attitude towards the going-ons in the class. The findings were
discussed and related recommendations made.
Key words: teacher effectiveness; affective dispositions; primary

schools; pupil input; Botswana.
Introduction and Background

Children are leading the way in demanding teacher accountability on the
classroom (Cox, Dyer, Robison-Pant. & Schweisfurth, 2010). One important
attribute pupils expect from their teachers is a classroom which is

139
psychologically conducive for learning. The way primary pupils perceive their
teachers in terms of effectiveness tends to influence their affective disposition in
the class room. Such perception can make the pupil cool and withdrawn or
lively and active in the class. Pupils that perceive their teacher as ineffective
tend to feel that there is not much they can learn from the teacher, and this
can ultimately affect their performance in the class. Learning under a teacher
one perceives to be effective prompts attention, participation, and good feelings
in the classroom. Hence a pupils perception of the effectiveness of the teacher in
front of him/her in a classroom situation tends to be governed by, to an extent,
the quality the affective and cognitive environment he/she has created in the
classroom.
Teacher effectiveness becomes a significant factor to which pupil easily
attribute their performance (Ee & Cheng, 2013; Hughes, 2012;Metto & Makewa,
2014). For example, according to Akiri and Ughurugbo ( 2009) "Poor academic
performance of students in Nigeria has been linked to poor teachers
performance in terms of accomplishing the teaching task, negative attitude to
work and poor teaching habits which have been attributed to poor
motivation (p.109).
In this study, teacher effectiveness as an important factor in classroom
climate was defined in terms of learners perception of their teacher's classroom
teaching behavior, teaching strategy; assessment behavior; provision of
feedback; effective use of visual media; and effectiveness in teaching English.
Theoretical Foundation
To Medley and Shannon (1994) teacher effectiveness exists in three
dimensions: (1) the
degree to which a teacher achieves desired effects on students; ( 2) the extent to
which a teacher has the requisite knowledge and skills; and (3) how a teacher
behaves in the process of teaching. While the first one incorporates mainly
affective behavior; the second one is mainly cognitive; and the third one
mainly psychomotor, with some component of both cognitive and affective
behavior. As key operators in a service industry good social foundation and
interpersonal skills are necessary skills that must be possessed by all teachers for
them to be effective in the classroom. Exhibition of these skills creates a
conducive classroom environment which enhances learning. For example, it is
difficult for a child to learn from a teacher he/she deems unfriendly. Teacher
training programmers tend to overlook this essential behavior of the teacher.
The nature of the classroom atmosphere determines the quality of the
relations, strategies and processes that goes on in the classroom of the classroom
and personal interaction is valued more by primary school students than
qualities related to teaching and learning (Jeffery, 2001, p. 2). Teachers
emotions therefore are considered to be important factors in teacher training,
development and practice because they affect teachers commitment, interest
and personal welfare (Jeffery, 2001). Personal interaction is an aspect of what
might be termed effective personality, which is a large component of classroom
climate.
Possession of necessary knowledge and skills is fundamental to
effectiveness in teaching
and a teacher is effective to the extent that he/ she exhibits these skills. An

140
effective teacher is one that is versed in the content to be taught and competent
in the skills to be imparted. Even if the teacher possesses very good
interpersonal skills and is very good in his/her subject matter but lacks the skills
on how to deliver the materials he she cannot be said to be effective (Nikolova,
Todorova, & Valcheva, 2006).
The extent to which a teacher possesses and exhibits these skills attracts
or repels pupils attention, participation and involvement in the classroom, and
tends to develop in them some favorable or unfavorable dispositions in primary
school classrooms. Such affective disposition may include perception of the
classroom as being conductive or nonconductive to learning; or the disposition
might engender difficulty in learning the subject or preference or lack preference
for group work. The deposition might also make learners to develop favorable
or unfavorable attitude towards the subject matter (Cole, 2008).
Problem and Purpose of the Study

