Background: The aim of this study was to understand and be part of a process of change in the training of primary health care nurses in Venda.

Methods: Because participatory action research (PAR), which is an emancipatory-critical paradigm, to a great extent shares the same worldview as adult education and sustainable community development, all of which were part of the training process, it seemed the most appropriate research method to use.

Results: During the one-year diploma training of the nurses, the nursing students and trainers visited three rural villages, did a survey and held ongoing meetings with the community members in the villages. Qualitative methods were used to understand the nurses' perceptions of the training process. All the time there was an awareness that new knowledge was being created whichcould be used for the curriculum of the next cycle of nurse training.

Conclusions: The results showed that the students had been both empowered and disempowered by the experience. They found it easier to communicate well with the communities they went back to after their training and some problem- based research was spontaneously undertaken by trainees who had been part of the nurse training programme with clinic attenders. However, the nurses also experienced a great deal of resistance from the health system. They wondered whether the whole process had not been biased by them being health workers and felt that they had not had enough access to financial decision making and were therefore powerless to help their own communities with this area of development. New knowledge that emerged was the need to reflect regularly together on any learning process, the parallels in the vocabulary of family medicine and community development and that the financial planning for such a process should be integrated with the other components.