Transcript Learning Outcome

Workshop on
“Emerging Trends in
Curriculum Development”
Dr. Syed Hasan Shoaib
LEARNING OUTCOMES
Use of learning outcome for Curriculum
planning
 Learning outcomes are defined
 Outcomes inform decisions about the
Curriculum
 There is move away from process model of
Curriculum planning, where what matters is the
teaching and learning material and methods

LEARNING OUTCOMES

Focus is on product model where focus is on the
ultimate outcome
Why change?

Medical knowledge has increased
exponentially.

The role played by information technology has
developed.

The pattern of disease is different.

The approach to health-care delivery has
changed.

Society in general has altered.
Why change?

Patients' expectations of doctors in particular
have changed.

There have been changes in professional roles and
boundaries.

The attitudes of doctors to work have changed.

The student body in many medical schools is
different from what it used to be.
Examples of
Learning Outcomes
The Five Star Doctor

An article published by Dr. Charles Boelen
in WHO journal of “changing medical
education and medical practice”
Examples of
Learning Outcomes
What is five star doctor?
1.
Care provider
2.
Decision maker
3.
Communicator
4.
Community leader
5.
Manager
Examples of
Learning Outcomes
What is seven star doctor?
1.
Care Provider
2.
Decision-maker
3.
Communicator
4.
Community Leader
5.
Manager
6.
Researcher
7.
Life-long Learner
Examples of
Learning Outcomes
What is Tomorrow’s Doctor?
1.
The doctor as a scholar and scientist
2.
The doctor as professional
3.
The doctor as a practitioner
ISSUE?
We are currently using the
traditional Curriculum. Can this
Curriculum cater to the
learning outcomes specified in
the Five Star Doctor, Seven Star
doctor and Tomorrow’s doctor?
Curriculum design
“Seek not for any definition of curriculum.
There is no such elixir.” Hugh Sockett
BUT most agree a curriculum is ……
All planned and unplanned learning
experiences in a medical education institution
The Difference between Course and
Curriculum

A curriculum explains generally the program of
study. For example, a curriculum might be “2
courses in natural science, 2 courses in
language, and 2 courses in fine art.” A
curriculum typically lists large categories under
which many courses may fall. Sometimes, a
curriculum can be very specific and may
identify a specific course
The Difference between Courses and
Curriculum

Course is a subset of Curriculum. It explain in
detail what courses are offered during a
semester within the Curriculum.
Courses might be Anatomy, Physiology,
Biochemistry etc.
In Nutshell:
COURSE IS A SUBSET OF
CURRICULUM
AIMS & OBJECTIVES

Aims are general statements of intent. Their
focus is mainly what a teacher intends to
achieve or what a course intends to achieve.

Objectives are rather more specific statements
of what students should be able to do as a
result of a course of study

Aim: PMDC wants that the students at the end
of MB.B.S. Course should become Community
Oriented doctor

Objectives: At the end of M.B.B.S. course the
doctor should be able to:
 Manage
a case of Tuberculosis
 Manage
a case of Pneumonia
SPICES Model
Teacher-centered
Info. gathering
Discipline-based
Hospital-based
Standard Programs
Apprenticeship
Student-centered
Problem-based
Integrated
Community-based
Electives
Systematic
CURRICULUM
PERSPECTIVES
OBJECTIVE
 Discuss the different perspectives of
curriculum
•
Traditional
•
Behaviourism
•
Cognitivism
•
Constructivism
•
Pragmatism
Traditional
 Learning
which focuses on
transmission of discrete pieces of
information
ASSUMPTIONS

Knowledge needs to be transmitted-from teacher
to student

Recitation is instrumental to learning
Design

Emphasis is on delivery of isolated and
disconnected content of subject matter

Is mainly teacher centered
Teaching

Emphasizes rote memorization

Focuses on assigning and listening to students
recitations
Behaviourism
Behaviourism operates on the principle of
stimulus-response. It is based upon the
idea that all behaviors are acquired
through conditioning
John B Watson
ASSUMPTIONS

Behavior is the result of stimulus – response (i.e.
all behavior, no matter how complex, can be
reduced to a simple stimulus – response
association).

