Title: Curriculum and Goals and Objectives
1Curriculum and Goals and Objectives
- W. Thomas Lawrence, M.P.H., M.D.
- Section of Plastic Surgery
- Kansas University Medical Center
2What Are They?
- Mentioned Regularly in PIF and Educational
Literature - You Will Receive RRC Citations If You Dont Have
Them - Dr. Bob Ruberg and AACPS Colleagues Wrote a
Plastic Surgery Curriculum - I used to include the book in my PIF as my
curriculum- I suspect others did too
3Are They Necessary?
- We All Completed Plastic Surgery Training and Are
Competent Plastic Surgeons - Dont We Know Intuitively What Our Residents Need
to Know? - Shouldnt We Just Run Our Training Programs Like
the Ones We Trained In? - Cant We Just Look at the Table of Contents of
McCarthys (soon to be Mathes) Text, Selected
Readings or Corequest to Determine What Our
Residents Need to Learn About?
4Do They Really Make a Difference?
- Havent Plastic Surgery Residents Achieved Enough
Educational Milestones To Be Aware of What they
Need to Learn by This Point?
5Do They Really Make a Difference?
- Has the Quality of Education Provided to
Residents Not Changed Significantly Since Writing
Goals and Objectives Became Required? - No Scientific Studies have Demonstrated Improved
Products of Plastic Surgery Training Programs Due
to the Presence of a Well Defined Curriculum and
Goals and Objectives
6Do We Want the Specialty to Remain Static or to
Continually Improve?
- Specialty of Plastic Surgery is Defined by the
Products of our Training Programs - If We Want the Specialty to Continually Improve,
We Need to Continually Improve Our Training
Programs - What Worked For Us May Not Be the Best Training
Model - Bright Individuals Will Achieve Success in Spite
of Less than Ideal Training
7If You Want to Produce a Silk Purse, It is Best
to Start with Silk.
- Applicants Are Getting Better
- Integrated/ Co-ordinated Programs Are Attracting
Stellar Medical Students - Diminished Number of Independent Programs Has
Increased Competition for 2-3 Year Positions - We Owe It To These Talented Individuals to
Provide Superb Training
8- If You Want Excellence, First Have a Clear Idea
of What You Want to Produce - Peters and Waterman- 1982
- Development of Curriculum with Goals and
Objectives Forces us to Evaluate This
9What is a Curriculum?
- Word Derived from Greek word for Course as Used
in Describing Chariot Races - Webster says A Fixed Series of Studies
Required.in a Major Field of Study - Kern, Thomas, Howard and Bass Define it as a
Planned Educational Experience
10What is a Plastic Surgery Curriculum?
- Totality of Educational Experiences That Allow
Residents to Achieve Competence in the Cognitive,
Personal and Psychomotor Skills Required to be
Effective Plastic Surgeons
11What is a Curriculum?
- Dynamic and Interactive
- Changes Related to Evaluations, Changing Needs
and Changing Educational Tools - Constantly Evolving
12Curriculum Defined by 4 Questions in Technologic
Model
- What Educational Purposes are Sought?
- What Experiences Can be Provided to Attain These
Purposes? - How Can These Experiences Be Organized?
- How Can This Be Evaluated?
13Limitations of Technologic Model
- Does Not Include Clinical Judgment, Decision
Making in Uncertain Situations, Ethics, Values - Does Not Incorporate Interpersonal Interactions
of Teacher and Learner
14 Other Types of Curricula
- Syllabus Based
- List of Topics
- Easy to Transpose to Lecture Series
- Objectives Based
- Based on Learning Goals and Objectives
- Includes Specific Measures of Competence
15Considerations in Curriculum Development
- Construct to Achieve Societally Valued Skills and
Values - Construct Around Continuity of Care Experience to
Achieve Self-Actualization
16Challenges of Curricula in Clinical Specialties
- Lack of Predictability in Terms of Exposure to
Clinical Problems - Creates Difficulties in Co-ordination of Didactic
and Clinical Exposures - Creates Uncertainty in Quality and Quantity of
Experiences - Creates Difficulty in Creating Graduated
Responsibilities
17Process Based Curricula
- Differ from Syllabus and Objectives Based
Curricula which are more Product Based - Aspects More Applicable to Clinical Teaching
- Involves Preoperative Study and Planning,
Intraoperative Teaching and Skill Development,
Postoperative Patient Care and Assessment - More Individualized to Learner Skills and
Preferred Learning Methods
18Process Based Curricula
- Places More Responsibility on Learner
- Forces Learner to be more Proactive and Less
Reactive - Fosters Abilities in Learners to Assess Knowledge
Base, Formulate Questions, Think Critically and
Interpret Data Efficiently - Requires Immediate Feedback
- Contributes to Development of Skills for Lifetime
Learning
19Optimal Plastic Surgery Curricula
- All Types of Curricula have Limitations
- Clinical Curricula Best Incorporate Aspects of
All - Product Based Components Define Desired Skillset
for Individual Finishing Program - Process Based Components Often Applicable to
Clinical Teaching
20Steps in Curriculum Development
- Problem Identification and General Needs
Assessment - Identify Problem
- Educate Residents in Plastic Surgery
- Who are the Involved Parties?
