Dasar-dasar Pengembangan Kurikulum Pendidikan Dokter

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Dasar-dasar
Pengembangan Kurikulum
Pendidikan Dokter
Titi Savitri Prihatiningsih
Bagian Pendidikan Kedokteran
Fakultas Kedokteran Universitas Gadjah Mada
Definisi Kurikulum
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Kurikulum pendidikan tinggi adalah
seperangkat rencana dan pengaturan
mengenai isi, bahan kajian maupun bahan
pelajaran serta cara penyampaian dan
penilaian yang digunakan sebagai pedoman
penyelenggaraan kegiatan belajar-mengajar di
perguruan tinggi
Definisi Kurikulum

The curriculum is all the experiences that
students have under the guidance of the
university
Asas Pengembangan Kurikulum
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Asas Filosofis
Asas Sosiologis
Asas Psikologis
Asas Pengorganisasian
Asas yuridis
Komponen Kurikulum
Tujuan
Materi
Penilaian
Proses Belajar
Mengajar
Langkah-langkah
Pengembangan Kurikulum
Model Tyler (1949)
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Tentukan tujuan pendidikan yang akan dicapai
Pengalaman belajar apa yang dapat diberikan
agar tujuan tersebut tercapai
Model Warwick (1975)
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Susun kurikulum yang paling ideal
Pertimbangkan segala sumber yang ada
Identifikasi hambatan atau kendala
Modifikasi kurikulum ideal dengan
mempertimbangkan hambatan
Disain cetak biru kurikulum dan perhatikan
struktur, ruang lingkup, urutan dan
keseimbangan
Model Warwick (1975)
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Persiapkan materi pembelajaran
Disain proses belajar-mengajar yang efektif
dengan memperhatikan cetak biru kurikulum
Model Hilda Taba (1962)
1.
Menentukan tujuan pendidikan:
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Merumuskan tujuan umum
Mengklasifikasi tujuan
Merinci tujuan (mis. Pengetahuan, ketrampilan,
dll)
Merumuskan tujuan dalam bentuk spesifik
Model Hilda Taba (1962)
2. Menseleksi pengalaman belajar
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Relevansi dengan kenyataan sosial
Keseimbangan ruang lingkup dan kedalaman
Variasi pengalaman belajar
Penyesuaian dengan minat dan kebutuhan
mahasiswa
Model Hilda Taba (1962)
3. Pengorganisasian materi dan kegiatan belajar
mengajar
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Menentukan pengorganisasian kurikulum
Menentukan urutan atau sequence
Menentukan integrasi
Menentukan fokus pembelajaran
Model Hilda Taba (1962)
4. Evaluasi hasil kurikulum
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Menentukan kriteria penilaian
Menyusun program evaluasi yang komprehensif
Menentukan teknik pengumpulan data
Menentukan penafsiran data evaluasi
Menterjemahkan evaluasi ke dalam kurikulum
Harden (2000)
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1.
2.
3.
4.
5.
Identifying the need
Establishing the learning outcome
Agreeing the content
Organizing the content
Deciding the educational strategy
Harden (2000)
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6. Deciding the delivery methods
7. Preparing the assessment
8. Communication about the curriculum
9. Preparing the educational environment
10. Managing the study programme
Kurikulum baru HARUS
diujicoba
Langkah ujicoba kurikulum
1.
2.
3.
4.
5.