Behaviors can be measured, trained, and
changed.
Design

Write observable and measurable learning
outcomes

Specify the desired performances in
advance (the learning outcomes serve this
purpose) and verify learning with
appropriate assessments
Teaching

Lectures, tutorials, demonstrations, and
other forms of teacher controlled
teaching tend to dominate

Behaviorism techniques used in education
are contracts, consequence, extinction
and behavior modification

Reinforce accomplishments with
appropriate feedback
Cognitivism
Cognitive theory defines learning as "a semipermanent change in mental processes or
associations."
Jerome Bruner
ASSUMPTIONS

The cognitivist paradigm views the
learner as an information processor (like
a computer)

There are cognitive processes that take
place and influence the way things are
learned

Learning involves the acquisition or
reorganization of the cognitive structures
through which humans process and store
information”
DESIGN

Emphasis is on structuring, organizing,
and sequencing information to facilitate
optimal processing

Focus of learning that allows and
encourage students to make connections
with previously learned material
TEACHING

Educators use techniques such as advance
organizers, analogies, hierarchical
relationships and matrices to help
learners relate new information to prior
knowledge

Students encouraged to use memory
device such as mind mapping, graphic
organizer to enhance their understanding
and good memory
Constructivism
Constructivism is a philosophical position
that views knowledge as the outcome of
experience mediated by one's own prior
knowledge and the experience of others
John Dewey
ASSUMPTIONS

Learners build personal interpretation of
the world based on experiences and
interactions
 The
purpose of learning is for an
individual to construct his or her own
meaning, not just memorize the
“right” answers and regurgitate
someone else’s meaning.
DESIGN

Focus is on authentic tasks, experiences
and settings

Emphasizes problem solving and
understanding
TEACHING

Instructors tailor their teaching strategies
to student responses

Encourage students to analyze, interpret,
and predict information

Teachers rely heavily on open-ended
questions and promote extensive dialogue
among students.
Pragmatism
The term pragmatism derives its origin
from a Greek word meaning to do, to
make, to accomplish. Pragmatism posits
that truth can be known only through its
practical consequences
Charles Peirce
ASSUMPTIONS

Experience is at the centre of the
universe

Knowledge is hypothetical and changing
constantly

Knowledge is experienced

It cannot be imposed on the learner

It is a personal activity

It is socially constructed
DESIGN

Emphasis is on those subjects, activities and
experiences which are useful to the present
needs of the learner and also meet the future
expectations of adult life as well

The curriculum should consist of varieties of
learning experiences which promote original
thinking and freedom to develop social and
purposeful attitudes
TEACHING

Teaching methods focus on hands-on
problem solving, experimenting and
projects, often having students work in
groups

Learning by doing and learning through
experience
RECAP
Traditional
Behaviorism
Cognitivism
Constructivism
Pragmatism
Perspective
Learning is
transmission of
knowledge
Learning is
acquired by
conditioning
Learning is a
change in
mental
processes or
associations
Learning is
subjective
representations
of objective
reality
Knowledge is
experienced
Design
Emphasis on
content
Observable
and
measurable
learning
outcomes
Structuring,
organizing,
and
sequencing
information
Emphasizes
problem solving
and
understanding
Emphasis is on
learning
expeience
Teaching
Focuses on
memorization
Contracts,
consequences,
extinction and
feedback
Use of
techniques
such as
advance
organizers,
analogies,
hierarchical
relationships
and matrices
Encourages to
analyze,
interpret and
predict
information
Learning by
doing and
experience
THANK YOU
What?
Where?
Why?
How?
Who?
When?
Dr. Syed Hasan Shoaib
Department of Medical
Education
Shalamar Medical and Dental
College
Overview
Learning Outcome:
Demonstrate the process of PBL

PBL
 Why?
 What?
 Where?
 How?
 Who?
 When?
PBL can be used as:

