An Approach to Curriculum Development

Report
GME Lunch n Learn Series
Cuc Mai
September 2012
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Common Program Requirements:
• Competency-based goals and objectives for each
assignment at each educational level
•
Internal Medicine Specific Program Requirements:
• For each rotation or major learning experience, the
competency based goals and objectives (the written
curriculum) must contain the educational plan, goals
and objectives, educational methods, and the
evaluation tools that the program will use to assess the
resident’s competence.
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Recognize key components of curriculum
development
Demonstrate how each of these components
can be used to benefit learners and promote
scholarly activity
Identify resources to improve curriculum
development skills
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Develop a curriculum to teach residents
about how to diagnose and treat
musculoskeletal diseases and increase
number of joint injections performed during
residency.
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Builds a rationale for the curriculum
Focuses the curriculums’ goals and objectives
Focuses the educational and evaluation
strategies
Makes you an expert and scholar
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Musculoskeletal disorders are common and a
major cause of disability
Patients want quick access
Training increases confidence and decreases
referrals
National organizations recommend training in
musculoskeletal exam; diagnosis; management
Preferred training is in clinical practice with trained
preceptors
Houston TK et al. A primary care musculoskeletal clinic for residents: success and sustainability. J Gen Intern
Med 2004; 19: 524-529.
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Assess the differences between your specific
learners and the general audience
Assesses the environment to help tailor the
intervention
Prevents duplication
Identifies stakeholders and builds
relationships with stakeholders

Methods for collecting information:
◦ Reviewed existing training
◦ Senior resident exit survey, Survey of current residents,
& Focus group of residents

Findings:
◦ Strong desire for training
◦ Low levels of training and clinical experience and self
rated proficiency
◦ Wrong case mix in Rheumatology and Orthopedics
◦ Preferred direct supervision of patient care by
practitioners with expertise in musculoskeletal medicine
Houston TK et al. A primary care musculoskeletal clinic for residents: success and sustainability. J Gen Intern Med
2004; 19: 524-529.
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Goal: broad educational goal
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Objective: specific measurable objective
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Helps prioritize
Direct content
Identify learning methods
Enable and direct evaluation
Provides clear communication to learners,
faculty, and stakeholders
Required
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Types of Objectives
◦ Learner Objectives
 Cognitive, Affective, Psychomotor
◦ Process Objectives
 Curriculum Implementation Measures
◦ Patient/Healthcare Outcome Objectives
 Patient Outcomes: pt satisfaction
 Healthcare/System Outcomes: board pass rate
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Who will do how much of what by when?
◦
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Who (1)
Will do (2)
How much (3)
Of What (4)
By When (5)
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Maintain congruence between objectives and
methods
Use multiple educational methods
Choose methods that are feasible
Table 5.2 Matching Educational Methods to Objectives*
Type of Objective
Affective:
Attitudinal
Cognitive:
Knowledge
Cognitive:
Problem-Solving
+++
+++
+++
++
+
+
++
++
+
++
+++
+++
++
Small-group learning
Problem-based learning
Team-based learning
Learning projects
Role models
Demonstration
Role plays
Artificial models and simulation
++
++
+++
+++
++
+++
+++
+++
+
+
+
++
++
+
++
+
++
+
++
++
Standardized patients
Real life experiences
Audio or video review of learner
+
+
+
++
++
Educational Method
Lectures
Programmed learning
Discussion
Reflection on experience
Feedback on performance
Behavioral / environmental
interventions**
+
+
+
+
+
Psychomotor:
Skills or
Competence
Psychomotor:
Behavioral or
Performance
+
+
+
+
+++
+++
+
+++
+++
+
+
+
+
++
+++
+++
+
+
+
+
++
++
+
+
++
++
+++
+++
+++
+
+++
+
+
+
+++
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Musculoskeletal Curriculum:
◦ Development of workshops and syllabus materials
on diagnosis and management for common
musculoskeletal disorders, including injection
therapy.
◦ Institution of a new primary care musculoskeletal
clinic supervised by Internal Medicine preceptors
with a special interest in musculoskeletal diseases.
Houston TK et al. A primary care musculoskeletal clinic for residents: success and sustainability. J Gen Intern
Med 2004; 19: 524-529.

Identify Resources
◦ Personnel, Time, Facilities, Funding
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Obtain Support
◦ Internal vs. External
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Develop Administrative Mechanisms
Anticipate and Address Barriers
◦ Competing Demands, Attitudes
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Develop a Plan for Introducing Curriculum
◦ Pilot, Phase In, Full Implementation

Musculoskeletal clinic
◦ Financial analysis and feasibility analysis had to be
done
◦ Administrative support was obtained.
◦ Plan discussed with Rheumatology and Orthopedics
Houston TK et al. A primary care musculoskeletal clinic for residents: success and sustainability. J Gen
Intern Med 2004; 19: 524-529.
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Need to determine if goals are met
Provides information for improvement
Documents accomplishments
Specifics to Consider
◦ Evaluation Questions
 Address learner objectives
◦ Evaluation Design
 Consider internal and external validity
 Posttest, Pretest/Postest/Control Group
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Recognize and apply these 6 steps to
curriculum development
◦ Problem Identification & General Needs
Assessment, Targeted Needs Assessment, Goals &
Objectives, Educational Strategies, Implementation,
Evaluation & Feedback

Define objectives in specific and measurable
language
◦ Who will do how much of what by when?
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Use references to help your faculty develop
curriculum for your learners
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Kern D, Thomas P, Hughes M, Barker L, Bass
E, Carrese J, Wolfe L. The Six-Step Approach
to Curriculum Development. SGIM Workshop.
5/2009.
Kern D. Curriculum Development for Medical
Education. Second Edition.
Thomas P, Kern D. Internet Resources for
Curriculum Development in Medical
Education. An Annotated Bibliography. J Gen
Intern Med. 2004; 19: 599-605.

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