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PubMed1985

Curriculum evaluation: status and options.

A questionnaire was used to ascertain: the status of the curriculum; curriculum characteristics; factors which have been useful in facilitating and improving the curriculum; opinions of the teaching staff on various ways of improving the educational process; and frequency of utilization of various teaching methods and audio-visual aids. The questionnaire was sent to 100 randomly selected faculty members (about 60% of total faculty members). The responses were statistically analysed to explain and elucidate the nature of the curriculum, factors or agents which have influenced the curriculum, the pattern of utilization of teaching methods and audio-visual aids, and the problems which have inhibited the rate of change. The implications of these findings for facilitating and improving the educational process are discussed.

Audiovisual Aids↗

PubMed1989

Problems with curriculum implementation in in-service clinical education.

We report a hitherto poorly documented cause of failure of curriculum implementation. The case of the clinical training of foreign medical graduates (externs) in Hong Kong is used to illustrate problems that may arise in professional education where in-service work in institutions is part of the educational process. The example is particularly relevant to health professional education which generally involves a significant in-service component. We used participant observation, questionnaires and brief interviews to obtain data from 97 externs and 48 supervisors. The results indicated that between a third and a half of the externs did not receive experiences as designated in the curriculum. Apart from age, individual characteristics of the externs did not show statistically significant relationships to the kind of experience obtained. The major significant variable (P less than 0.01) was the type of hospital where the exposure was gained. In one type of hospital the externs shared the work-load, whilst in the other type they were largely used as observers with minor technical duties. The supervisors' perception of the externs' professional capabilities varied according to the hospital. We believe that the failure of curriculum implementation was related to conflict between institutional needs, which must be safeguarded by the supervisors, and the educational needs of the learners. This conflict affects the perceptions of the supervisors and without their full cooperation the curriculum cannot be delivered. The roles and perceptions of supervisor and learner must overlap sufficiently for the system to be effective and this must be taken into account by curriculum planners.

Attitude of Health Personnel↗

PubMed1993

Integration of the surgical specialties into an innovative undergraduate curriculum.

A dilemma exists concerning the most effective way to incorporate surgical specialty teaching into an innovative undergraduate curriculum. Should the specialties form part of the core curriculum or should they be available as electives? The aim of this study is to describe an educationally sound and time-effective way to give all students an exposure to the surgical specialties while maintaining the philosophy of an innovative curriculum. The SCORPIO method was used, on a trial basis, in 1992 to teach cardiothoracic surgery, neurosurgery, plastic surgery and urology to fourth-year medical students at a university teaching hospital. The teaching was evaluated by comparing group pretest performance with a posttest assessment given one month after each of the teaching sessions. Student perceptions were assessed by a questionnaire and a time analysis was carried out comparing SCORPIO with the traditional ward tutorial system. Students completed the sequence pretest, teaching and posttest on 169 occasions. Group performance increased from a pretest mean 28% (SD16) to a posttest mean 44% (SD13) P < 0.0001. Student acceptance was favourable, with high ratings given to the structured, problem-based style of teaching. The time to run the programme was one-eight that to teach by the ward tutorial system. This teaching model is a practical way to incorporate the surgical specialties into the core curriculum of a school moving towards a student centred, problem-based, integrated curriculum.

Australia↗

PubMed1995

A response to the ACME-TRI report: the Dalhousie problem-based learning curriculum.

With the class of 1996, Dalhousie University Faculty of Medicine instituted a totally revised curriculum. The revisions transformed an entirely traditional curriculum to a student-centred curriculum, which is based on learning in context, and incorporates a problem-based approach to the entire curriculum. This paper describes our experience in the actual implementation of our revised curriculum, in the context of the Association of American Medical Colleges Assessing Change in Medical Education--The Road to Implementation (ACME-TRI) Report.

Canada↗

PubMed2004

Effect of an Internet-based curriculum on postgraduate education. A multicenter intervention.

We hypothesized that the Internet could be used to disseminate and evaluate a curriculum in ambulatory care, and that internal medicine residency program directors would value features made possible by online dissemination. An Internet-based ambulatory care curriculum was developed and marketed to internal medicine residency program directors. Utilization and knowledge outcomes were tracked by the website; opinions of program directors were measured by paper surveys. Twenty-four programs enrolled with the online curriculum. The curriculum was rated favorably by all programs, test scores on curricular content improved significantly, and program directors rated highly features made possible by an Internet-based curriculum.

