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DR SAIFUL’S NOTES ON MEDICAL & ALLIED HEALTH PROFESSION EDUCATION: CURRICULUM PLANNING & DEVELOPMENT Dr. Muhamad Saiful Bahri Yusoff MD, MScMEd Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 1 Content An Overview, Concept And Rational Of Curriculum Planning And Its Types. ........................................................................................................2 Curriculum Aims, Goals, Objectives, Outcomes And Expected Competencies ............................................................................................9 Needs Assessment / Analysis In Curriculum Planning ..........................13 Elements Of Curriculum .........................................................................21 Models Of Curriculum Development.......................................................25 Steps In Curriculum Development .........................................................34 Roles Of Stakeholders In Curriculum Development ..............................48 Educational Strategies In Curricular Development And Implementation .................................................................................................................53 Basic Concept Of Curriculum Evaluation...............................................60 Models Of Curriculum Evaluation...........................................................66 Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 2 AN OVERVIEW, CONCEPT AND RATIONAL OF CURRICULUM PLANNING AND ITS TYPES. 1. Before we create a curriculum we need to know the goals of education? What type of health care professional we need and what process of education? For example the criteria for “Tomorrow’s health professionals” with core values; Caring, compassionate, sympathetic, ethical, competent, leaders and communicator. 2. What is curriculum: • Word of curriculum origin from Latin word currere means ‘a race course’. Based on the origin word it is refered to ‘a course of study’. • According to Taba (1962), “curriculum is a plan of learning.” • Saylor et. al (1981) defined curriculum as “a plan for providing sets of learning opportunities for person to be educated.” • According to Tanner & Tanner (1978) curriculum is “the planned and guided learning experiences and intended learning outcomes, formulated through the systematic reconstruction of knowledge and experience.. for the learners’ continuous and willful growth in person-social competence.” • Bushoff et. al defined curriculu as “a curriculum is an educational plan defining: o The aims, goals of an educational actions o The ways, means and activities employed to achieve these goals o The methods and instruments required to evaluate the success of the action.” • According to Bowen curriculum is “a total instructional program composed of syllabus or individual course programs.” • Good defined curriculum as “a general over-all plan of the content or specific materials of instruction that the school should offer to the students by way of qualifying him for graduation or certification for entrance into professional or vocational field.” • From class lecture (Dr Hafiza): o A structured plan of intended learning outcomes, underpinning knowledge, skills, behaviour and associated experiences (www.tafensw.edu.com.au/students/glossary/welcome.htm). o An educational plan that spells out which goals and objectives should be achieved, which topic should be covered and which methods are to be used for learning, teaching and evaluation (www.iime.org/glossary.htm). Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 3 o A series of planned instructions that is coordinated and articulated in a manner designed to result in the achievement by students of specific knowledge and skills and the application of this knowledge. o Curriculum is everything student is encountered during school hours or while participating in school sponsored events. o Everything that happens in relation to the educational programs (Genn, 1995). o A planned educational approach to achieving identified professional outcomes. o A good curriculum is owned by all stakeholders (person who involved in the curriculum such as student, lecturer, administrator, community and governor). o Their objectives is not to please all people all the time but rather how to design a meaningful educational program which increase the competence of individual student, offering them additional fulfillment in their professional roles and enhancing effectiveness of their health care institutes. • Concerning above definition we can conclude that curriculum is a course of education which is designed to specific group of student for achieving specific knowledge, experiences, skills and attitude to fulfill and enhancing their profession roles. 3. The curriculum process: • Educational environment (location, context characteristic, facilities and etc) – first step • Student (selection, characteristic, background and etc) – second step (input) • What to learn and how to learn (methods and strategies) – third step • Educational outcomes – final step (output) • Assessment – involved in every steps above. • So curriculum process: input Æ process Æ output 4. Rationale and purposes of curriculum planning • To ensure student learn to the best of their ability. • To clarify the ideas and purposes that should guide the work in delivering the curriculum. • To set out some reasonable expectation for staff to follow as they exercise their professional responsibility to deliver the objectives and goals of curriculum. • To establish a baseline work upon which to built new curriculum statement. (curriculum should be reviewed at least once in 5 year duration). 5. Forces that impact on curriculum Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 4 • Social forces – change in the characteristics of population mobility, role of media, explosion of internet and all other new things eventually affect education eitheir positive or negative way but none can be ignored. • Subject knowledge. • Human knowledge. 6. Changing trends in curriculum – through out the world health education curriculum is undergoing the process of change and innovations. This is necessary because: • Society is changing. • Diseases demographic are changing. • Medical science expands exponentially. • Concepts of learning are changing. • Newer teaching technologies are available. • Example of trends is community oriented curriculum. 7. Factors influencing curriculum planning – a number of factors need to be ensure during the course of curriculum planning • Staffing. • Facilities. • Funding. • Community participation. • Students demographic. 8. Types of curriculum: • Formal curriculum o It is the part that the curriculum developers are intended to include in the curriculum. Formal is the accepted, committee passed, written documents that are supposed to guide practice. • Informal curriculum o Informal curriculum is those activities that happen that are not designed, planned, or formally accepted by the school. Students learn much things from the extracurricular activities as well as from interactions with other students or from non-teaching interaction is the formal curriculum. • Hidden curriculum Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 5 o It is the aspects that the students learn during the formal or planned curriculum. It is ‘caught’ rather ‘taught’. The hidden curriculum includes the norms and values of the surrounding society. • The planned, taught and assessed curriculum The closer the match between the planned, taught and assessed curriculum the better is the curriculum • Null curriculum o The institute definitely not interested to teach the contents of the null curriculum o The contents are the outdated facts and information that are not important for present salutation. o Its results due to lack of regular review of the curriculum 9. Recent trends in health professional education: • Education for capability o The core and choices (special study modules, electives) o Practical training and generic competency. o The components of education for capability include the introduction of core curriculum with additional areas of individual choice. o Principle features of core curriculum: • Common to all students • Cover essential competencies • Includes knowledge, skills and attitude • Requires high standards of mastery from the students. Mastery in the core ensures the maintenance of standards and basic competencies of the education. o Option is according to choices The Taught Curriculum The Planned Curriculum The Learned Curriculum The assessed Curriculum The Planned Curriculum The Taught Curriculum Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 6 • It allows in depth work and the achievement of high level competencies such as critical thinking. • Professionalism o Professionalism can be defined as the capability and level of competency of someone to do certain responsibility or specific task/work/job which is guided by appropriate knowledge, trained skills, attitude and expertise. o Clear trend in the 1990’s toward professionalism in the design, in management and in teaching curricula. o It is now recognized that those who teach needs to be trained to do so. • Continuing Medical Education o Another trend is the commitment to life-long learning. Within the year of graduating the professionals find that there is an initial training and their practical life. o This leads to the concept of education – from basic through post graduate education and into continuing education. • Student-centred o Student-centred education focuses on the capabilities and motivation of the learner. o Students take responsibility for their own education as undergraduates and throughout their professional career. o Teaching guides self-directed learning, small group tutorials, problem based learning avoids formal teaching session. o Student-centred approach is like eating in a restaurant with table and no fixed menu and can eat by own choice. Here the restaurant can provide and facilitate to get the desired menu. o As Teacher-centred approach is like eating in a restaurant with table with fixed menu where someone has to eat what the restaurant chooses. • Focus on problems or tasks (Problem-Based Learning) o Problem-based learning (PBL) is the learning hat results from the process of working towards understanding or resolving a problem. o The key features of a problem-based curriculum are to: • Analyze health care problems as the main method of acquiring and applying knowledge. • Develop independent lifelong learning skills by the students and the use of small tutorial groups, as the central educational event. Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 7 • Integration of subjects and sometimes profession (multi-professional education) o Integration of the curriculum: multi-professional and multi-disciplinary education. o Multi-professional education: students of different profession (medicine, dentistry and nursing) are taught together. o Multi-disciplinary integration: • Horizontal integration: topics traditionally taught separately are taught together. • Vertical integration: topic taught by 2 or more department. o Early introduction of clinical subjects throughout the curriculum. • Evidence based medical education o It is the process of developing medical education using study, research finding as the basis. o Four step of EBME • Setting the question • Creating the evidence • Appraising the evidence • Acting on the basis of evidence • Unity between education and practice o Campus and community partnership Medicine in both the community and hospital context. 10. Constraints and obstacles • The obstacles to change in the health profession curriculum are o Jealously regarding departmental power bases. o The status quo against newer, alien ideas. o Little incentive to change o Difficult to motivate the senior members of the faculty to the new idea and innovation. Community based teaching. Experience gained only in the community Experience gained in hospital and in community Experience gained only in the hospital Hospital-based teaching Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 8 11. Required strategies to overcome the constraints • Building a broad base of ownership • Clear statement of overall goal of the innovation that is compatible with the ultimate goals of the institute. • Adequate dissemination of information • Organizational structure which is compatible with the innovation • Educational resource and financial support • Faculty development and rewards “Changing curriculum in the medical school is like rearranging the lifeboats on the titanic” (Abrahamson, 1977) Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 9 CURRICULUM AIMS, GOALS, OBJECTIVES, OUTCOMES AND EXPECTED COMPETENCIES 1. Effective teaching: • Become leaner-centred • Think of outcomes and objectives. 2. Definition of learning • Operational definition of learning o Learning can be seen as a change in the ability to do things as a result of experience. • Learning is an active process of transformation of ideas, translation of meaning and formation of attitudes, skills and value. 3. Aims, goals, objectives, outcomes and competencies are statement about what you want a learner to be able to do. 4. Aims • Aims are general statements that provide direction to the intent educational action, usually written in amorphous (formless, shapeless) term using: learn, know, understand, appreciate and are not directly measurable. • An anticipated outcome that is intended or that guides your planned action. • Aims are usually statements of what a teacher intends to do. • Examples: student will understand and become proficient at identifying different types of curriculum 5. Goals • Goals are statements of educational intention which are more specific than aims • Goal is the end toward which an effort is directed • Goals indicate what a course or perhaps an institution is seeking to achieve • A program goal is a very general statement of what the program hopes to accomplish. The goal is the first part of the program’s strategic plan. • Goals may encompass an entire program, subject area or multiple grade levels. • They may be in amorphous term or in more specific behavioral term 6. Learning objective/outcome • Learning objective/outcome is defined as a contract shared with learners that describe what they will be able to do after learning that they could not do before. Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 10 • Objectives are the clear and specific statements of what students should be able to as a result of a course of study. • Objectives are usually specific statements of educational intention which describe either general or specific outcomes. • Objectives are the fundamental tools in curriculum planning because they make rational choice of teaching and learning activities possible. • Objectives are also essential for planning a valid assessment of student learning. • Objectives are specific statement that describe observable, measurable behaviour and provide indicators of student progress. • Represent the steps between the student’s current level performance and the end result. • Example: list the major components of blood. 7. Outcomes and competencies • An outcome is what you expect your students’ to achieve, whereas a competency demonstrates how much your students can achieve that outcome. • An outcome is one level less general than an objective and hence more fully defines the expectations listed in the objectives. Outcomes must be measurable. • Outcomes are the knowledge and skills. Competencies are the specific activities used to measure a student mastery of knowledge/skills or outcomes. • Example: describe the normal structure and function of the principal body system at the molecular, cellular, organ system and behavioral level. 8. Characteristic of a well constructed competency: • A well constructed learning objectives or competency is o Express one objective o Specific in nature o States what the student will be able to do after the learning experience o Uses concrete verb to specify the desired activity that must be performed by the student to demonstrate competency • Competencies better define the course outcomes which better define the course objective. 9. Writing objectives • Objectives always contain operative terms (verbs: action word), which indicates the kind of behaviour that students will be required to demonstrate in order to show that the objectives has been achieved. 10. Grouping of objectives Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 11 • Objectives that require information of an intellectual kind for their achievement and are group as knowledge objectives. • Objectives refer to skill of a practical kind and are thus group as skill objectives. • Objectives suggest an attitude of mind and are therefore classified as attitudinal objectives. 11. Bloom Taxonomy • Cognitive domain (Bloom 1956) o Knowledge Remembering previously learned material, recall of facts, observation, mastery of subject matter. o Comprehension The ability to grasp the meaning of material, understanding information, translates knowledge into new context. o Application The ability to use learned material in new and concrete situation. Use information, use methods, concepts, theories in new situation, solve problems. o Analysis The ability to break down material into component parts so that its organizational structure understands. o Synthesis The ability to put parts together to form a new whole. Use old ideas into form new one, generalize from given facts, relate knowledge from different areas, predict, draw conclusion. o Evaluation The ability to judge the value of material for a given purpose. Compare and discriminate between ideas, make choices, verify value of evidence. • Affective domain (Krathwohl 1964) o This domain concentrate of feelings and emotions o Taxonomy educational objectives Receiving • Awareness, willingness to receive Responding • Willing response, feeling of satisfaction Valuing Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 12 • Acceptance, preference, commitment Organizing • Conceptualization of values and organization of a value system Characterizing • Internalization and relate behaviour that reflects • Psychomotor domain (Simpson 1972) o It is specific to Discrete physical functions Reflex action Interpretive movements Teachers needs to pay a great deal of attention to develop the skill objectives o Taxonomy educational objectives (please refer to learning domains note) Perception Set Guided response Mechanism Complex overt response Adaptation Origination 12. Miller’s Pyramid of Competency (1990) Please refer back to evaluation and teaching process note 13. Advantages of learning objectives/outcomes For the teacher learning outcomes o Define curriculum content o Focus teaching o Provide assessment criteria For the learner learning outcomes o Make the curriculum transparent o Clarify, organize and priorities learning o Help self-evaluation o Encourage responsibility Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 13 NEEDS ASSESSMENT / ANALYSIS IN CURRICULUM PLANNING 1. Definition of needs assessment/analysis • A needs analysis/assessment is a process for identifying the knowledge and skills necessary for achieving of an organizational goal (Brinkerhof & Gill, 1994) • A needs analysis is a method of finding out the nature and extent of performance problem and how they can be solved (Molenda, Pershing & Reigelut, 1996) • A needs analysis/assessment is a process for pinpointing reasons for gaps in performance or a methods for identifying new and future performance needs (Gupta, 1999) • In general, a needs analysis/assessment is a systematic approach to identifying social problems, determining their extent, and accurately defining the target population to be served and the nature of their service needs (Rossi P.H, Freeman H.E & Lipsey W.L, 1998) 2. Needs as verb • Need as verb points to what is required or desired (Witkin B.R & Altschuld, 1995) or what is necessary (Scriven, 1999) to fill the discrepancy (i.e. solutions, means (tools) to an end) 3. Perfomance Need vs. Treatment Need • The distinction between performance needs and treatment needs is important (Scriven, 1999) • Performance Needs o When we say that, international students need to be able to read English, we are talking about the needed level of performance (a gap exist) • Treatment Needs o When we say, they need classes in reading, or instruction in the phonics approach to reading, we are talking about the treatment (a solution) • Treatment Needs Assessment (NA) drives an action Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 14 • Performance Needs Assessment (NA) drives funding • Treatment NA is comparative, determine where the shoe is pinching • Treatment is an action, is an input • It compares, looks for what work, looks for fault 4. So, what is a need assessment? • A systematic a set of procedure undertaken for the purpose of setting priorities and making decisions about program or organizational improvement and allocation of resources. The priorities are based on identified needs (Witkins & Altschud, 1995) • Assessing needs is the process of determining the presence or absence of the factors and conditions, resources, services and learning opportunities that curriculum planning need in order to meet their education goals and objectives within the context of an institution’s mission. 