Curriculum
OR

Teaching Methodology
Why Problem Based Learning (PBL)?
1 It is assumed that learning is an active
process of constructing knowledge, rather
than a passive process of memorization.
2 In PBL students are encouraged to actively
construct their own knowledge because
students discuss the subject matter studied,
ask questions and answer questions.
Why Problem Based Learning (PBL)?
3 Active interaction in the group stimulates
students towards a deep understanding of
the subject matter.
4 Finally, because most PBL problems have a
close link with future practice, students are
assumed to be better able to apply what they
have learned in practice.
Why Problem Based Learning
(PBL)?
5 Decision-maker
6 Communicator
7 Community Leader
8 Manager
9 Researcher
10 Life-long Learner
11 Problem Solver
New areas of
development
for medical
professionals
Why Problem Based Learning (PBL)?
Problem Based Learning
PBL - what is it?
What is problem-based learning?
“ A learning method based on the principle of
using problems as a starting point for the
acquisition and integration of new knowledge.”
H.S. Barrows 1982
Problem-solving vs problem-based learning
- different but inter-related -
Problem-solving –
Arriving at decisions based on prior knowledge
and reasoning
Problem-based learning –
The process of acquiring new knowledge based
on recognition of a need to learn.
The Relative Proportion of Problem-Solving to
Problem-Based Learning Changes as the
Curriculum Progresses
Problem
solving
Problem-based
learning
Time in the curriculum
Branda
PBL - Process
Brainstormhypothesize
Read the
problem
Next Scenario
EVALUATE
Identify learning
issues
Research-Learn
(2-7 days)
Return-RereadReport-Review
Traditional
Tutorial
“Tutor ”
“Students”
PBL
Tutorial
“Tutor ”
“Students”
How do students discuss the problems in
PBL?

While discussing the problems in PBL the
Maastricht 7 jumps approach can be used.

It provides an approach that applies the learning
principles in a systematic manner to guide
students to generate learning issues from the
problem.
Maastricht 7 jumps approach:
1- Clarifying terms and Concepts
2- Defining the Problem
3- Analyzing the problem/Brainstorming
4- Categorizing
5- Formulating Learning Issues
6- Self Study
7- Discussion of newly acquired knowledge
Discussion Phase: Step 1-5

The problem is initially tackled in a discussion phase
that lasts 1-2 hours. This phase involves 5 steps.

1- Clarifying terms and concepts:
This helps the group to start with a clear and common
understanding of terms and concepts in the problem.

2- Defining the Problem:
To clearly formulate a concrete defined problem or
propose a definition of the problem. This helps to
establish the boundaries of the problem under
discussion.
Discussion Phase: Step 1-5
Step 3: Brainstorming

Analyzing the problem: This step is meant to
refresh the knowledge present within the group
and to activate the prior knowledge. Listing to as
many explanations or alternatives as possible for
the problem without excluding any explanations is
important.
Discussion Phase: Step 1-5
Step 4 : Categorizing

Categorizing explanations listed in the
brainstorming step. This helps in defining
interrelationships between previous listed
explanations. The group builds a coherent
description of the explanations of the processes,
the group thinks, underlies the problem.
Discussion Phase: Step 1-5
Step 5 : Learning Issues / Learning Objectives

Formulating Learning Issues: Depending on the
previous discussion, whatever is still not known or
unclear can be formulated into clear, well-defined
learning issues for self directed learning.
An important part of PBL is the learning
between sessions
Self Study Phase: Step 6

Step 6 : Self Study:
 This
step is meant to help the student to select
relevant literature sources.
 Students
are provided with a list of materials
that are related to the problem. The students
preferably make a selection of appropriate
materials from this list.
Self Study Phase: Step 6

After selecting the sources, many steps follow. All
group members are required to study the
resources, gain a clear understanding of the
knowledge to link previous knowledge to new
attained knowledge and to prepare to report back
critically on the acquired knowledge.
Report Phase: Step 7

Discussion of newly acquired knowledge: This
phase is usually scheduled after a couple of
days to allow time for self study. This session
lasts 1-2 hours.

In this step all members of the group
participate to answer the learning issues
generated previously. Students may ask
questions to clarify matters, elaborate on the
new knowledge, test their understanding and
depth of insight into the topics discussed
Who is responsible for what?
The Student Roles:
By rotation every group member fulfils one of the following
roles:

Discussion leader: the discussion leader is the chair. He/She
has the responsibility of structuring the discussion,
summarizing, stimulating, asking questions, concluding and
following the 7 jump approach.