- Residents, Faculty, Other Health Care Providers,
Patients, Society - Includes Assessment of both Current Approach and
Ideal Approach - Varying Current Approaches
- Different Ideas of Ideal Approach
- May Vary in Different Environments
21Steps in Curriculum Development
- 2. Needs Assessment of Targeted Learners
- Varies Somewhat Depending on Prerequisite
Training and Experiences - Involves Knowledge, Analytic Capabilities,
Interpersonal Skills and Psychomotor Skills - Must Consider Predisposing Factors-
- Knowledge, attitudes and Beliefs That Influence
Motivation to change - Different Learning Method Preference
- Must Consider Reinforcing Factors and Motivating
factors
22Steps in Curriculum Development
- Goals and Objectives
- Educational Strategies
- Includes Didactic Lectures, Audiovisual Aids,
Clinical Discussions, Clinical Experiences,
Practical Laboratories, Simulations via
Standardized Patients or Virtual Reality - Different Techniques Teach Different Things
Better - Some Learn Better by Different Methods
- Reinforcement of Information
- Maintains Interest
23Steps in Curriculum Development
- Implementation
- Obtain Support and Resources
- Faculty
- Support Staff
- Space
- Support from Hospital and Institution
- Identify Barriers to Implementation
- Money
- Competing Specialties
- Others in Specialty
- Introduction of the Curriculum
- May Pilot or Phase In
- Curriculum Refinement
24Steps in Curriculum Development
- 6. Evaluation and Feedback
- Formative- Ongoing Feedback
- Summative- Final Assessment
- Assess Learners and Process
- Involve all Stakeholders
- Dean, Department Chair, Other Program Directors
- Need Good Evaluation Methodology
- Introduction of the Curriculum
- Curriculum Refinement
25Steps in Curriculum Development
26Curriculum Ultimately Involves Series of
Educational Experiences
- Designed to Allow Achievement of Goals and
Objectives - Curriculum is Not Really List of Experiences
Designed to Provide Education, It is What Happens
During These Experiences
27Curriculum
- Clinical Experiences
- Exposure to Clinical Problems in Clinic or ER
- Opportunity to Further Assess the Problem with
History, Physical Examination and Other
Appropriate Tests - Carry out Therapeutic Interventions either
Operatively or Nonoperatively - Clinically Manage the Patient Through Treatment
- Assess the Results of the Intervention in the
Inpatient and Outpatient Settings both
Immediately Long Term
28Curriculum
- Didactic Experiences
- Lectures on Specific Topics
- Patient Based Discussions of Different Clinical
Problems in Preoperative Conferences, Interesting
Case Conferences, Morbidity and Mortality
Conferences etc. - Anatomic Dissections
- Evaluation of Pathologic Specimens
- Training Labs e.g. Microsurgery, Facial Plating
- Mock Patients
29Possible Components of Hand Surgery Curriculum
- Clinical Exposure Through Hand Call (Verified on
PSOL) - Didactic Lectures on Hand Problems
- Anatomic Dissections of Hands
- Pathologic Evaluation when Appropriate e.g.
Dupuytren's - Microsurgery Lab for Developing Skills for
Revascularization or Nerve Repair - Involvement in Radiologic Evaluations, EMG, and
Hand Rehabilitation Therapy
30Curriculum Components
- Significant Overlap in What is Taught
- Different Experiences Vary in Terms of Impact on
Different Types of Learners
31Components of Curriculum
- Can Vary in Different Locales in That Educational
Resources Differ e.g. Orthopedic Contribution Can
be Significant or Unavailable - Customize the Curriculum for Your Own Program
32Goals and Objectives
- Guideposts That Identify What We Want Our
Residents to Learn
33Dictionary Definitions
- Goal
- The End Toward Which Effort is Directed
- Objectives
- Something Toward Which Effort is Directed
34What is a Goal?
