Principles of Curriculum Developmentacademicdepartments.musc.edu/.../Presentations/Principles.pdf · I am pleased to have the opportunity to share with you some thoughts on the principles
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Principles of Curriculum Design: Tips for Clinician-Educators Jeffrey G. Wong, MD Faculty mentoring workshop May 1, 2014
I am pleased to have the opportunity to share with you some thoughts on the principles of curriculum development In preparing for this talk, I significantly relied on the three references that are provided at the end of the presentation and while many of these ideas have been frequently discussed and circulated in educational circles, I hope that my take on them, as a practicing faculty member and clinician-educator, will provide you some practical tips for improving your own teaching.
Goals of the Session
• Be able to state why educational curricular design is important
• Be able to list and use a structural framework for designing curricula
• Begin to design curriculum for teaching within individual disciplines
Presenter
Presentation Notes
There are three overarching goals that I hope you will achieve during this next 45 minutes or so. First, I’d like you all to be ___. . . Why it is necessary to even think about creating curricula. The second goal is for you to be able to list and use a structural framework for designing curriculum then having done that, I’d like you to try to design a curriculum that would be specific to your situation and your teaching interactions with residents and students.
Structure of Presentation
• Curricular Theory – Four Central Questions
• Six-step process for designing curriculum
• Opportunity for skill practice
Presenter
Presentation Notes
The structure of this talk will follow in this fashion. I’ll first start off with a little bit of theory as it relates to developing and designing curriculum. Next, we’ll briefly go through a six-step process that can help one when formally designing an educational curriculum and we’ll end the session by allowing you the opportunity to design a curriculum that you can take back to your respective educational programs and put into use.
Presenter
Presentation Notes
The structure of this talk will follow in this fashion. I’ll first start off with a little bit of theory as it relates to developing and designing curriculum. Next, we’ll briefly go through a six-step process that can help one when formally designing an educational curriculum and we’ll end the session by allowing you the opportunity to design a curriculum that you can take back to your respective educational programs and put into use.
Curriculum Broadly Defined
• Comprised of all the experiences that learners have that enable them to reach their learning goals
• A statement of the intended aims and objectives, content, experiences, outcomes and processes of an educational program
Presenter
Presentation Notes
What is curriculum? Well, broadly defined it is ____ This is at a Macro level where one is talking about the purpose of an entire program or residency. In the United Kingdom the Postgraduate Medical Education and Training Board defines the curriculum as (click). Curricula are important and can also be helpful in a narrower, less broad sense, at a micro level as it were, as well. For instance, within the context of a specific rotation, what might you want the learners to accomplish from their ICU experience, or their outpatient clinic or their consultative service activities? This could be even narrowed down further – in this simulated patient care activity involving an unstable patient scenario, what specific skills do I want my learners to be able to master? The need for developing curriculum has certainly become more emphasized over the past several decade in the United States as the RRCs and the ACGME have developed standards and expectations for resident achievement. This is a far cry from the “olden days” when you merely placed a learner on a patient care team and told them to “get out and learn things” without a specific plan in place.
Presenter
Presentation Notes
While this type of experiential learning is necessary and desirable for graduate medical education, experiential learning by itself tends to be somewhat haphazard and insufficient for assuring adequate training. I trained in internal medicine in days before there were well developed curricula and the topics I studied and the patient diseases I learned how to manage were essentially dictated by what was admitted to the hospital or seen in the clinic – and it was unequal with the experience of my colleagues training at the same time. (click) Furthermore, without a set curricula, it was often very unclear exactly what I was suppose of learn and how I would achieve this. Complicating this matter further, it resulted in difficulties for the program when they needed to pass off on whether or not I was competent or incompetent in any particular area. While having a curriculum does not necessary guarantee that these problems will be fixed, it certainly frames the argument in a way that makes attainment much more likely.
Why Curricula are necessary
• Experiential learning is haphazard and insufficient – Inequalities in the learning experience – Uncertainties in the achievement of
learning goals and objectives – Difficulties in attesting to learners’
mastery/competence/incompetence for external stakeholders
Presenter
Presentation Notes
While this type of experiential learning is necessary and desirable for graduate medical education, experiential learning by itself tends to be somewhat haphazard and insufficient for assuring adequate training. I trained in internal medicine in days before there were well developed curricula and the topics I studied and the patient diseases I learned how to manage were essentially dictated by what was admitted to the hospital or seen in the clinic – and it was unequal with the experience of my colleagues training at the same time. (click) Furthermore, without a set curricula, it was often very unclear exactly what I was suppose of learn and how I would achieve this. Complicating this matter further, it resulted in difficulties for the program when they needed to pass off on whether or not I was competent or incompetent in any particular area. While having a curriculum does not necessary guarantee that these problems will be fixed, it certainly frames the argument in a way that makes attainment much more likely.
Four Central Questions
1. What is supposed to be learned? 2. How will the program be organized? 3. What learning activities will achieve
the educational purposes? 4. How do we know whether or not the
educational purposes have been attained by the learners?
Presenter
Presentation Notes
When thinking about designing a curriculum or and educational plan of study, keeping four central questions can be helpful: Goals Objectives Methods Evaluation What is the educational purpose or what are the educational purposes of the program or activity? Why are we doing this in the first place? (click) How will the program be organized? This includes its overall structure and who the teachers will be. It also takes into consideration this particular portion of the larger whole and places it in context. (click) What learning experiences will best achieve the educational purposes? What activities will the learners do in order to learn what we want them to know? (click) How will we determine whether or not the educational purposes have been attained? How will we know that what we wanted to happen actually occurred? (click)
Structure of Presentation
• Curricular Theory
• Six-step process for designing curriculum
• Opportunity for skill practice
Presenter
Presentation Notes
So that’s the brief run down on curricular theory. The curriculum can be defined very broadly or in a narrow fashion and really has to do with explicitly describing the purpose, the structure, the conduct and the evaluation of the educational program or activity. If you happen to be a program director or some other type of higher level administrator, your focus will tend to be broader and at a macro level. If you are a clinician educator, your focus will be on a narrower, micro level. But the underlying principles are the same. (click) The next part talks about a six-step process for designing a curriculum.