Scribe: the scribe takes notes of the analysis and discussion.

Participant: all group members are expected to participate
in the discussion through providing and asking for information,
summarizing, active listening, and providing and asking for
feedback.
Who is responsible for what?
The Tutor Role:

The tutor is an educator who guides the tutorial
group to successfully achieve the objectives of
a curriculum. He/She may ask questions to:
 Draw
attention to inconsistencies
 Widen
the discussion.
 Check
for accuracy.
 Stimulate
integration of knowledge
When can the process go wrong?

There are some situations that can affect the
group dynamics in a PBL group. For example the
presence of:
A
Dominant member: A member who speaks a
lot and does not provide an opportunity for
the others to participate.
 An
Un-Prepared member: A member of the
group who does not study for the report phase
and does not contribute to the learning of the
others.
When can the process go wrong?
A
Reading Member: A member who brings a
couple of references to the report phase and
reads aloud from the books or papers.
A
talkative tutor: A tutor that alters the
process by providing mini-lectures during the
tutorial.
A
silent tutor: A tutor that does not intervene
when needed.
When can the process go wrong?
Absent = Unsatisfactory
Let colleagues/tutor know if you are
sick and won’t make it to a session
Kuby
Evaluation

At the end of the tutorial groups, feedback of the strengths
of the group process and the matters that require
improvement are to be discussed within the group.
Providing well structured feedback and receiving feedback
assists in further fruitful cooperation and gaining more indepth discussions.

Issues that students are evaluated upon and should pay
attention to:
 Dealing
with work: well prepared for the meetings,
reported findings in own words.
 Dealing
with others: active listener, team-work
 Dealing
with oneself: open for feedback, being on time.
Evaluation

Issues that tutors are evaluated upon and should pay
attention to Stimulate students to:
 Report
what they learned in their own words.
 Search
for links.
 Formulate
 Review
clear learning issues.
various references.
 Apply
the knowledge to the discussed problem and
to other situations.
 Provide
and receive feedback on self and group
function.
Conclusion

Problem Based Learning can provide you with a
learning process that is knowledgeable,
informative, motivating and full of enjoyment.
TEN Questions to ask
when planning a course or
curriculum
BY
R.M. Harden
Medical Education 1986,
20(4): 356-365
1) What are the needs in relation to the
product of the training program?
The need to produce doctors to serve the
public accompanies two others in any medical
school – the production of teachers and of
researchers.
 Do all doctors need to be trained in the skills
required for carrying out research in their
own area of practice?
 How should these three needs be balanced?
 Training needs analysis is a process of both an
extensive and intensive study of product
requirements.

1) What are the needs in relation to
the product of the training
program?
A number of approaches may be used to identify
needs as a step in curriculum planning:

The wisemen approach.

The Delphi technique, a method relying on
the judgment of an expert panel of 'wise
men', has been used in curriculum planning
to obtain a consensus opinion.
(Miller,
1974).

A study of errors in practice.

Critical incident studies.
1) What are the needs in relation to
the product of the training
program?

Task analysis of established practitioners.

Analysis of morbidity and mortality
statistics.

Study of star performers.

Analysis of existing curricula including
syllabi and examinations.

Views of recent graduates.
In many countries, the answer to this question
is already specified in general terms by
government and by professional bodies.
2) What are the aims and objectives?

A medical school may decide that its major
aim is: “To produce doctors who are able
and motivated on qualification to meet the
community's needs while also being capable
of continuing their education”.

The decision might be taken: “To produce
basic doctors who are unable to work in any
branch of medicine without further formal
vocational training as postgraduates”.
2) What are the aims and objectives?

The curriculum responds to the needs of the
community by explaining what the product will
be able to do by the time he/she has
successfully completed the programme.

Another approach which may be an appropriate
alternative to aims and objectives is
competence-based.

Not all needs may be reflected in the aims and
objectives of the course or curriculum.
3) What content should be included?