Menyusun bahan ujicoba
Melakukan ujicoba kurikulum
Revisi dan konsolidasi
Review kurikulum yang telah disusun
Pelaksanaan
Competency-based
Medical Education
Competency is an action
performed to a specific
standard under specific
condition
Competencies
(a cognitive perspective)
“Competence embraces the structure of
knowledge and abilities” (Messick, 1984)
 “Competence rests on an integrated deep
structure (understanding) and on the
general ability to coordinate appropriate
internal cognitive, affective and other
resources necessary for successful
adaptation” (Wood & Powers, 1987)
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There are enabling factors for competence
Competencies
(a cognitive perspective)
Competence derives from possession of a
set of relevant attributes such as
knowledge, skills and attitudes, called
competencies
 a competency is a combination of
attributes underlying some aspect of
successful professional performance
(Gonczi et al, 1993)
Competence in an area therefore requires
a specific set of prerequisite competencies
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Competency is …
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A complex set of behaviour built on the
components of knowledge, skills and
attitudes
Differences between Content-based/Structure/Process-based
and Competency-based
Educational
Programme
Driving factor
Curriculum
Structure/Contentbased
Content-knowledge
acquisition
Competency-based
Outcome-knowledge
application
Driving force for process Teacher
Learner
Path of learning
Non-hierarchical
Hierarchical
Differences between Content-based/Structure/Process-based
and Competency-based
Educational
Programme
Structure/Contentbased
Competency-based
Responsibility for
content
Teacher
Student and teacher
Goal of educational
encounter
Knowledge acquisition
Knowledge application
Typical assessment tool
Single subjective
measure
Multiple objective
measures
Differences between Content-based/Structure/Process-based
and Competency-based
Educational
Programme
Structure/Contentbased
Competency-based
Assessment tool
Proxy
Authentic (mimic real
task of professional)
Setting for evaluation
Removed
Direct observation
Evaluation
Non-referenced
Criterion-referenced
Differences between Content-based/Structure/Process-based
and Competency-based
Educational
Programme
Structure/Contentbased
Competency-based
Timing of assessment
Emphasis on summative
Emphasis on formative
Program completion
Fixed time
Variable time
Curricular Design for CBE
1. Competency identification
2. Determination of competency components
and performance levels
3. Competency evaluation
4. Overall assessment of the process
Examples of performance levels
1.
2.
3.
4.
5.
Novice
Beginner
Competent
Proficiency
Expert
1.
2.
3.
Beginning level
Intermediate level
Advanced level
1. Melihat/tahu
2. Melakukan di bawah
supervisi
3. Melakukan mandiri
Outcomes
(areas of competence)
Educating
Doctor
Curriculum
Development
Competencies
Knowledge, Skills, Attitudes
Roles and Functions of Health Professional
Competencies required for performance of roles/functions
Knowledge, skills, attitudes for acquisition of competencies
Assess
Roles and Functions of Health Professional
Assess
Competencies required for performance of roles/functions
Assess
Knowledge, skills, attitudes for acquisition of competencies
Elements of CBME (1)
1.
2.
Competencies to be achieved are carefully
identified, verified and made public in
advance
Criteria to be used in assessing achievement
and the conditions under which achievement
will be assessed are explicitly stated and
made public in advance
Elements of CBME (2)
3. The instructional program provides for the
individual development and evaluation of
each of the competencies specified
4. Assessment of competency takes the
participant’s knowledge and attitudes into
account but requires actual performance of the
competency as the primary source of evidence
Elements of CBME (3)
5. Participants progress through the instructional
program at their own rate by demonstrated the
attainment of the specified competencies
Characteristics of CBME (1)
1.
2.
3.
Competencies are carefully selected
Supporting theory is integrated with skill
practice. Essential knowledge is learned to
support the performance of skills
Detailed training materials are keyed to the
competencies to be achieved and are
designed to support the acquisition of
knowledge and skills
Characteristics of CBME (1)
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1. Competencies are carefully selected
2. Supporting theory is integrated with skill
practice. Essential knowledge is learned to
support the performance of skills
3. Detailed training materials are keyed to the
competencies to be achieved and are designed
to support the acquisition of knowledge and
skills
Characteristics of CBME (2)
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4. Methods of instruction involve mastery
learning, the premise that all participants can
master the required knowledge or skill
provided sufficient time and appropriate
training methods are used
Characteristics of CBME (3)
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5. Participants’ knowledge and skills are
assessed as they enter the program and those
with satisfactory knowledge and skills may
bypass training or competencies already
attained.
6. Learning should be self-paced
Characteristics of CBME (4)
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7. Flexible training approaches including
large group methods, small group activities
and individual study are essential components
8. A variety of support materials including
print, audiovisual, and simulations keyed to
the skills being mastered are used
9. Satisfactory completion of training is based
on achievement of all specified competencies.
Characteristics of CBME (5)
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Evaluation is focused on the measurement of
the mastery of information and skills.