The lack of ability to create and maintain a conducive classroom
atmosphere, which is an important aspect of effectiveness in teaching, limits
pupils ability to develop favorable dispositions during classroom processes.
This ultimately has an unfavorable effect on learning. Teacher training
programmer do not tend to take trainees emotional or affective development
into serious consideration during training, but according to Medley and
Shannon (1994), teacher effectiveness involves, among others, the degree to
which a teacher achieves desired or favorable effects upon students. This
provides an overriding foundation for the development of favorable cognitive
behavior. The absence of a classroom with conducive affective or emotional
atmosphere, does not enhance the replication of the favorable emotional or
affective behaviors by the pupil, and also does not maximize learning by the
pupil. This study aims at finding the relationship among pupil perceived
teacher effectiveness factors and their own level of exhibition of related
behavior in their classrooms.
Research Hypothesis
The main hypothesis of the study is that pupil perception of teacher
effectiveness has a significant influence on their affective dispositions in primary
classrooms. This will be tested at
.05 alpha level.
Literature review
Akiri and Ugborugbos (2009) study with a population of Nigerian
teachers found that teachers who were rated as ineffective actually produced
students of lower academic ability. However, the difference found in the mean
performance of the students was statistically not significant. This agrees with an
earlier study by Adu and Olatundun (2007) which found that effective teacher
produced high performing students. Lamb, Schmitt and Cornotto (2010),
expressed the same sentiments when they observed that students ratings of
classroom processes correlate positively with teachers level of effectiveness.
Literature sources show that the learner is the main customer in the
educational system. The learning and teaching process cannot take place without
learners going to school and attending classes. For example, it was noted in

141
Education for Kagisano (1977) that:

The principal aim of education is individual development. The
individual is of unique value and it is only through change in the
development capacities and attitudes of individual that society changes.
The focus of education in schools and classrooms should therefore be
upon learners; enabling them to acquire the knowledge, skills, attitudes
and behavior that will give them a full, successful life and continued
personal growth; and of education in school and equipping them to
participate affectively in a rapidly changing society (p. 23 ).
It therefore follows that educational policy and practice be centered on
the needs of the leaner. However, educational research that seeks to identify
variable that influence school and teacher effectiveness tend to concentrate on
such inputs as availability and quality of resources, teacher experience, teacher
motivation and school management issues, to mention but a few of the key input
variables. Sawchuk (2010) observed that researchers tend to focus on education
administrators, school heads, and other practitioners in the field of education
but less attention is given to the learners themselves. Learners as the central
players in the process of learning can offer valuable information with respect to
which teacher are the most effective.
The same viewpoint is expressed by Charakupa (I 995) in a study entitled
Why we learn Science: A time to listen to junior high school pupils in
Botswana. The author made a comment to the effect that:
Normally when science curricula are drawn up in Botswana, learners are
not considered as participants for official planning purposes. It
therefore follows that such learners may not be aware of why they are
required to study science since it is not common practice to provide
students with policy documents (p. 201).
Research continues to show that delivery of education differ markedly
by region or location and these variations can negatively or positively affect
each learners experiences. Primary schools in urban centers characteristically
have access to better educational infrastructure such as libraries, electricity,
computers and other instructional resources. These have a positive bearing on
the teaching and learning process. Rural and particularly remote primary
schools in Botswana, on the other hand, have limited access to the important
instructional resources resulting in less than satisfactory learning and teaching
environment. Research works focusing on school effectiveness and variables that
influence it have documented qualitative difference between regions, as the
following quotation clearly indicates:
The first reason is that some schools are located in privileged areas in
the sense that students in these schools come from homes whose
parents care about their child's education, ensure that their children
are well fed, try to help their children to learn to read as possible, show
interest in school work, provide ready access to books in the home and
so on. (Postlethwaite & Ross, 1992, p 1)
The apparent diversity and complexity of educational enterprise makes it
even more imperative that educational planners, policy makers, school
administrators, teachers and other key stakeholders put in place process and
procedures that will ensure systematic incorporation of learner perspectives in

142
the day to day school activities. The United Nations (1989) recognized the need
for soliciting and implementing the learners views by publishing the
Convention on the Rights of Children (Resolution 44/25) that was ratified by the
General .Assembly of 20th November 1989. Article 12 of the Convention on the
Rights of Children (CRC) states that:
States Parties should assure the child who is capable of forming his or
her own views the right to express those view freely in all matters
affecting the child, the views of the child being given due weight in
accordance with the age and maturity of the child.
Therefore, there is evidence in the literature indicating that learners are
the main recipients of educational service provided within a country. Secondly
evidence seems to point to a situation where the learners views and ideals are
not adequately incorporated into mainstream decision making machinery. The
current study attempts to solicit learners views and perceptions regarding
teacher effectiveness and investigates how these perceptions influences their
attitudes towards school work.
Methodology and Design