5. Purposed of a needs assessment (Schuh J, Upcraft L & aasociates, 2001) • For professionals in curriculum planning, a needs assessment is specially useful in the justification of program policy • To examine and expressed need and develop alternative to address it • To generate ideas and document perceptions about various issues (exploratory in nature) • To collect information to support likely alternatives (decision making) • To estimate relative acceptability of various alternatives (identifies potentially controversial issues) • To select the most acceptable policy or program from alternatives (allow stakeholders to influence institutional response to needs) • To determine whether needs have been met (documents effectiveness of unit) 6. What will a needs assessment do for you (use) (Rossi P.H, Freeman H.E, Lipsey, Mark W.L, 1998) • A needs assessment answers questions about the social conditions a program is intended to address and the need for the program Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 15 • Needs assessment may also be used to determine whether there is a need for a new program and to compare or priorities needs within and across program areas 7. Key factors in conducting NAs (Witkins B.R & Altschuld J.W, 1995) • Keep in mind the value and necessity of broad-based participation by stakeholders • Choose appropriate means (tools) of gathering information about critical issues and other data • Recognize core values in the group whose needs are being assessed • Needs assessment is a participatory process; it is not “done to people” • Needs assessment is a political activity. Some people may view the process as causing a loss control. Priorities derived may be counter to well established ideas in the system • Data gathering methods by themselves are not a needs assessment. Data collection is one component in the process. 8. Once again, what is a needs assessment? • Assessing curriculum planning needs is the process of determining the presence or absence of the factors and conditions, resources, services, and opportunities that curriculum need in order to meet their goals and objectives within the context of an institution’s mission 9. Where should we focus the needs assessment? • Focus on the end to be attained, rather than the means (tools). This means we must know where we want to go… mission, goals & outcomes (Witkin & Altschud, 1995) • Institutions should narrow their focus and use their assets to advance their mission, rather than to broaden their focus and dilute what they do the best (Schuh, Upcraft & Associates, 2001) 10. Target groups & levels of need (Witkin & Altschud, 1995) • Level 1 (primary) o The focus in on service receivers: Students Clients Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 16 Patients Information users • Level 2 (secondary) o The focus is on service providers and policy makers: Teachers Parents Administrators Caseworkers Professional staffs Support staffs • Level 3 (tertiary) o The focus is on resources of solutions: Buildings Facilities Equipments Supplies Programs Delivery systems Working conditions Time allocation 11. Steps of Needs Assessment • Step 1: Determine Purposes o Performance problems o New systems and technologies o Automatic or habitual training • Step 2: Identify Resources o Who has the data o Where is the data o What are the constraints, if any, to obtaining the data • Step 3: Select Tools o Interviews o Observations of employee performance o Examinations of records Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 17 o Group facilitation o Surveys • Step 4: Conduct in stages o Multiple steps o Multiple tools o Usually start with interview of key management personal and subsequent interviews, observations, survey, etc. • Step 5: Use findings for decision making o Appropriate solution to problem o Other intervention o Content o Strategies o Reception 12. 3-phase plan for conducting a needs assessment (Witkin & Altschun, 1995) • Phase 1: Pre-assessment (exploration) • Phase 2: Assessment (data gathering) • Phase 3: Post-assessment (utilization) 13. Needs Assessment Tools • Surveys • Questionnaires • Interviewing • Focus groups • Observations • Performance measures o Ranking o Grading o Scoring o Rating 14. Educational Needs Analysis • It primarily concerned with the purposeful collection and analysis of data and information in order to identify the need for change Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 18 • Identify the suitable strategies that will successfully promote change 15. Delphi Method Of Need analysis • The Delphi technique is a method for obtaining forecasts from a panel of independent experts over two or more rounds. Experts are asked to predict quantities • After each round, an administrator provides an anonymous summary of the experts’ forecast and their reasons for them. When experts’ forecast have changed little between rounds, the process is stopped and the final round forecasts are combined by averaging • Delphi is based on well-research principles and provides forecast that are more accurate than those from unstructured groups (Rowe & Wright, 1991, 2001) • The objective of most Delphi application is the reliable and creative exploration of ideas or the production of suitable information for decision making • The Delphi method is based on a structured process for collecting and distilling knowledge from a group of experts by means of series of questionnaires interspersed with controlled opinion feedback (Adler & Zigo, 1996) • According to Helmer (1977) Delphi represent a useful communication device among a group experts and thus facilitates the formation of a group judgement • Wissema (1982) underlines the importances of the Delphi Method as a monovariable exploration technique for technology forecasting 16. Fowles (1978) describes the following 10 steps for the Delphi method: • Step 1: o Formation of a team to undertake and monitor a Delphi on a given subject • Step 2: o Selection of one or more panels to participate in the exercise. Customarily, the panelist are experts in the area to be investigated Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 19 • Step3: o Development of the 1st round Delphi questionnaires • Step 4: o Testing the questionnaires for proper wording (e.g. ambiguities, vagueness) • Step 5: o Transmission of the 1st questionnaires to panelist • Step 6: o Analysis of the 1st round responses • Step 7: o Preparation of the 2nd round questionnaires (if possible testing) • Step 8: o Transmission of the 2nd round questionnaires to the panelist • Step 9: o Analysis of the 2nd round responses (step 7 – 9 are reiterated as long as desired or necessary to achieve stability in the results) • Step 10: o Preparation of a report by the analysis team to present the conclusions of the exercise 17. Needs assessment process (final thoughts) • First focus… either performance or treatment needs level 1, 2 or 3 • Needs assessment is an inquiry tool. The process must be flexible and must look for the facts • Look for needs, not wants • Look for failure data or fault data, then look for treatment data and comparative data • More needs assessment fail probably because of inadequate data presentation than for any other reason • Use mixed methods… both quantitative and qualitative, when possible 18. Conclusion: Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 20 • Needs assessment is an essential tool in making sure that the programs that are needed and that new interventions will meet an unaddressed need of curriculum. Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 21 ELEMENTS OF CURRICULUM 1. Development and Design • Development describe the process of curriculum making • Design describe the end result or the product of curriculum development • So curriculum development produce curriculum design • Development can be described as a series of steps, like o Define educational purposes o Construct activities/experiences that can be meet the purposes o Organize activities/experience o Evaluate whether purposes have been met • Design can be described as an arrangement of curricular elements or components 2. Elements of curriculum • Aims o One sentence (more or less) description of overall purposes of curriculum, including audience and the topic • Rationale o A paragraph describing Why aim is worth achieving This section would include assessment of needs • Goals and objectives o List of the learning outcomes expected from participants in the curriculum o A discussion of how the curriculum supports national, state, and local standards • Audience and pre-requisites o Who curriculum is for o The prior knowledge, skills and attitudes of those learner • Subject-matter/content Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 22 o Area of content o Facts o Arena of endeavor, that the curriculum deals with This is a further elaboration of the topic description in the aim • Instructional plan o Activities the learners are going to engage in o The sequence of those activities o What the teacher is to do in order to facilitate those activities This is like lesson plan except for a curriculum it may include more than one lesson • Materials o List of materials necessary for successful teaching of the curriculum Books, tables, paper, chalkboard and other tools Needs to spell out these additional materials in your teaching guide The actual material prepared by the curriculum developer Any special requirements for classroom setup and supplies • Assessment and evaluation o Plans for assessing learning and evaluating the curriculum as a whole o May include description of a model project, sample exam questions or other elements of assessment 3. What are the essential elements of a curriculum • The curriculum has at least four important elements o Content o The teaching and learning strategies o Assessment processes o Evaluation processes 4. Approaches of curriculum planning • Approaches with particular focus for curriculum development o Engineering approach – aims and objectives Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 23 o Mechanic’s approach – teaching methods and techniques o Cook book approach – content o Railway approach – time tables o Detective approach – problems o Religious approach – ideas o Bureaucratic approach – rules and regulation o Magician approach • Approaches with an emphasis with staff development o United nation’s approach o People’s approach o Dictator approach o Consumer approach o Consultant approach 5. Curriculum map • A curriculum map is a representation of the curriculum which displays the different elements of the curriculum, so that the whole picture and the inter-relationships between these different elements can be displayed • It is also displays the essential features of the curriculum in a clear and succeeding manner • Starting points for the map may differ depending on the audience 6. Functions of the curriculum map • It is powerful tool for showing the links between the elements of a curriculum • It makes the curriculum more transparent to the stakeholders • It also display the essential features of the curriculum • It provides structure for the systematic organization of the curriculum • The starting point may be differ depending on the audience 7. Area in a map • Students • The expected outcomes • The curriculum content or areas of expertise covered Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 24 • Assessment • Learning opportunities • Learning location • Learning resources • Time tables • Staff • Curriculum