In the Faculty of Health sciences, University of the Witwatersrand, Johannesburg, the Centre for Health Science Education (CHSE) offers a longitudinal professional development programme in the form of a postgraduate diploma in health science education (PGDip). The diploma consists of four modules to be completed over one or two academic years: Theories of teaching and learning; Methods of teaching in the Health Sciences; Assessment in the Health Sciences and Curriculum Development. Participants are encouraged to engage with the theories of higher education and to become critically reflexive of their practice and their context. We aim to develop practitioners who are able to theorise and enact their roles with respect to their own disciplines and society in general as change agents. For most healthcare practitioners who enrol in this course, the curriculum is a revelation of ‘ways of thinking and being’ which challenge their inherent assumptions about their teaching role and higher education in general. Feedback tends to be positive concerning their depth and breadth of learning, and their intention to change their previous pedagogic practices. Whilst some indeed do describe improved classroom practices, several report on their frustration in trying unsuccessfully to influence practice of colleagues or policies within their Departments or Schools (Mc Inerney et. al, 2017). It was therefore of interest to examine the underlying structures which govern what is valued as knowledge in the course and the ways in which the participants engage with this knowledge, in order to improve their ability to become “educational” change agents in their own environments. The research questions guiding this study included: 1. What is valued as knowledge in the programme which leads to empowering participants? 2. What are the dispositions and practices of the course participants that either enable or constrain developing agency? The LCT dimension of specialization was enacted as the analytical tool to examine the underpinning organizing principles of the forms of knowledge valued by the PGDip in the field of health science education, and the aptitudes, dispositions, and ways of being of its knowers (Maton 2014.) The data for this study were sourced from PGDip course and module proposals, university policies and archival documents, participants’ written final assignments, semi structured interviews, observations and critical reflections. Ethics approval to conduct the study was granted from the University of the Witwatersrand’s Human Research and Ethics Committee. All eleven Wits staff members who completed the postgraduate diploma in Health Science education in 2016 volunteered to participate (non-Wits members of the 2016 cohort were excluded from the study). In addition, nine line-managers and/or Heads of Schools of the 2016 diplomates were interviewed. Interviews were audio-recorded, then transcribed verbatim for analysis. Epistemic relations in this context were underpinned by knowledge and evidence of application of educational theory. Social relations exhibited a shift from a positivist ontology to a more critical realist stance, which identified legitimate knowers as those able to acknowledge the contestation of knowledge and relinquish the authority they perceived conferred by their professional identities in the hierarchical healthcare system. For some participants, their transition from a “knowledge code” orientation of content delivery at the start of the course towards a more nuanced “knower code” acceptance of student individuality exhibited a code shift which presaged success in developing their own agency. This analysis afforded a detailed examination of the curriculum and led to a series of adjustments in subsequent cohorts of the course, which includes more scaffolding of the forms of knowledge and knower dispositions valued in the course. The use of LCT highlighted that identity work is important in developing agency following a longitudinal professional development programme and identification with an education-oriented community of practice empowers participants to change.