The study followed a quantitative research approach as the data collected
is analyzed using quantitative techniques. The study used a survey design to
determine the degree of association between pupil perceptions of teacher
effectiveness and their own perceived affective depositions in the classroom. A
questionnaire was distributed to learners in primary schools to capture their
views in relation to teacher effectiveness variables.
Sampling
Survey data was collected from 472 learners taken from 29 primary
schools drawn through stratified random sampling method. Private schools
located in an urban environment and public remote schools were sampled to
ensure a representation of the population subgroups in the country. It was
necessary to sample from a larger pool of rural remote schools so as to be
faithful to the apparent geographic diversity in the country. Table 1 shows the
proportion of the sample to the total population. In each of the sampled schools,
all the Standard 7 pupils were given a questionnaire to complete. A total of 472
learners completed the questionnaire. They ranged in age from 11 to 13 years.
Table 1
Sampling Guide
Urban school Remote school Total
Population (n) 15 39 54
Sample (n) 6 13 19
Sampling Ratio (%) 40 33 35
Instrumentation and Data Collection

A Pupil Questionnaire made up of 44 Likert-type items was developed
and used for collecting data from the pupils sampled for the study. This
measured, on the part of the pupil; learners perception of: interest in English
language (3 items), classroom environment (7 items), difficulty in learning
English language (2 items), preference of group work (2 items), and attitude

143
towards class (8 items). On the part of the teachers; learners perception of:
classroom teaching behavior (5 items), classroom assessment behavior (2 items),
teaching strategy (3 items), provision of feedback (3 items), effective use of
visual media (2 items), and effectiveness of teaching English language (7 items).
The researchers secured the permission to carry out the study under the
auspices of Examination, Research and Testing Division (ERTD) of the Ministry
of Education. The permission of the head-teachers and the teachers were secured
through a letter written in advance before the researchers visit. On each
appointed day, the researchers visited the schools and administered the
questionnaire to all Standard 7 pupils in each of the 19 schools in the study.
Data Analysis and Interpretation of Results

To test the single but composite hypothesis for the study, a Pearson
correlation analyses between each aspect of the pupil perception of teacher
effectiveness variable and each of the affective disposition in primary classroom
variables were carried out. The results gave the entries in a correlation matrix
presented in Table 2. These show that except for the relationship between pupils
perception of teachers effectiveness in the use of visual media and both
preference of group-work and attitude towards the class, all the other
relationships were significant at an alpha level of .05 (see Table 2).
Generally teaching behavior as perceived by pupils was found to
significantly related to pupils interest in the subject- English language,
Classroom environment, their perceived level difficulty of learning English, their
preference for group work in the class and their general attitude towards the
going-ons in the class. Positive correlations were also found between teachers
affective depositions and pupils perception of the teachers teaching
effectiveness in terms of classroom assessment behavior, teaching strategy,
provision of feedback and their

144
Table 2
Matrix of Pearson Correlations among variable representing Teacher Effectiveness and

Pupils Affective Dispositions in the classroom.
Interest in Classroom Difficulty Preference Attitude

English environment in learning of Group towards
language English work class
language
Classroom .214* .170* .110* .252* .225*

teaching
behavior
Classroom .316* .316* .095* .130* .275*
assessment
behavior
Teaching .220* .222* .099* .204* .150*
Strategy
Provision of .350* .298* .109* .210* .174*
Feedback
Effective use .086* .190* .086* .068 .011
of visual
media
Effectiveness .291* .211* .170* .257* .325*
in teaching
English
*p< .05; df =469; Critical r =.082
overall effectiveness in teaching English Language. Pupils perceived level of