Ambulatory Care↗

PubMed1998

The Malmö model: a problem-based learning curriculum in undergraduate dental education.

A new undergraduate dental curriculum was introduced in Malmö in 1990 which is based on problem-based learning (PBL). The principles of PBL are strongly influenced by evidence from cognitive psychology and they form the educational strategy throughout the whole curriculum. Two further essential principles underpin the curriculum: a holistic attitude to patient care, and the promotion of oral health. Basic sciences and clinical dentistry are integrated within a structure based on oral conditions prevalent in the community. Students are encouraged to build their new knowledge, understanding and skills into the context of what they have already learned. This approach is facilitated by the presentation of conceptual models, one of which, The Oral Ecosystem is described in detail. The educational programme also gives students opportunities to learn in the clinical context from an early stage, and we endeavour to promote a scientific attitude from the very beginning of the programme. This paper describes the curriculum at three organisational levels (whole curriculum, single course, individual week).

Curriculum↗

PubMed2004

Renewal of the clinical-phase dental curriculum to promote better learning at the University of Oulu.

The degree awarded to a dentist in Finland is Licentiate of Dentistry, and it takes 5 years to achieve it. The old curriculum at the Institute of Dentistry, University of Oulu, Finland, was based on the departmental division, and there was minimal integration between the disciplines. According to student feedback, the old curriculum was overloaded. The amount of contact teaching was up to 40 h per week throughout the academic year. Based on the workload regulation model launched at the University of Oulu, the actual workload of students for three clinical years was found to exceed the confirmed curriculum (40 study weeks per year for 3 years, representing 180 European Credit Transfer System (ECTS) credits) by 68 ECTS credits (representing 45.3 study weeks). Because of the heavy workload, students did not have time actively to deepen their scientific reasoning. To tackle this problem and to maintain the high academic standards, the Institute of Dentistry, University of Oulu, Finland, decided to change the dental curriculum. The properties and qualities of the competent dentist were listed and arranged in the corners of an octagonal to provide the model of the key dental competencies. Based on this, a thorough core analysis of the courses was carried out by the departments. The new curriculum consists of 10 broader integrative entities, so called dental teaching strands (DTSs), wherein the teaching given by the different departments has been combined. The effort was successful. We managed to remove overlap in the substance of the courses to reduce the students' actual workload by about 45 ECTS credits (representing 30 study weeks and 1200 h of studying) and to promote better scientific reasoning and learning results. The authentic learning and comprehensive patient care comprise the core of the clinical practice.

Clinical Competence↗

PubMedDate not supplied

The curriculum blueprint: an application to nurse practitioner education.

A psychometric model for the construction of examinations (the test construction process) is adapted as a conceptual framework for curriculum design. The outcome of the process, the curriculum blueprint, is proposed as particularly advantageous for nurse practitioner education, which is somewhat unique among nursing specialties in its need to accommodate the competing demands of several regulatory or educational approval bodies that influence the content of its curriculum. The curriculum blueprint provides a visual dimension and therefore is useful as a communication tool. An excerpted example of a curriculum blueprint is offered.

Curriculum↗

PubMed1997

A multi-disciplinary curriculum for 11- to 13-year-olds: immunization, plus!

A sixth grade curriculum entitled "Immunization, Plus!" Was developed to promote adolescent immunization. This targeted immunization curriculum utilized contemporary learning theory and innovative teaching approaches and styles to maximize acceptability among educators. Because instructional time in school was limited, a thematic curriculum was created to embed immunization and communicable disease content within mathematics, science/health, and language arts units. The curriculum, which reflected the theory of multiple intelligences among students, offered an array of different learning formats, including linguistic, logical-mathematical, spatial, and bodily-kinesthetic. The curriculum was made available free of charge to school districts in California, and its evaluation was planned to track distribution, utilization, and changes in students' knowledge, attitude, and behavior.

Adolescent↗

PubMed2005

Effect of a community oriented problem based learning curriculum on quality of primary care delivered by graduates: historical cohort comparison study.