Criterion-referenced should be used
Implications for using CBME (1)
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1. Organizations must be committed to
providing adequate resources and training
materials
2. Audiovisual materials need to be directly
related to the written materials
3. Training activities need to match the
objectives
Implications for using CBME (2)
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4. Continuous participant interaction and
feedback must take place
5. Trainers must be trained to conduct
competency-based training courses
6. Individuals attending training must be
prepared for CBT as this approach is likely to
be very different.
Design activities for CBME (1)
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1. Identification of specific clinical
performance or clinical skills (e.g. CPR, etc)
2. Identification of the conditions under which
the clinical performance or clinical skills
must be demonstrated (e.g. using simulators,
role plays, etc)
3. Development of the criteria or standards to
which the skills must be performed
Design activities for CBME (2)
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4. Development of the competency-based
learning guides and checklists which list each
of the steps and sequence required to perform
each skills or activity
5. Development of the reference manuals
which contain the essential, need-to-know
information related to the performance or
skills to be developed
Design activities for CBME (3)
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6. Development of the models to be used
during training
7. Development of training objectives which
outline what the participant must do in order
to master the clinical performance or clinical
skills
8. Development of course outlines which
match a variety of training methods and
supporting media to course objectives
Design activities for CBME (4)
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9. Development of course syllabi and
schedules which contain information about
the course and which can be sent to
participants in advance so they are aware of
details concerning the course.
Delivery and Evaluation Activities for
CBME using a clinical skill as an
example
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1. Administration of a precourse questionnaire
to assess the participants’ knowledge and
attitudes about course content
2. Administration of precourse skill
assessments using model to ensure
participants possess the entry level skills to
complete the course successfully and role
plays to determine the level of their
communication skills
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3. Delivery of the course by a
trainer/facilitator using an interactive and
participatory approach
4. Transfer of skills from the instructor to the
students through clinical counselling skill
demonstrations using slide set, videotapes,
models, role plays and finally clients
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5. Development of the students’ skills using a
humanistic approach, which means
participants acquire the skills and then
practice until competent using anatomic
models and role plays
6. Practice of the skills following the steps in
the learning guide until the participant
becomes competent at performing the skills
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During this time, the trainer functions as a
coach providing continous feedback and
reinforcement to participants. Only when
participants are assessed and determined to be
competent on a model do they work with
clients
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7. Presentation of supporting information and
theory through interactive and participatory
classroom session using a variety of methods
and audivisuals
8. Administration of midcourse test to
determine if the participants have mastered
the new knowledge associated with clinical
skills
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9. Guided practice in providing all
components of the clinical performance
10. Evaluation f each participant’s
performance (i.e. knowledge, attitudes,
practice and clinical skills) with clients. The
evaluation by the trainer using performancebased test. The participant is either qualified
or not qualified as a result of knowledge,
attitude and skills assessments.
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11. Presentation of a statement of
qualification which identifies the specific
clinical performance the individual is
qualified to provide
Learning principles underlying CBME (1)
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1. Learning is most productive when the
student is ready to learn. The Clinical teacher
should create a climate that will nurture
motivation
2. Learning is most effective when it builds on
what the students already knows or has
experienced
Learning principles underlying CBME (2)
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3. Learning is most effective when students
are aware of what they need to learn
4. Learning is made easier by using a variety
of training methods and techniques
5. Opportunities to practice skills initially is in
controlled or simulated situations are essential
for skill acquisition and for develoment of
skill competency
Learning principles underlying CBME (3)
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6. Repetition is necessary to become
competent or proficient in a skill
7. The more realistic the learning situation,
the more effective the learning
8. To be effective, feedback should be
immediate, positive and nonjudgemental.
Key Words
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Relevant- task oriented – participatory –
friendly – varied – built on past experience
Faculty members must be genuinely
interested in teaching and must be trained in
interactive method
From teacher-oriented to learner oriented,
including self-paced learning and assessment
Key Words
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Changing from narrow-discipline oriented
teaching to a problem-solving approach
Moving from lecture-oriented teaching to
experiential and interactive learning
Changing the medical teacher’s role to a
coach of student learning
Thank You

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