- A Global Statement Regarding Competency in a
Specific Area - Example Develop Expertise in the Evaluation and
Management of Traumatic Hand Injuries
35Goals
- Goals Make You Add Your Personal Philosophy to
What the Textbook Provides - Make Educational Program More Coherent and
Integrated
36Goals
- Formed From a List of Skills and Knowledge the
Resident is Expected to Acquire During Training - Ideally Should be Linked as a Progression of
Goals from the More General to the More Specific
37What is an Objective?
- A Precise Statement of What a Student Should Be
Able to Do to In Order to Demonstrate That He Has
Learned Successfully Engel 1975 - A Full Sentence Describing a Specific Skill that
Should be Obtained - The Nature of Particular Activities to Be
Carried Out Must Be Precisely Conveyed
38What is an Objective?
- Objectives Should Clearly Describe a Residents
Performance or Behavior Indicative of a Learning
Outcome - Examples
- Perform an Examination of FDS Function in the
Hand - Perform an Examination of the Sensory
Distribution of the Median Nerve in the Hand
39Objectives
- Who?
- Will Do?
- How Much?
- Of What?
- By When ?
40Types of Objectives
- Cognitive- Knowledge
- Affective- Attitude
- Psychomotor- Skill or Competence
- Psychomotor- Behavior or Performance
- Process- e.g. Attendance
- Outcome
41Objectives
- Based on Goals
- Leave No Question As to What the Resident Is
Expected to Learn - But They-
- Dont Dictate How Learning is to be Done
- Leave the Teacher and Resident to Select Suitable
Techniques
42Orders of Objectives
- First
- Ability to Reproduce Material in Same Form
Learned - Second
- Reflect Understanding of an Organized Body of
Concepts and Principles - Third
- Require Application of Theories, Concepts and
Principles to Unencountered Problems
43Organization of Curriculum
- Objectives
- Content Method of Organization
- Evaluation
44Principles For Writing Goals and Objectives- Med
Council of Canada
- Review Existing Objectives/Literature/Reports
- Identify Professional Attributes of Ideal MD
- Develop a Basic Educational Philosophy
- Assign Priority to Problem Solving
- Deduce Objectives from Terminal Practice-based
Behaviors - Establish Scientific Basis for Clinical Practice
- Establish a Maintenance Evaluation Method
45Steps in Writing Objectives
- Identify the Goals of Learning
- Break Goals into Component Learning Outcomes
- Identify Current Learner Competencies
- Determine those Outcomes that Need to be
Addressed in Learning Sessions - Write Learner Centered Objectives
- Arrange Learner Objectives into Reasonable
Teaching Sessions
46Donts in Writing Objectives
- Describe the Learning Process Instead of Outcome
e.g. Increase Knowledge of ____ - Indicate the Type of Learning Involved Rather
than Outcome e.g. Have Conference on ___ - Write a List of Topics
47Why Do We Need Them?
- Experts Feel They Facilitate Learning
- If you dont know where youre going, youre
never going to get there. - A quality education rarely results from
unplanned actions. Ralph Tyler - If you want excellence, first have a clear
vision of what you want to produce. Peters
Waterman
48Why Use Objectives?
- Help Residents Organize Knowledge
- Help Residents Classify Patterns of Information
- Provide Faculty with Guidance
49Why Do This?
- Residents deserve to know what is to be learned
- Residents deserve to know what is expected of
them - Residents deserve to know how and on what they
will be graded
50Why Do This?
- Helps Guide Residents in Using Their Time
Effectively - Helps Residents Prioritize Learning
51Why Do This?
- Faculty need to know what to teach
- Faculty need to know what to reinforce
clinically - Faculty need their knowledge and clinical skills
updated
52Why Do We Need Them?
53What Does the RRC Require?
- Goals and Objectives for
- Each Rotation
- Each Year of Training
54Learning Styles- Kolb
- Concrete Experience
- Learn Best from Clinical Exposure, Hands On Labs
- Reflective Observer
- Learn Best from Case Discussions
- Abstract Conceptualizer
- Learn Best from Lectures Independent Reading
- Active Experimenter
- Learn Best from Clinical Experiences
55Other Factors Affecting Learning in Adults
- Gender
- Males Tend to be More Black/White and Feel That
One Right Answer Can Be Provided to any Given
Problem - Females Tend to be More Intuitive and Feel
Solutions to Problems are More Situational - Generational
- Baby Boomer Concerned About Global Benefit of
Knowledge - Gen Xer Concerned About Whats In It For Me