teacher effectiveness in the use of visual media was found to have a significant
influence in their interest in the subject matter and the extent to which they
perceive the subject to be difficult or easy.
Discussion, Conclusion and Recommendations
The study has established a significant relationship between learners perception
of teacher effectives and how the level of effectives influence their attitude
towards learning in general. Specifically, the study has established a significant
relationship in four key areas. The four key areas are teachers teaching
behavior, classroom assessment skills, provision of feedback and effective use of
visual media.
Teacher's teaching behavior
Variables that influence the perceived effectiveness of the teacher include
content presentation ability, ability to use group work and close supervision of
the class. Effective teachers not only present content clearly but ensure that all
learners understand the current information before proceeding to the new
material. Dividing learners into groups and walking around the class to assist
and provide feedback to groups enhances learning and thus improves teacher
effectives. Therefore, group work by itself is not very effective; it has to be
supported by supervision and provision of feedback to the group members.

145
Classroom Assessment Skills

Formative assessment in the classroom allows the teachers to determine
whether the learners are following or not. In most cases teachers are the ones
who pose questions: but questions from the learners themselves may provide
more useful diagnostic information that the teacher can use to assist the class or
the individual child. According to the views of the learners; effective teachers
encourage learners to ask questions and at the same time they show appreciation
of the contribution that the leaner in bringing into the classroom. Therefore, the
teacher should be able to set up learning and teaching environment where
learners are free to ask questions and learners are also free to stop the teachers at
any time if they do not understand the information.
Provision of Feedback
For formative assessment at the classroom level to be effective, the
teacher should constantly prove the learners with relevant and timely feedback.
This allows the learner to see how well they are progressing and identity and act
on problematic areas. Learners perceive effective teachers as those who give
assignments (homework), marks accordingly and provide relevant and timely
feedback..
Effective Use of Visual Media
Though information and communication tools are gaining popularity in
schools, teachers especially in primary schools still have to do a lot of writing on
the blackboards. In some schools the board is the main medium that the teacher
uses to teach on daily basis. Therefore, the condition of the board and the
teachers level of effectives in using it directly impacts on the learner. One way
of creating a conducive learning environment in the classroom is to make sure
that the information written on the board is legible so that learners can copy it
on to their exercise books.
The big question for this study was how well primary pupils
perception of the learning environment created by a teacher in the class
influence their development of effective behavior conducive to learning in that
class? In order words, to what extent do pupils hold teachers behavior in their
classrooms accountable for their own behavior and how does teacher induced
behavior impact their learning of English Language? Essentially, the perception
of students are used to evaluate the level at which the teacher is able to teach
effectively. Numerous research studies have been carried out to determine the
relationship between teacher effectiveness and learner performance (e.g., Akiri &
Agborugbo, 2009; Akiri, 2013; Onyekuru & Ibegbunam. 2013). Suffice to mention
at this juncture that the studies produced contradictory results. For example,
Akiri (2013) tested the significance of the relationship between teacher
effectiveness and learner performance using Pearson product moment
correlation coefficient. A positive correlation was established but the results
were not statistically significant. Following from the findings of the study, the
researcher subsequently noted that students grades and test scores do not
reflect the quality of instruction because teachers input is not the only factor
that influences student academic performance in schools.
Similarly, Starr (2002) had identified peer influence, race, ethnicity,
gender, motivating income, intellectual aptitude of the students, personality of
students, self-confidence, and previous instructional quality received by
students, house-hold environment, and parental education as students related