development Curriculum Map Content - Background - Abilities - Experiences Organization Clearly stated - Aims - Goals - Objectives Appropriate - Scope - Sequence - Related to aims - Related to practice Student orientated - Variety of methods - Opportunity of self direction - Learning in real life setting Explicit organization - Blocks - Units - Time tables Student feedback - Questionnaires - Focus group - Participation Evaluation Teaching & Learning Situation Content Assessment STUDENTS Intents Clear blueprint - Formative - Summative Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 25 MODELS OF CURRICULUM DEVELOPMENT 1. Curriculum model • A model can give order of the process • Curriculum development is a task, it requires orderly thinking. It needs to examine both the order in which decisions are made and the way in which they are made to make sure that all relevant considerations are brought to bear on these decision – Taba • Curriculum models can be divided into 2 major categories: o Prescriptive models Are concerned with the ends rather than the means of curriculum. One of the well known example is the objective model which arose from the initial work of is Ralph Tyler in 1949 • What curriculum designer’s should do? • Hoe to create a curriculum? o Descriptive models Emphasizes the importance of situation or context in curriculum design: • What curriculum designers actually do? • What a curriculum cover? Curriculum designers thoroughly and systematically analyse the situation in which they work for its effect and internal factors is assessed and the implication for the curriculum are determined • The purpose in presenting few models here is to acquaint with some of the thinking that has gone and is going on in the field oh health personal education 2. Different models in Curriculum Development • Ralph Tyler model (1949) o Tyler’s 4 question of instructional development: What are the purposes of the school? Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 26 • Think about, justify, delineate (outline) what you are going to teach, how this material is relevant to the common, and current purposes of schooling? What educational experiences (interaction between teacher and student during learning) are related to those purposes? • What content, processes and methods are you going to use to deliver instruction and information? What are the organizational methods which will be used in relation to those purpose • In the context of educational purposes, how can effectively organize the information and presentations so that they are effective? How will these purposes be evaluated? • How do you know you taught the content or process successfully? • Taba Model o The curriculum should be designed by the teachers rather than higher authority o Teacher should begin the process by creating specific teaching learning units for their students rather than initial creation of a general curriculum design o Taba proposed 8 steps sequence for curriculum planning: Diagnosis of needs (need assessment) Formulation of objectives Selection of contents Organization of contents Selection of learning experiences Organization of learning activities Determination of what to evaluate and the ways of means of doing that Checking for balance and sequence Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 27 Ralph Tyler identify two words ‘sources’ and screen’ (monitor, check, observe) in is model • Mager objective model o It is simple, easy to use and can be adopted for most course units. o It is a well recognized model which lends itself to both skilled and novice (trainee, learner) instructional design o Mager model answers the following questions: What should the learner be able to do? Under what conditions do you want them to be able to do it? How well must it be done? o Mager model concentrates on Behaviours • Performance expected as well as a result of successfully completing the class or training Conditions Student Society Subject Tentative general objectives Philosophy of learning Psychology of learning Precise instructional objectives Selection of learning experiences Organization of learning experiences Evaluation of learning experiences Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 28 • Define under what qualifying factors the student is expected to apply the knowledge/skills acquired as a result of training Criteria • Standards of performance that are measurable or demonstrate as mastery of the learning objectives • CIPP model/ process model o The Phi Kappa National study committee on evaluation chaired by Daniel L Stufflebeam developed the CIPP model o This is basically a model for curriculum evaluation rather than curriculum development o It is model useful for making important decision concerning the value and worth of the curriculum o It is believed that certain benefits are there from using the same model for curriculum development and evaluation o The CIPP model use for curriculum C – Context • To define the operating context within which the curriculum will be delivered • Determine the specific characteristics of the learners that helps to establish I – Input • Identify the assess and capabilities • Determine what the resources are needed to achieve the objectives • Search for external resources when required P – Process • Identify the procedural design that will be used for implement the curriculum • The general objectives are translated to specific objectives that constitute the instructional design P – Products Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 29 • Define the measurable outcomes of the curriculum during and at the end of instruction • The outcome are directly related to the curriculum objectives o Context Æ Input Æ Process Æ Products • Instructional design model o There are different models of the design process but all with certain amount of common Dick and Carey model (1978) • It has set of sequential tasks, with interaction or cycling trough the stages Roblyer model (1988) Gagne and Briggs (1974) Briggs, Gustafsan and Tillman (1991) o The component: Need analysis Learning objectives Evaluation plan Instructional strategy Theoretical framework Context for the instruction Evaluation • Formative • Summative • SPICES model o Innovative approach Student Oriented Problem based Integrated Community based Electives Systematic/spiral o Conventional approach Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 30 Teacher centred Information oriented/gathering Discipline based Hospital based Standard/uniform programme Apprenticeship based or opportunistic o Student centred vs. teacher centred learning Student centred • Student centred education focuses on the capabilities and motivation of the learners • Student takes responsibility for their own education as undergraduates and through out their professional career. It is an active learning • Teaching guides self-directed learning, small group tutorials, problem based learning avoid formal teaching sessions • The student under the guidance of teacher decides: o Learning objectives o Course content o The method that student will use to achieve the objectives o The learning resources o The sequences and pace of learning o Time assessment Teacher centred • Teacher centred education emphasis is on the teacher and what they teach • The teacher is the centre of the key figure. The emphasis is on activities such as formal lecture or formal laboratory activities. Learning is passive • Individual student has little control over what they learn • Teacher decides: Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 31 o Learning objectives o Course content o The method that student will use to achieve the objectives o The learning resources o The sequences and pace of learning o Time assessment o Problem Based Learning (PBL) McMaster University in Canada, Maastricht in Netherlands and Newcastle in Australia The purposes of this approach • To use problem based learning as a vehicle to develop a usable body of integrated knowledge • To develop the problem solving skills • PBL is the learning that result from the process of working towards understanding or resolving a problem The key features of a problem based curriculum are to: • Analyse health care problems as the main method of acquiring and applying knowledge • Develop independent life long learning skills by the students • Use a small tutorial groups, as the central educational event o Integrated teaching vs. discipline base teaching Integrated teaching is the organization of teaching matter to interrelate or unify subjects frequently taught in separate academic courses or department Traditional discipline base/specialty base • Emphasis on the classical disciplines • Contact with patient tends to be late • It is building block principle Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 32 • Early exposed subjects lay the foundation for the subjects that follow Integrated teaching • Integration of the curriculum: o Mulitprofessional education – students of different professions are taught together o Multidisciplinary integration Horizontal integration – topic traditionally taught separately are taught together Vertical integration - Topics taught by 2 or more department • Early introduction of clinical subject through the curriculum o Community based vs. hospital based education Factors supporting Community based education • Provides community orientation • The community provides useful learning experiences • Makes use of untapped resources • Encourage active learning • Introduction to the health care system o Uses of SPICES model The review of an existing curriculum by a curriculum committee • It helps to assess whether the curriculum relates to the perceived objectives or aims of the school The development of the new curriculum • Issues reviewed in the SPICES model can provide a frame work, around which a more meaningful discussion about curriculum planning can take place Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 33 The tracking of specific questions or issues relating to the curriculum Decisions about teaching methods Decisions about assessment Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 34 STEPS IN CURRICULUM DEVELOPMENT 1. Curriculum development is a process • The process involves o Review and research Reviewing the existing standards Researching and investigating new trends Analyzing the current program Making recommendations for change or new curriculum o Revise and rewrite Revising the written curriculum to reflect the standards Choosing new materials (if needed) Recommending and implementing initial staff development programs Development of an appropriate budget o Pilot or implement A group is selected to pilot the curriculum Provided with adequate training Student Assessment How to learn Method & strategies What to learn (Content) Educational Outcomes Educational Environment Input Output/products Process Context Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 35 This group should developed appropriate assessment tool for evaluating the effectiveness and work through potential problems before full implementation o Implement Full implementation of the curriculum based on the feedback of the pilot group Continued monitoring for effectiveness of the program Collecting evaluative data marks this time Assessment tools are more refined o Evaluate/ monitor/ improve Monitoring evaluative data is continued The focus is more on to integrate the curriculum with other subjects 2. Ten questions to ask when planning a course/curriculum (Harden RM, 1986): • What are the needs in relation to the product of the program? • What are the aims/objectives? • What content should be included? • How should the content be organized? • What educational strategies should be adopted? • What teaching methods should be used? • How should assessment be carried out? • How should details of the curriculum be communicated? • What educational environment or climate should be fostered? • How should be the processed be managed? 