OBJECTIVE: To assess whether the transition from a traditional curriculum to a community oriented problem based learning curriculum at Sherbrooke University is associated with the expected improvements in preventive care and continuity of care without a decline in diagnosis and management of disease. DESIGN: Historical cohort comparison study. SETTING: Sherbrooke University and three traditional medical schools in Quebec, Canada. PARTICIPANTS: 751 doctors from four graduation cohorts (1988-91); three before the transition to community based problem based learning (n = 600) and one after the transition (n = 151). OUTCOME MEASURES: Annual performance in preventive care (mammography screening rate), continuity of care, diagnosis (difference in prescribing rates for specific diseases and relief of symptoms), and management (prescribing rate for contraindicated drugs) assessed using provincial health databases for the first 4-7 years of practice. RESULTS: After transition to a community oriented problem based learning curriculum, graduates of Sherbrooke University showed a statistically significant improvement in mammography screening rates (55 more women screened per 1000, 95% confidence interval 10.6 to 99.3) and continuity of care (3.3% more visits coordinated by the doctor, 0.9% to 5.8%) compared with graduates of a traditional medical curriculum. Indicators of diagnostic and management performance did not show the hypothesised decline. Sherbrooke graduates showed a significant fourfold increase in disease specific prescribing rates compared with prescribing for symptom relief after the transition. CONCLUSION: Transition to a community oriented problem based learning curriculum was associated with significant improvements in preventive care and continuity of care and an improvement in indicators of diagnostic performance.

Aged↗

PubMed2006

Curriculum development and technology incorporation in teaching neuroscience to graduate students in a medical school environment.

Today's neuroscience faculty member wears multiple hats and requires diverse skills to succeed in the competitive environment in which they find themselves. A common refrain from graduates is that there is a need for better training in the diverse, multiple skills that they will need to succeed in obtaining a faculty position and excelling in that position once it is obtained. Our university recently developed a new neuroscience graduate program that allowed us to create a curriculum and core courses de novo and that could be tailored to provide training in diverse skills used by everyday neuroscience faculty members. The current article details our rationale, design, and implementation of this new curriculum and its two major core courses. The genesis of the new curriculum also provided an opportune time to introduce and test new teaching technology in the two neuroscience core courses. The technology incorporated included on-line WebCT course sites, computer performance system, and the Tegrity system. Herein, we elaborate on our experiences with the use of this technology in the small class graduate course setting and provide insight on student feedback on the perceived effectiveness of the technology. The mechanisms and considerations that are needed for incorporation of such technology are also discussed. While no single curriculum or technology incorporation scheme will be applicable to all programs, it is hoped that our experiences in curriculum design and technology incorporation will be beneficial to other universities as they consider refining existing programs or beginning new ones.

Curriculum↗

PubMed1998

Defining the boundaries of physiological understanding: the benchmarks curriculum model.

We set out to develop an anatomy and physiology (A&P) curriculum with a content that was relevant and well rationalized. To do this, we developed a benchmarks curriculum process that helps us to determine what our students need to learn in A&P and then to make sure there is alignment between those learning objectives and what we teach and how we assess our students. Using the benchmarks process, we first set the broad skill and content goals of the course. We then prioritize the topic areas to be covered, allocating the course time accordingly, and declare the learning objectives for each topic. To clarify each learning objective, a set of benchmark statements are written that specify in operational terms what is required to demonstrate mastery. After the benchmarks are written, we assemble the learning activities that help students achieve them and write assessment items to evaluate achievement. We have implemented the curriculum in a relational database that allows us to specify the numerous links that exist between its different elements. In the future, the benchmarks model will be used for ongoing A&P curriculum development with geographically distributed contributors accessing it via the World Wide Web. This mechanism will allow for the continuing evolution of the A&P curriculum.

Anatomy↗

PubMedDate not supplied

Teaching medication compliance to psychiatric residents: placing an orphan topic into a training curriculum.