Presenter
Presentation Notes
So that’s the brief run down on curricular theory. The curriculum can be defined very broadly or in a narrow fashion and really has to do with explicitly describing the purpose, the structure, the conduct and the evaluation of the educational program or activity. If you happen to be a program director or some other type of higher level administrator, your focus will tend to be broader and at a macro level. If you are a clinician educator, your focus will be on a narrower, micro level. But the underlying principles are the same. (click) The next part talks about a six-step process for designing a curriculum.
Activities 5. Develop Assessment methods 6. Evaluating Learners and Providing
Feedback
Educational Activity Description
Presenter
Presentation Notes
These are six-steps adapted from Dr. David Kern’s model as outlined in the second reference. There are: For those of you working at a more micro level, rather than trying to describe the program or the rotation, (click) you can alter the first step to merely describe the specific educational activity you’re going to outline. We’ll go over each of these briefly
1. Educational Description
• Provide description of program/ rotation/educational experience – PURPOSE: Provides learners with an
overview or a roadmap of what to expect
Presenter
Presentation Notes
Step 1. Educational description. An example might be: “The purpose of the resident’s outpatient continuity clinic is to provide learners with first-hand experiences in the diagnosis, management and treatment of ambulatory medicine patients.” You could then go on to describe more about the program Again, at a more micro level, this can be narrowly focused to a specific educational activity: An example might be: “The purpose of the unstable patient simulation is to provide for the learner a simulated, yet high-fidelity experience in diagnosing and managing an acutely and seriously ill-patient.
2. Targeted Needs Assessment
• What do learners need to learn? • Defining Learning Content (Internal and
2. Targeted needs assessment – In Kern’s book, Dr. Mark Hughes calls this “refining the foundation”. The process in which the curricular developers assess the differences between the IDEAL situation and the ACTUAL. state of affairs. (click) What do learners need to learn? This might be defined by the residency program or by the individual faculty member and is done in a way that works toward the educational purpose. Additionally, this needs assessment can be identified by others outside of the program (click) Requirements. . . . (click). The ACGME six-core competencies are specifically articulated domains that learning much achieve
ACGME Core Competencies
• Medical Knowledge • Patient Care • Systems-Based Practice • Practice-Based Learning • Professionalism • Interpersonal and Communication
Skills
Presenter
Presentation Notes
And to refresh your memories, these are the six-core competencies in the ACGME. A targeted needs assessment may also articulate which one or many of the core competencies the curriculum is designed to address
3. Goals and Objectives
• Provide an instructional road map • Provide clarity about the education
program to learners, teachers and external stakeholders
• Encourage higher order learning • Determine Assessment method
Presenter
Presentation Notes
Step three is to state learning goals and objectives. By explicitly stating your learning goals and objectives, you are Providing an instructional road map for the learning to transpire Providing clarity Encouraging higher order learning – not merely rote memorization Determining the assessment methodology – assessment will drive the curricular content
Goals
• A statement that describes what the learner will gain from the instruction
• Should be thought as broad and overarching statements
• Goals are not necessarily measurable
Presenter
Presentation Notes
A word about goals and objectives – sometimes they are used synonymously and are interchanged, however, in educational terms, there are quite different. A goals statement describes what the learner will gain from the instruction and this statement is often broad and overarching. For instance, a goal statement for a Cardiology consult rotation might be something like: At the conclusion of this rotation, the learner should be able to assess, diagnose, and manage patients with heart failure. Goals are not necessarily measurable, although they could be
Objectives • Are behaviorally explicit reflecting what
the learner should learn • Reflect the knowledge, skills and/or
attitudes that the residents should attain for each rotation or educational experience
• Objectives should be able to be measured. Who will do what and how will she/he be assessed?
Presenter
Presentation Notes
This is in contrast to an learning objective which contains a behaviorally explicit statement of what the learner should learn Reflects. . . Objectives should be able to be measured – as you write objectives, begin to think about assessment. How will I know that the learner has been successful? be able to recognize common historical symptoms and physical examination signs of heart failure, be able to classify the different types of heart failure based on underlying pathophysiological processes, be able to properly select and interpret diagnostic tests used to assess heart failure and be able to formulate management plans for patients with different types of heart failure.
Writing an Objective
• “At the completion of this activity, the learner will be able to _______ (action verb) as measured by _________ (type of assessment).”
Presenter
Presentation Notes
Use SFDP list of verbs handout
4. Strategies/Activities
• What strategy/activity will best help the learner attain the goals and objectives?
• Some considerations – Type of Learner – Type of Content being Learned – Amount of Content being Learned
Presenter
Presentation Notes
Step 4 – What strategy. . . Considerations: Learner – Skill or experience level Type of learner – best learning style Learner motivation/interests/goals Content – Amount/quantity Level of complexity Type of content (knowledge/skill/attitude)
Common Teaching Methods • Didactic Conferences • Bedside/Examination
Room Teaching • Case-Based
Teaching • Journal Club • Mentoring • Mortality/Morbidity
Conference
• Mannequin/Task Trainer Simulation
• Computerized Simulation Exercises
• Self-Directed Learning Modules
• Individual or Group projects/research
• Chart audits
5. Assessment Methods • What assessment methods will be used
to evaluate the resident’s performance? – Observation – Demonstration of knowledge, skills,