3. Approaches to address Harden’s questions • Approaches with the particular focus for curriculum planning: o Engineering approach – aims and objectives It implies tell us what you want and we will do it. Just like the bridge builder say give me the specification of the bridge and we will do it. Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 36 Similarly in curriculum terms, the focus for planning is a detailed statement of the aims of the medical school or institution plus general and specific objectives corresponding to these aims. The belief is that the first stage in curriculum planning must be the specification of the aims and objectives and that all other work relating to the curriculum is secondary to this activity. This approach has the advantages: • At first sight it appears to be a logical approach to curriculum planning (rational curriculum plan). • It may be seen to be useful tools because teachers know what they have to teach and students know what they have to learn. • If ones do not know where one is going how can one plan how to get there? There are, a number of major disadvantages with this approach: • It is not always possible to pre-specify precisely the intended outcomes of the curriculum. • Excessive detail in statements of objectives may obscure the overall concepts or aims of the curriculum. • Revision and updating of objectives is very time consuming; if this is not done regularly the curriculum will become obsolete. • Perhaps the most serious problem with this approach is that medical teachers are uncomfortable with it. o Mechanic’s approach – teaching methods and techniques The car mechanic is concerned more with the type of engine, the number of cylinders and the break horse Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 37 power that with the direction of the car and distance it has travel. In the same way in curriculum planning, rather the aims or objectives being the focus for change, that focus is the techniques used to execute the curriculum. These include: • Computer and computer-assisted learning • Problem-solving • Small-group teaching • Hands-on practical experiences • Traditional lectures Unwin (1985), has drawn attention to the disadvantages of this approach: • Technique is not a major element in the success or failure in a course of instruction. In this approach the curriculum is viewed as what happens to students in the school or institution in term of their learning experiences. o Cook book approach – content A detailed list is made all contents for the curriculum listed like a cookbook recipes. Advantages of the this approach: • Medical teachers can often think in terms of list contents for more easily than in terms of objectives. • If all the ingredients are present and correct then the overall product will be satisfactory. Disadvantages of this approach: • It tends to concentrate on the detail of specific parts rather than taking a broader overview of the whole course. • The approach ignores any overall policy or strategy. Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 38 • The criteria of selection of contents are often not made explicit and may be related to the areas of interest of those who are planning the curriculum rather than to the student needs. • May get into difficulties when decisions have to be taken o on the basis of the percentage of time devoted to each subject (timing too important). o on whether content should be chosen for its relevance to current practice or for its relevance to education and the development of the student (or both). • All the ingredients or contents may be present but if they are not put in the right time, the result may be ineffective. o Railway approach – time table The railway timetable is full of routes and the times when the trains arrive and depart at various stations. Similarly in this model of curriculum planning, the emphasis is • on which courses are held in each phase of the curriculum or term • on what happens at each hour of the day The basis for developing the curriculum is a timetable documents. Advantages of this approach: • This approach is an appealing one in the sense that it leads to a document which can be immediately implemented. • It is a practical approach for curriculum planning. Disadvantages of this approach: Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 39 • It direct attention away from the any fundamental rethink of curriculum aims and objectives and tend to perpetuate status quo e.g. in teaching methods. • Takes account of the logistics situation, including human resources and other resources available and the constraints. o Detective approach – problems The emphasis is on identifying the problems in relation to the existing curriculum and once the problems have been identified, the proposed changes attempt to put them right. Information about the problems: • Can be drawn from hearsay evidence on existing practices. • It can be based on the views of teachers in the curriculum. • It can be based on the views and experiences of the students. Advantages of this approach: • It concentrates attention on areas where change may be beneficial. • Identification and agreement about the problems may produce motivation for change. • Staffs that have gone through the process of identifying the problems are more likely to accept the need for, and direction of, curriculum change. • This approach collects hidden or widely dispersed information about the current position, allowing clarification and reasons for change. Disadvantages of the approach: Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 40 • Teachers may feel that they are being investigated, this can create resentment and, instead of co- operation, a resultant opposition to change. • It focuses attention on the past rather than the present and future. • Various clues may be misinterpreted and the underlying diagnosis or reasons may be ignored or misunderstood. This is equal to the doctor treating the presenting complain and ignoring the underlying pathology. o Religious approach – ideas Just as in religion, where there is a cause, a principle or a system of tenets held with ardour, devotion, consciousness and faith, so those responsible for planning the curriculum may hold some value or aspect of curriculum planning to be of supreme importance. In this approach the focus for curriculum development is some idea or approach which is not questioned which almost becomes an act of faith and which dominates the curriculum planning. Problem-based learning and integration has been used as examples because it is relatively new ideas. Advantages of this approach • It leads to the incorporation of any development in the curriculum. disadvantages of this approach • The methods or techniques which are not open to discussion and has to be accepted as an act of faith. o Bureaucratic approach – rules and regulations The major factor to curriculum planning in this approach is the rules and regulations of the institution or school. Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 41 E.g. subjects that must be taught in the curriculum necessary qualification of teachers (all teacher must have PhD degree). Some of the rules may be imposed on the school by government or a national body. Advantages of this approach • For the orderly running of any curriculum there must be basic guidelines covering the issues Disadvantages of this approach • When the rules determine the character and shape of the curriculum, the educational objectives sink out of sight. o Public relation approach – public image The main emphasis in curriculum planning is on the public image of the institution and its curriculum. What matters is the perception from the viewpoint of outside bodies, potential applicants, sources of funds and the public at large. Disadvantages of the approach • Lead to inappropriate curriculum in that what matters is the public perception of the school rather than the details and facts of the curriculum of it exists. • If the image is one of a school whose produce is already excellence and unable to be improved upon, any curriculum change becomes difficult. o Magicians approach – it appears speedily without being clear where it come from and who has been responsible • Approaches with an emphasis on the pattern of staff involvement o United nation approach Decisions are taken by a group representing a wide variety of interest and constituencies. Advantages of this approach Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 42 • Different interests are represented in the decision- making process but if the numbers are large it may make the group less effective as a decision-making body. • Staff may be on the group or committee because of their position rather than because of any interest or expertise in curriculum planning ot the teaching of their subject. • The responsibility of all members of the committee is to serve the good of the overall body or curriculum. • This approach may be practical as it represent a range of interests. • Implementation of a new curriculum will be facilitated if the representatives on the curriculum committee are the people with power. Disadvantages of this approach • There is tendency for individuals on the committee to regard themselves as representing their discipline or department rather than school as a whole. As consequence, the approach emphasizes the territorial claims of departments rather than presenting an overall view of the curriculum. • Size of the group to be involved in planning: o The larger the group, the more peer pressure there is fir colleagues, the more general overview is obtained and the fewer individuals need to serve on several committees to keep in touch with what is happening. o The smaller the group, the easier it is to organize action and the less staff time it takes. o People congress approach Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 43 In this approach all who are concerned an any way with the curriculum or with teaching take part in