OBJECTIVE: Medication compliance is an orphan topic. Training in the understanding and management of noncompliance does not neatly fall within the domain of psychopharmacology, nor does it clearly fit into other core curricula areas, such as clinical interviewing or psychotherapy training. The objective of this article is to increase awareness about this vagueness among academic psychiatrists and to offer a suggested curriculum to facilitate implementation. METHODS: The authors present a curriculum covering major aspects of the theory and practice of compliance. The proposed curriculum is divided into five core components that can be used together or separately. These components are: 1) definition of compliance and noncompliance; 2) understanding how compliance depends on efficacy; 3) assessment of compliance and noncompliance; 4) the importance of the therapeutic alliance; and 5) pharmacological and psychosocial strategies to improve compliance. These five sections can be modified into specific lectures that are added to ongoing psychopharmacology, psychiatric interviewing, or psychotherapy courses. RESULTS: A careful review of the American Board of Psychiatry and Neurology (ABPN) core curriculum found no mention of medication compliance/adherence as a specific training goal, and our residency program, like many others, did not have a specific course that focused on this issue. To address this omission, the authors designed and taught a five-session course for PGY-III and PGY-IV psychiatry residents that specifically addressed assessment and management of noncompliance. It was piloted in the 2003-2004 academic year. The course was very well received and formed the basis of this material presented in this review and discussion. CONCLUSION: The principles of understanding, assessing, and managing medication compliance should be a part of the core curriculum for every psychiatric residency training program.

Curriculum↗

PubMedDate not supplied

A description of a pharmacotherapy curriculum in a university-based family medicine program.

OBJECTIVE: To describe the methods by which a family medicine residency program implements a pharmacotherapy curriculum. The goal of the curriculum is to teach family medicine residents the principles of rational drug therapy. SETTING: A university-based family medicine residency program. TEACHING STRATEGIES: Specific learning objectives are discussed and the following teaching strategies are expanded upon: (1) monthly noon conferences; (2) a printed formulary and pharmacotherapy handbook; (3) a pharmacy and therapeutics committee; (4) policy statements for drug representatives and use of samples; (5) an on-site pharmacy; (6) quarterly newsletter; and (7) inpatient consultation coverage. PHARMACIST ROLE: The role and responsibilities of the pharmacy faculty and pharmacist(s) who implement this curriculum and the methods used to evaluate its effectiveness are also described. The availability and funding of the pharmacy faculty member can sometimes be arranged with local schools of pharmacy seeking clerkship sites. Interaction with pharmacy students also serves to enhance the educational experience of the family medicine residents. CONCLUSIONS: The family medicine program implements a comprehensive curriculum designed to teach family medicine residents the principles of rational drug therapy. The curriculum may be expanded upon as necessary, or, if the entire program is not feasible, certain elements may be extracted and applied in other institutions.

Curriculum↗

PubMed2003

Communicating curriculum reform to students: advice in hindsight...

BACKGROUND: In view of the changing health care needs of communities, curriculum reform of traditional curricula is inevitable. In order to allay the apprehension that may accompany such change, curriculum development and implementation should be an inclusive process, with both staff and students being well informed of the planned reform. In 2001, the Nelson R. Mandela School of Medicine implemented Year 1 of a problem-based learning curriculum. During the design phase, students and staff were invited to take part in the development and were kept abreast of developments through meetings and newsletters. METHOD: A survey of Years 1-5 students of the last intake into the traditional curriculum was undertaken a few months prior to the implementation of the new programme. RESULTS: Students were generally well informed about the impending change, having heard about it from fellow students and staff. The more senior the students, the less the perceived impact of the reform. Although most of what students had heard was correct, some, however, had misconceptions that were generally extreme views (e.g. all self-directed learning; no Anatomy) about the new programme. Others expressed valid concerns (e.g. underpreparedness of students from disadvantaged schools; overcrowding in hospitals). CONCLUSIONS: Advice offered to institutions considering curriculum reform include using various methods to inform internal and external affected parties, ensuring that the student representative body and staff is well informed, reiterating the need for the change, confirming that the new programme meets recognised standards and that the students most affected are reassured about their future studies.

Curriculum↗

PubMed2004

Description and evaluation of an EBM curriculum using a block rotation.