Content gains admission in a course by satisfying
any of four criteria:
 It directly contributes to the course objectives.
 It is a 'building block' which equips the
students with skill or knowledge needed to
tackle a later part of the course.
 It allows students to develop intellectual
abilities such as critical thinking.
 It aids the understanding of other subjects on
the course.
4) How should the content be organized?
Should the basic sciences provide a foundation for
the study of medical disciplines followed finally by
disordered function of the body? Or is it better to
work back from disordered function, explaining it
in terms of deviation from the normal?
 Should subjects be covered in a particular order?
For example, should psychiatry be introduced
before, during or after the study of general
medicine?
 Which teachers or departments should be
responsible for covering each subject?

4) How should the content be organized?


Organizational frameworks:
The system -based approach:
 Students
visit each system only once in their
undergraduate education.
 Visit each system several times:
 In phase 1, students learn about normal structure
function and behaviour (basic science) in relation
to the systems.
 In phase 2, they learn about abnormal structure
function and behaviour (pathological sciences) in
relation to the systems.
 In phase 3, they learn about the clinical
applications of their previous learning (practice of
medicine).
4) How should the content be organized?

Spiral curriculum:
 As
the student
moves on
through different
experience there
is value in revisiting previous
learning to reexplore and
extend it.
5) What educational strategies should
be adopted?
The term educational strategy implies the approach
taken to the conduct of the educational programme.
 SPICES model for curriculum planning:
 Student-centered/ teacher-centered.
 In a student-centered approach students can choose
when they will study, their pace of study, the method
of study and what they will study.
 Problem-solving/information-gathering
 Integrated (multidisciplinary)/specialty (discipline).
 Community-based/hospital-based.

5) What educational strategies should
be adopted?

Elective/standard


In elective programmes, students have a
small core and for the remainder of the
time choose which aspects of the subjects,
or even which subjects, they wish to study.
Systematic (planned)/apprenticeship.
6) What teaching methods should be
used?

To select the most appropriate teaching
method to achieve the desired student
outcomes.

Student grouping:

Whole class teaching;

Classes divided into smaller groups of seven
or eight students; or

Individualized learning where students work
on their own.
6) What teaching methods should be used?

Teaching methods (the choice of tool):











Slides,
Audiotape,
Film,
Videotape,
Overhead projector,
Printed text,
Computers,
Simulators,
Models,
Exhibitions and patients, or/and
Computer- assisted learning (CAL).
6) What teaching methods should be
used?

The well-prepared, dynamic lecture is effective and
often the best use of available resources, especially if
the class size is large.

The educational value of a method is dependent as much
on how the method is used as on the choice of method.

The choice of method should reflect:
 The
course aims and objectives;
 Class
 The
size;
availability of local facilities; and
 Staff
experience in the various techniques.
7) How should assessment be carried
out?

“The curriculum instructs teachers in what to teach; the exam. Instruct
students in what to learn”.
(Melnick D, 1991)



The assessment strategy should be developed at the planning stage.
Both the student and the course should be assessed.
Assessment techniques:









Multiple choice questions
Essay questions
Short answer questions
Patient management problems
Modified essay questions
Oral examinations
Traditional clinical examinations
Objective structural clinical examinations
Reports by tutors or supervisors
8) How should details of the curriculum
be communicated?
Details of the curriculum have to be communicated
to staff responsible for teaching and to the students
for whom the curriculum has been designed.
 Most commonly this is done through syllabi and
timetables.
 The most existing is the use of concept mapping.
 Another approach is the presentation of the aims
and objectives of the courses.
 Study and tutor guides provides an important
curriculum information source for students and
tutors.

9) What educational environment or
climate should be fostered?
Educational Environment May have profound
effects on the students' behaviour and
performance and on the outcome of the
curriculum.
 Does the environment encourage scholasticism,
propriety, social awareness and cooperation
between students?
 Using available instruments, to measure the
climate of the educational environment in an
institution.

10) How should the process be
managed?
Who is to be responsible for planning,
implementation and monitoring?
 How can change or innovation be brought into
the curriculum?
 What is the role of the head of department, the
course teachers and any curriculum or course
committee that has been established?
 Who should be represented on the committees?
 What is the role of the students themselves in
the management process? Should they be
represented on any course or curriculum
committees?

Conclusion
Harden’s Ten questions is an
essential tool for course planning
THANK YOU