decision- making. Advantages of this approach • It surveys a broad sample opinion • It is seen as more democratic than other approaches • It can override or overrule any single powerful personality • By involving staff in the planning it facilitates the implementation of curriculum change Disadvantages of this approach • The consensus agreement may be more theoretical than actual when many people remain silent and do not contribute to the discussion. If the process is not organized properly, the general confusion allows one or two individuals to dominate the proceedings as others opt out of the discussions. • The group may be too large to reach real decisions and produce plans. • It may be wasteful in time and not cost-effective. • It is easy to get side-tracked on minor issues and difficult to maintain concentration on the major issues. • It may be raised barriers to change rather than solutions by confirming staff’s previous prejudices. • It tends to break up into smaller groups or subgroups because of the large number of people involved. o Dictator approach Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 44 In this approach, one person, e.g. the dean of the medical school, has very clear idea of what curriculum changes he wishes and how these can be brought about. Advantages of this approach • Strong leadership and usually a clear goal to which progress is made • Most effective and efficient way of bringing about change in a curriculum. Disadvantages of this approach • Much will depend on the quality of the leader, on his perception of the needs of the curriculum and on his relationship with his colleagues. If his views on the curriculum do not correspond with what in fact is required, then the curricular end-products may be inappropriate and difficult to implement effectively. o Consumer approach The consumer can be divided into 3 categories: • Primary – student • Secondary – public who will face the product of the training process. • Tertiary – the other members of the health care team with whom the doctor will work, including nurse, social worker and etc. Primary consumer – student: • In the past, students have been very active and influential in bringing about curriculum change. • When discussing the present situation they will be more aware than members than members of staff of the hidden curriculum (those parts of the curriculum and learning experiences which are not formally identified and therefore do not appear in timetable and syllabi). Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 45 • They may be aware of the climate of the educational environment. • Their role in curriculum development has often been very helpful and their views frequently reflect a degree of maturity which surprises some staff members. • They are better informed than many staff in term of the extent of the curriculum. • Disadvantages: o Their point of view is at only one point in time. o Students do not have broad educational background and an overview of medicine which will allow them to make appropriate judgment. Secondary consumer – the public: • Perhaps almost completely neglected in the process of revising the curriculum has been the customer for whom its finished product is intended. • The public and patient groups have become much more articulate in their critism of medical education. • More attentions have been focused on patient- doctor communication. • A representative of this group made valuable contributions. Tertiary consumer • If the care of patients is in the charge of a health care team a different professionals working together, it may be useful to have some representative of the other professions on the curriculum committee. Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 46 • They can provide an insight into some underlying problems of the medical curriculum and such opinions and views may be of assistance to those developing the curriculum. o Consultant approach In this approach some outside assistance or resource is harnessed in the form of a consultant. It is not consultant’s responsibility to decide or make decision, they just put forward proposal or recommendation to the curriculum planning. Advantages of this approach • Consultant can be or should be able to take an objective and unbiased view of the curriculum. • He may be sufficiently apart from local politics not to be influenced by them. • He will have experience of alternative approaches to medical education and experience well beyond that of staff whose experience has been limited to that of their own medical school. • The consultant brought in to advice about the curriculum can give the task the high priority that is required of it, whereas the local teachers may well, but may be diverted from the task due to a lot of commitments to their job. 4. Curriculum development plan • Needs assessment • Goal statement • Task analysis • Instructional objectives • Evaluation criteria • Evaluation instruments • Design learning situations Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 47 5. Steps in curriculum development • Step 1: Organizational Development o Clear statement of the outcome o Long and mid term planning o Provision and collection of resources o Strategies for quality control • Step 2: Program development o Contextual analysis o Knowledge analysis with its sub topics o Writing of the skills lists with its sub topics o Writing the course list o Composition of the course map with its sub steps o Statement about skills tests and evaluation writing the implementation draft o Editing the draft program o The draft program the serve as the basis • Step 3: The development of curriculum development • Step 4: The development of learning objectives • Step 5: The development of teaching and learning methods • Step 6: The development of teaching and learning materials • Step 7: The development of human resources and skills Reference: 1. Harden RM (1986b), Approaches to curriculum planning, Medical Education, Vol.20, pp458-466. Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 48 ROLES OF STAKEHOLDERS IN CURRICULUM DEVELOPMENT 1. Definition: • Stake + Holder: o Stake: a stick pointed at one end or the post to which a person in bound to be burnt alive or at risk o Holder: as occupant or a possessor o Stakeholder: a person who has charge of a stake (risk/responsible) until it is known who has won it. • Definition of stakeholder o All persons, agencies and organization with an investment or ‘stake’ in the health of the community and the local public health system. This broad definition includes persons and organization that benefit from and/or participate in the delivery of services that promote the public’s health and overall well- being. (www.map.naccho.org/MAPP_Glossary.asp) o Stakeholders are any individual internal or external to an organization that has a “stake” in the success of the institution (i.e. students, faculty (teacher), staff, system administrator, college council, etc) (www.cobleskill.edu/StrategicPlan/02.html) o Are those who have an interest in a particular decision, either an individual or the representative of group. This includes people who influence a decision or can influence it, as well as those affected by it. o Stakeholders are defined as individuals or organization who stand to gain or lose the success or failure of a system or program 2. Stakeholder in education • People in education are especially resistant to change • They often go through four stages when faced with a new program or curriculum o Unrelated concerns Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 49 The person does not believe the new program will affect them o Personal concerns How will it affect the person as an individual? o Task-related concern Specific concern over how to teach or implement the new curriculum, what strategies and learning experiences to use, what equipment will be necessary, what material may be needed, and more o Impact-related concerns How the new program or curriculum will affect others within the school and the community 3. Stakeholders analysis • Stakeholder may be the users, the providers and the recipients • These who have an impact on or impacted by any program or system • Stake holders may have positive and negative views regarding a educational program • Steps in stakeholders analysis o Identifying the stakeholders o Priorities the stakeholder o Understand stakeholder perspectives o Incorporate stakeholder perspectives into the program 4. Stakeholders in a curriculum • Direct stakeholder o The faculty (teacher) o The student o The parents o Administrators o School staffs • Indirect stakeholder o Government o Community leaders o Political leaders Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 50 o Society 5. Four key questions to be addressed by all stakeholders • How do I define curriculum? • What is my single biggest concern when the curriculum committee is choosing a new curriculum? • How can I communicate my concerns to the curriculum committee? • What kind of process would I like to see the curriculum committee follow as it evaluate different program? 6. Ten stages in participatory curriculum development process (PCD) • Awareness-raising workshop for key stakeholders • Follow-up workshop with wider group of stakeholder • Training need assessment • Development of curriculum frameworks • Develop details curricula • Leaner-centred teaching methods training • Learning material development training • Testing a new/revised curricula • Refine PCD evaluation system • Maintain process of PCD 7. Target group analysis in PCD • Name of program • Overall population of the community • Number of persons for whom the program is useful • Number of persons who are likely to participate in the 1st year • Number of persons who have time and money for participation • Number of years in which the program can be offered • Skills and knowledge needed for entering the program • Actual level of education of the target group • Homogeneity of the target group • Possible motivation for participation • Methods and instruments for contacting and addressing the target group (publicity) Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 51 8. PCD approach overview – the team has been actively collecting data and consulting stakeholder on learner skills and business needs 9. Parents and other stakeholders involvement in PCD • Parents should have access to the curriculum framework • Opportunities for input occur at regularly scheduled meetings. The school system should continue to solicit input from the general public on all parts of the curriculum revision • Parents ca be informed about the curriculum framework through the leadership training classes, cluster meetings, through the newsletter • Parents and general people is solicited for input over a particular period • Students are involved in the review of curriculum framework and are represented on the council • To set consistent, rigorous expectation for all students, teachers are to hold them. Parents need to be informed