146
factors that influence the academic performance of students

On the other hand, a study by Onyekuru and Ibegbunam (2013) found a
significant relationship between teacher effectiveness and teaching experience.
Also, Medley and Shannon (1994) also found a significant relationship between
teacher effectiveness and the performance of learners in the classroom. The
current study has provided more evidence in support of a positive and
significant relationship between teacher effectiveness and learner performance.
Teacher effectiveness construct in this case is indicated by pupils response to
survey items that required them to rate the level of effectiveness of their
teachers. The evidence shows that pupils associate teacher effectiveness with the
ability of the teacher to create a conducive learning environment that caters for
the cognitive as well as the affective dispositions of learners. It is difficult for a
learner to learn from a teacher whom one does not appreciate in terms of his/
her teachers classroom teaching behavior; teaching strategy; assessment
behavior; provision of feedback ; effective use of visual media; and effectiveness
in teaching English.
A warm personal interaction skill, which is a large component of ones
affective personality, is valued more by primary school students. Teacher
emotions therefore are considered to be important factors in teacher training,
development and practice because they affect teachers commitment, interest
and personal welfare (Jeffery, 2001). This study has shown that teacher
effectiveness variables relate significantly to the affective behavior exhibited by
the pupils in the classroom. A conclusion can be drawn that pupils tend to adjust
their behavior according to the personality of class teacher. A part from the
professional personality, the affective personality of teachers matter in the type
of learning environment they create in their classroom. Here it is shown that
pupils perception of some aspects of the teachers affective personality has
significant influence on pupils difficulty in learning the subject; preference or
lack of preference for group work; favourable or unfavorable attitude towards
the subject; and interest or lack of interest in learning the subject. The views of
the learner play an important role in the way learners themselves appreciate the
teaching and learning processes within the classroom. This perception is an
important determining factor in the childs attitude towards the subject and
learning itself. Therefore, incorporating learners affective feelings both at the
policy generation and implementation levels should be standard practice. This
will go a long way in making learning and teaching more meaningful and
transparent to learners of the 21st century. Additionally, teacher training and
development both at the pre-service and in-service should incorporate
modalities that will assist teachers to develop positive affective dispositions that
will benefit learners in the classroom.
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IJLTER.

Special Education Administrators Ability to Operate to Optimum Effectiveness .................................................... 53

Development of Teaching Plan in the Curriculum of Medical Sciences ....................................................................... 65

Recover the Lost Paradigm: Technology Guided by Teaching Methods ..................................................................... 97

International Journal of Learning, Teaching and Educational Research

Special Education Administrators Perceptions of

Juanell D. Isaac, Teresa M. Starrett, and Jane B. Pemberton

Abstract. Special education administrators play a vital role in assuring

Keywords: special education administrator; responsibilities; challenges;

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With the establishment of Public Law 94-142 (Education for all

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27) of the 49 professional v6) of the 19 data-based research studies occurred

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administrators. This information was used to create a survey with updated

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2016 The authors and IJLTER.ORG. All rights reserved.

significant responsibility unless the special education administrators are from

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2016 The authors and IJLTER.ORG. All rights reserved.

Table 1: Special Education Administrators Perceptions of Responsibilities

BGT Administers the special education budget 4.62 0.79

PRD Encourages the use of assessment to inform instruction 4.48 0.80

STA Monitors staff caseloads 4.42* 0.66

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2016 The authors and IJLTER.ORG. All rights reserved.

Table 2: Special Education Administrators Perceptions of Level of Challenge

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PRD Creates supportive and safe learning environments 2.28 0.86

EOS Evaluates secretarial/clerical staff 1.72 0.83

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Special Education Administrators Responsibilities vs. Challenges

2016 The authors and IJLTER.ORG. All rights reserved.

Table 3: Comparison between Special Education Administrators Responsibilities and

2016 The authors and IJLTER.ORG. All rights reserved.

2016 The authors and IJLTER.ORG. All rights reserved.

2016 The authors and IJLTER.ORG. All rights reserved.

school board meetings regularly and making presentations as essential with

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2016 The authors and IJLTER.ORG. All rights reserved.

2016 The authors and IJLTER.ORG. All rights reserved.

2016 The authors and IJLTER.ORG. All rights reserved.

International Journal of Learning, Teaching and Educational Research

The Impact on Absence from School of Rapid

Andrew John Macnab

Sharif Mutabazi, Ronald Mukisa,

Abstract. Malaria is the principal preventable reason a child misses

Keywords: Absenteeism; Community-based education; Health

2016 The authors and IJLTER.ORG. All rights reserved.

2016 The authors and IJLTER.ORG. All rights reserved.

2016 The authors and IJLTER.ORG. All rights reserved.

The communities identify the problem.

Year 1. Pre-intervention. Year 2. Intervention.

HEADA trains teachers to conduct

HEADA and the 4 communities maintain dialogue to sustain the school-based

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Public forums were initiated by HEADA to generate dialogue and active

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recommendations (prompt assessment, accurate diagnosis and comprehensive

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Table 1. Demographics and Study data: Year 1 Pre-intervention and Year 2

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