BACKGROUND: While previous authors have emphasized the importance of integrating and reinforcing evidence-based medicine (EBM) skills in residency, there are few published examples of such curricula. We designed an EBM curriculum to train family practice interns in essential EBM skills for information mastery using clinical questions generated by the family practice inpatient service. We sought to evaluate the impact of this curriculum on interns, residents, and faculty. METHODS: Interns (n = 13) were asked to self-assess their level of confidence in basic EBM skills before and after their 2-week EBM rotation. Residents (n = 21) and faculty (n = 12) were asked to assess how often the answers provided by the EBM intern to the inpatient service changed medical care. In addition, residents were asked to report how often they used their EBM skills and how often EBM concepts and tools were used in teaching by senior residents and faculty. Faculty were asked if the EBM curriculum had increased their use of EBM in practice and in teaching. RESULTS: Interns significantly increased their confidence over the course of the rotation. Residents and faculty felt that the answers provided by the EBM intern provided useful information and led to changes in patient care. Faculty reported incorporating EBM into their teaching (92%) and practice (75%). Residents reported applying the EBM skills they learned to patient care (86%) and that these skills were reinforced in the teaching they received outside of the rotation (81%). All residents and 11 of 12 faculty felt that the EBM curriculum had improved patient care. CONCLUSIONS: To our knowledge, this is the first published EBM curriculum using an individual block rotation format. As such, it may provide an alternative model for teaching and incorporating EBM into a residency program.

Clinical Competence↗

PubMed2006

Long-term impact of four different strategies for delivering an on-line curriculum about herbs and other dietary supplements.

BACKGROUND: Previous research has shown that internet education can lead to short-term improvements in clinicians' knowledge, confidence and communication practices. We wished to better understand the duration of these improvements and whether different curriculum delivery strategies differed in affecting these improvements. METHODS: As previously described, we conducted a randomized control trial comparing four different strategies for delivering an e-curriculum about herbs and other dietary supplements (HDS) to clinicians. The four strategies were delivering the curriculum by: a) email over 10 weeks; b) email within one week; c) web-site over 10 weeks; d) web-site within one week. Participants were surveyed at baseline, immediately after the course and 6-10 months after completing the course (long-term). Long-term outcomes focused on clinicians' knowledge, confidence and communication practices. RESULTS: Of the 780 clinicians who completed the course, 385 (49%) completed the long-term survey. Completers and non-completers of the long-term survey had similar demographics and professional characteristics at baseline. There were statistically significant improvements from baseline to long-term follow-up in knowledge, confidence and communication practices; these improvements did not differ by curriculum delivery strategy. Knowledge scores improved from 67.7 +/- 10.3 at baseline to 78.8 +/- 12.3 at long-term follow-up (P < 0.001). Confidence scores improved from 53.7 +/- 17.8 at baseline to 66.9 +/- 12.0 at long term follow-up (P < 0.001); communication scores improved from 2.6 +/- 1.9 at baseline to 3.6 +/- 2.1 (P < 0.001) at long-term follow-up. CONCLUSION: This e- curriculum led to significant and sustained improvements in clinicians' expertise about HDS regardless of the delivery strategy. Future studies should compare the impact of required vs. elective courses and self-reported vs. objective measures of behavior change.

Adult↗

PubMed1997

Resource document for curriculum development in cancer genetics education. American Society of Clinical Oncology.

PURPOSE: The rapid growth in the use of genetic testing for heritable cancers and other diseases has led to the establishment of many committees to assess the status and future implications of such testing. The American Society of Clinical Oncology (ASCO) published a statement on genetic testing for cancer susceptibility in May 1996. In that statement, ASCO recognized the need for a major initiative to develop courses and other educational materials for ASCO members and other health care professionals that were pertinent to cancer genetics and the role of cancer predisposition testing in clinical oncology. These curriculum guidelines represent an effort to promote formal instruction on the assessment and management of familial cancer risks in training programs and continuing education courses. DESIGN AND RESULTS: An Ad hoc Task Force was created from the ASCO membership and other professional organizations. Goals of ASCO's cancer genetics education initiative, curriculum guidelines, and plans for implementation of the curriculum have been developed. To gain understanding and competency in cancer genetics and cancer predisposition testing, the curriculum emphasizes formal instruction in: (1) basic concepts and principles of genetics; (2) an understanding of the role of genetics in the etiology, diagnosis, and management of different malignancies; (3) an understanding of the ethical, legal, and social issues that surround predisposition testing; and (4) long-term management plans for individuals at high risk for cancer. This document is broad in scope and applicable to all types of malignancies. It should be considered as the framework around which cancer genetics education is developed. It is expected that implementation of training activities over the next few years will allow ASCO to fulfill its obligations to the membership. CONCLUSION: This curriculum should prove a valuable guide to those who wish further education on cancer genetics and the appropriate use of cancer predisposition testing.

Curriculum↗