about what it means for a student to demonstrate mastery of any particular indicator • All teachers will be required to see on-going assessment as a regular part of instruction. The reports to parents should be sent home at Research best practice Qualitative interview with stakeholder Consultation with external experts Web-based electronic survey Learner need analysis Consultative form workshop Curriculum development team workshop Curriculum framework Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 52 specific intervals and will indicate if the student is on, below, or above grade level Stakeholders should be able to participate meaningfully in decision making Stakeholders should play their part in delivering sustainable curriculum development Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 53 EDUCATIONAL STRATEGIES IN CURRICULAR DEVELOPMENT AND IMPLEMENTATION 1. STRATEGY • It is a plan, policy, way or approach • What is curriculum strategy? o The activities that are adopted to provide the best possible way to achieve the goal of an educational institute • What educational strategy should be adopted? o In education the choice is complex and six major issues identified by Harden et. al, 1984 o Choice of activity is depend on the circumstances prevailing, aims and objectives, available resources and constrains of the institute o No single activity is ideal 2. Curriculum Strategy: • Innovative approach: SPICES o S – Student centred o P – Problem based o I – Integrated o C – Community based o E – Electives o S – Systematic/spiral • Conventional approach: TIDHSA o T – Teacher centred o I – Informations orientation/gathering o D – Discipline based o H – Hospital based o S – Standard/uniform program o A – Apprenticeship based or opportunistic 3. Recent strategies in health profession education Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 54 • Education for capability o The core and choices (special study modules, electives) o Practical training and generic competency • Community based medical education • Problem based learning • Student centred education • Integration and early clinical contact • Evidence based medical education • Unity between education and practice 4. Education for capability • It is a balance between general education and vocational education • The component of education for capability includes o The introduction of core curriculum with additional areas of individual choice o Greater emphasis on practical training o Community orientation in medical education o Increase emphasis on generic competencies or transferable personal skills • Principles features of core curriculum o Common to all students o Covers essential competencies o Includes knowledge, attitude and skills o Requires high standards of mastery from the students o Added to and build on, in subsequent stages of the curriculum or phases of education o Mastery in the core ensures the maintenance of standards and basic competencies of the education • Options are according to the choices o It allows in depth work and the achievement of high level competencies such as critical thinking • Practical training and generic competencies Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 55 o Along the practical training in university of Sheffield (Levy, 1992) identified four generic competencies Management and organization Team work Communication skills Problem solving 5. Students Centred • Student centred education focuses on the capabilities and motivation of the learners • Student have to take more responsibility for their own learning • Student can choose their own study time, their pace of study, method of study, and also their learning needs and can also assess their learning • Make them to acquire independent life long learning skills • Teacher only facilitate them, help them and guide them in right way 6. Problem Based Learning (PBL) • PBL is the learning that “result from the process of working towards understanding or resolving the problem” • The key features of problem based curriculum are to o Analyze health care problems as the main methods of acquiring and applying knowledge o Develop independent lifelong learning skills by the students o The use of small tutorial groups, as the central educational event 7. Integration and early clinical contact • Integration refer to the bringing together of different parts in to meaningful whole • The word meaningful is the utmost importance in context of curriculum • In integrated teaching emphasis is on bringing different subject together • In curriculum the integration occurs in two ways Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 56 o Multi-professional o Multi-disciplinary 8. Unity between education and practice • How can we achieve the unity? o Community oriented curriculum Medical education that focuses on both population groups and individual persons while taking into account the health needs of the community (network of Community oriented education, 1979). Here community needs and expectation get priority and community often use as a learning resource o Community based education It is the system of education using community as learning environment with active involvement of students, teachers, members of the community and also representatives from other sectors • Community and Campus partnership 9. Evidence Based Medical Education (EBME) • EBME is the comprehensive, explicit and judicious use of current best evidence in developing curriculum and in making decision about the care of individual patient • It is the process of developing medical education using study/research findings as the basis • Four steps of EBME o Setting the question The question must be searchable, relevant and explicit o Searching the best evidence Clinical evidence, descriptive studies or reports of expert committees o Appraising the evidence Validity of the evidence Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 57 At least from one properly conducted large RCT – evidence from well designed non experimental studies from more than one centre or research group o Acting on the basis of evidence After getting the appropriate evidence it is necessary to decide how to integrate this evidence in the institutional or clinical practice or practice guidelines • Grading of evidence: a multidimensional approach having six dimensions known as QUESTS is in use for scoring of evidence o Quality How good is the evidence? o Utility To what extent can the method be transferred and adopted without modification? o Extent What is the extent of the evidence? o Strength How strong is the evidence? o Target What is the target? What is being measured? How valid is the evidence? o Setting How close does the context or setting approximate? How relevant is the evidence? 10. Barriers to implement the change • “Changing curriculum in the medical school is like rearranging the lifeboats on the titanic” (Abrahamson, 1977) • The Association of American Medical Colleges (1992) identified five barriers to implement the change o Faculty members’ inertia o Lack of leadership o Lack of oversight for the educational program Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 58 o Limited resources and no defined budget o Perception of, there is no evidence that implementing the changes will make necessary improvement • Menin and Kaufman (1989) identify the institutional barriers to implement the change in medical school all over the world o Fear of loss of control by traditional educators o Failure to innovators to alien their proposals with the values and goals of the institute o Predominance of the status duo o Departmental allegiances o Unrealistic expectations o Faculty promotion based on research and services o Innovators not being influential leaders of opinion 11. Required strategies for change • The logical approach to change are o Device an overall strategy o Turn the strategy into a plan o Seek sanction from those in authority o Implement the plan • Lewin identified three strategies in the change and implementation process o Unfreezing Change is initiated when a stable situation is unfrozen so as to make it ready to move o Moving Change is produced as forces re-align themselves around a new centre of equilibrium o Refreezing Change is made permanent and becomes the new orthodoxy until it is challenged • Chin and Benne (1976) identified strategies o Empirical/rational Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 59 Persuades through reasoned argument and reference to fact and research finding o Normative/re-educative Achieves change through education both formal and non formal o Power/coercive Use of political and economic sanctions and rewards 12. Strategies for change • Conduct an organizational analysis o Current situation, problems and forces that are the cause of problems • Conducting an analysis factors relevant to produce the needed change both positive and negative • Selecting the change strategy, based on the previous analysis • Monitoring the implementation process to identify thee unexpected situation 13. Strategies for planned curriculum change • Create a climate, even a demand for change • Diminish the threat associated with innovation and hard-line approach • Appreciate timing • Gear the innovation to the organization • Engage in information dissemination and evaluation • Get organizational leader behind the innovation • Build an active base of support • Establish rewards • Plan for the post adoption period • Other (have an implementation plan) Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 60 BASIC CONCEPT OF CURRICULUM EVALUATION 1. What is evaluation? • Evaluation describes how to assess the nature, impact and value of an activity through the systematic data collection, analysis and interpretation of information with a view to make an informed decision. • Evaluation involves 3 activities o Outlining clear purposes o Gathering evidence o Judgement • Evaluation should be an apart of development rather than apart from it. 2. Why evaluate? • Evaluation takes place for 2 reasons o To prove the quality o To improve the quality • This includes o Keeping track of the project progress o To improve the quality of learning for students o To elicit the principles of good practice o To objectively analyze new products (the students) 3. Why curriculum evaluation? • It involves making judgments about the effectiveness of curricula and whether they are meeting the needs of students • It involves gathering of information in order to determine how well the curriculum is performing • The reasons are to make improvements such as changes to the curriculum document • It is intended to be a shared, collaborative effort involving all the major education partners • Teacher self-evaluation is an important aspect Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 61 • Good teaching practice is an important aspect 4. What to evaluate? • Usability • Teaching and learning effectiveness • Accessibility (where and when can material be used) 5. Focuses of evaluation • The effectiveness of school programs (program evaluation) • The effectiveness of the curriculum (curriculum evaluation) • Progress in student learning (student evaluation/assessment) • The effectiveness of teachers’ instruction (teacher self-evaluation) 6. Methods of curriculum evaluation • Evaluation and revision occurs through out all stages of the development and implementation of the curriculum. This is to facilitate accountability to the professions, society, the education facilities and the learners • There is regular review of the curriculum to reflect the changes that influence the professional setting of staff • There is regular review of the implementation of the curriculum • Educators and trainers, learners, the profession and the key external stakeholders participate in regular and on going evaluation of the curriculum and its outcomes, as appropriate • The curriculum is revised and modified in response to the evaluation process • Learners receive constructive feedback following assessment by peers, educators and trainers, and are facilitated and supported in the self evaluation process • Development and implementation of curriculum is externally moderated as required by the organization, the national standard body and the sector • The timeframe and extend of the evaluation will depend on o Regulation o Organizational quality assurance system Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 62 o The length of time since the curriculum was developed o External changes which make new material essential for inclusion o Existing content obsolete (need to be deleted) 7. Choosing quantitative and qualitative means based on • The quantitative and qualitative data that are collected from o Focus group (staff and student) o Questionnaire o Structured interview o Participants observation o Message to e-mail list o Diary entries o Critical incident analysis o Subject-specific research paper o Local report o University reports o Student monitoring o Server statistic o Student feedback o Staff development feedback 8. Importance of curriculum evaluation • Evaluation is as essential part of the educational process • It provides evidence of how well students’ learning objectives are being achieved and whether teaching standard are being maintained • It enables the curriculum to develop • A curriculum should constantly develop in response to the needs of student institution and society • Evaluation can check that curriculum is progressing in the desired way 9. Purposes of curriculum evaluation • To ensure teaching is meeting students’ learning needs • To identify areas where teaching can be improved • To inform the allocation of faculty resources Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 63 • To provide feedback and encouragement for teachers • To support application for promotion by teacher • To identify what is valued by health profession schools • To facilitate development of curriculum 10. Phases of the evaluation process • Preparation phase o What is to be evaluated o Type of evaluation to be used o The criteria against which student learning outcomes will be judged o Appropriate assessment technique with which to gather information • Assessment phase o Identify information gathering strategies o Construct or select and administer instrument o Collect and organize the information o Identification and elimination of bias • Evaluation phase o Interpretation of assessment information and making judgments about student progress • Reflection phase o To consider the extent to which the previous phases in the evaluation process have been successful o Evaluation of the utility and appropriateness of the assessment techniques used 11. Characteristics of an ideal evaluation • Reliability • Validity • Acceptability – to evaluator and to person being evaluated • Inexpensiveness/ feasibility Steps in the evaluation process Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 64 PREPARATION PHASE ASSESSMENT PHASE EVALUATION PHASE & REFLECTION PHASE 12. Planning for evaluation • 5 questions to be asked when assessing and evaluating of curriculum o Criteria – What? What curricular competencies will be evaluated? What essential learning or key features of subject area competencies will be evaluated? o Purpose – Why? Why is data being gathered and recorded? What will be done with the information gathered? How will it be used to benefit student learning? o Tools – How? How will data be gathered and recorded? What methods and tools will be used? o People – Who? Who will gather and record data and draw conclusion? Who will be involved in the process of decision making and the formulation of new action? 1) Define the purposes and scope of the evaluation 2) Specify evaluation question 3) Develop the evaluation design and data collection plan 4) Collection data 5) Analyse the data 6) Use the evaluation report for program improvement Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 65 o Opportunity – When? During what part of the project process will the assessment and evaluation take place? Specifically, what will students are doing? Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 66 MODELS OF CURRICULUM EVALUATION 1. What is evaluation? • Evaluation describes how to assess the nature, impact and value of an activity through the systematic collection, analysis and interpretation of information with a view to making an informed decision • Evaluation involves 3 activities: o Outlining clear purposes o Gathering evidences o Judgment • Evaluation is part of development rather than apart from it. 2. Approaches to curriculum evaluation: • Goal-based o Determining whether pre-stated goals of educational or training programs were met. • Goal-free o Uncovering and documenting what outcomes were occurring in educational or training programs without regard to whether they were intended program goals focus. • Responsive (contingency-unforeseen event) o Comparing what was intended for instruction to what actually was observed. • These approaches are based on the classical curriculum evaluation models as presented by Stufflebeam and Shinkfield (1990) o The decision-making The collecting information about educational or training programs for the purpose of decision-making. o The accreditation It is for forming professional judgments about the processes used within education or training programs. 3. Models of curriculum evaluation: • Robert Stake’s countenance model (1967) Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 67 • Scriven’s goal-free models (1970s) • Stenhouse research model • Tyler’s objectives model • Parlett and Hamilton’s illuminative model (1977) • Stake’s matrix for processing descriptive data • Eisner’s educational connoisseurship model • Stufflebeam’s CIPP model 4. Scriven’s goal-free model (1970s) • Introduced the term ‘formative’ and ‘summative’ • Broaden perspective of evaluation • Evaluator should not know the educational program’s goals in order not to be influenced by them • Evaluator therefore totally independent • Evaluator free to look at processes and procedures, outcomes and unanticipated effects • Methodology, the field is open to the hunter but he did have a ‘lethal’ checklist of criteria for judging any aspect of the curriculum 5. Stenhouse’s research model (1970s) • Evaluation as part of curriculum development • Continuous cycle of formative evaluation and curriculum improvement at school level • Relationship between curriculum developer and evaluator is central • Curriculum developer offer solutions • Evaluator is the practical man who temper enthusiasm with judgment • The developer is the investigator; teacher o Autonomous professional self-development through self-study o Study of others and testing ideas 6. Tyler’s objectives model • Tyler’s principle deals with evaluating the effectiveness of planning and actions • Curriculum should be evaluated in relation to its pre-specified set of objectives Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 68 • Requires an objectives-based curriculum model • Evaluation measures fit between student performance and objective • Methodology will depend on the evaluator’s definition of ‘measurement’ (standard setting) 7. Stufflebeam CIPP model • Context o Planning decisions What needs are to be addressed Defining objectives for the program • Input o Structuring decisions What resources are available What alternative strategies should be considered What plan has the best potential • Process o Implementing decisions How well is the plan being implemented What are the barriers What revision are needed • Product o Recycling decisions What result are obtained Were need reduced What should be done with the program • Context evaluation o Most basic kind of evaluation o Objective To define the context Identify population Assess needs Diagnose problem o Method: system analysis, survey, document review, hearing, interview, tests, Delphi (Wiseman technique) Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 69 o Relation to decision-making Decide on setting Goals and objectives Planning Providing basis for judging outcomes o Provides rationales for determining objectives o Uses experiential and conceptual analysis, theory, authoritative opinion to judge basic problems which must be solved • Input evaluation o Objective Identify and assess system capabilities Alternative strategies Implementation design Budget o Method: resources analysis, feasibility analysis, literature research, exemplary program visits and pilot projects o Decision Selecting sources Structuring activities Basis for judging implementation • Process evaluation o Objective Identify/predict defects in design or implementation and record and judge procedural activities o Method: monitoring, describing process, interacting, observing o Decision: For implementing and refining program design and procedures Process control Information to use in interpreting outcomes o Provides periodic feedback to those responsible for implementation o Maintain a record of procedures as they occur Curriculum planning & development in Medical & Allied Health Schools Dr Saiful’s notes on Medical Education 70 • Product evaluation o Objective Describe and judge the outcome Relate them to objectives Interpret worth o Method: operationally measuring criteria, collecting stakeholder judgment o Decision To continue Terminate Modify Refocus And present record of effects o Purpose to measure and interpret attainment at end of project cycle o Operationally measures objectives and compare to predetermined standards o Interpret outcomes using context, input and process information. • Steps in CIPP model o Focus the evaluation o Collect information o Organize information o Analyze information o Report information o Administration of the evaluation report • CIPP model of curriculum development is a process of developing the curriculum. • CIPP model of curriculum evaluation is the process to see the effectiveness of the developed and implemented curriculum.