Presentation on theme: "SES09: Teaching the Competencies: Thinking Outside-of-the-Box"— Presentation transcript:
1 SES09: Teaching the Competencies: Thinking Outside-of-the-Box 2010 ACGME Annual Education ConferenceBardia Behravesh, MA &Alice Edler, MD, MA, MPHDepartment of Graduate Medical Education
2 Session ObjectivesIdentify innovative teaching methods used by your residency programs and share them across programs.Leverage existing resources within your institution to teach the ACGME General Competencies.Use a systematic curriculum design approach to develop curriculum.
3 BackgroundIn 2008, Stanford GME conducted a needs assessment with the goal of identifying ways in which it could better serve its residency programs.63 of 75 Program Directors responded to an online survey.Following the survey, 69 of 75 Program Directors were interviewed.
4 Findings46% of respondents requested centralized teaching of the competencies (i.e. delivered by the Dept of GME).23% of respondents requested more information about educational techniques and resources.19% of respondents requested web-based learning modules that teach the competencies.
5 GoalsIdentify educational techniques and resources to share across programs.Identify avenues for centrally teaching the competencies (including the utilization of web-based learning modules).
6 Goal 1: Techniques & Resources Initial approach: Searched the web for teaching and evaluation methods (best practices) to post to the Dept of GME web site.Challenges:Limited resources available onlineCostThinking Outside-of-the-Box: Which programs are currently using innovative methods to teach the core competencies (i.e. what ideas can we borrow from our own programs and share across all programs)?
7 Program InnovationsSolicited voluntary submission of innovative teaching strategies by Program Directors.Flagged innovative teaching strategies during internal program reviews.Collected strategies into a spreadsheet and posted to the Dept of GME web site.
11 Exercise 1 Review the learning activities described in the handout. Using the blank fields, describe an innovative activity developed by your own program that you could potentially share with other programs within your institution.
12 Goal 2: Centralized Education Initial approach: Looked at developing and/or purchasing web-based learning modules.Challenges:In-house development is costly.Off-the-shelf solutions do not fit needs exactly.Customization of off-the-shelf solutions difficult/costly.Thinking Outside-of-the-Box: What existing content (already available at our institution) can we leverage to teach the competencies?
13 Regulatory Compliance Training Stanford satisfies various regulatory requirements through the use of online training.Topics include:Patient RightsHIPPAEmergency CodesQuality ManagementCultural DiversityResidents are required to complete the modules on a yearly basis.
14 Mapping Content to Competencies Determined what web-based learning modules were available.Used a spreadsheet to map the modules to the competencies.Posted spreadsheet to the Dept of GME web site.
15 Mapping Content to Competencies ModuleLength (min)FrequencyACGME CompetencyMKPCPBLICISProfSBPPatient Rights (PA)30YearlyXRapid Regulatory60Bi-AnnualLIFE Curriculum: FatigueCode of Conduct20Cultural DiversityEmergency Codes51xHIPAAQuality ImprovementRespiratory Precautions25Restraints/Seclusion
16 E-learning as a “springboard” A web-based learning module should not be thought of as PRIMARY and SUFFICIENT for competency education.Pre-existing curriculum can act as a springboard for additional learning.Partner the goals and objectives of the pre-existing curriculum with those of additional learning activities.
17 Systematic Curriculum Development Two commonly used curriculum design approaches in medical education:Tyler’s principles for curriculum and instructionTyler R, “ Basic Principles of Curriculum and instruction” Chicago, University of Chicago Press, 1949Kern’s six step approach to curriculum developmentKern D, Thomas P, Howard D, Bass E, “Curriculum Development for Medical Education”, Baltimore, Johns Hopkins University Press 1998
18 Pro’s of Tyler Rationale Simple and straight forwardStarts with Goals and ObjectivesGood for institutional curriculum developmentGood for modification of pre-existing curriculumTeacher-oriented
19 Tyler’s Four Questions What educational purposes should the curriculum seek to attain?What learning experiences should be selected to achieve these goals and objectives?How should these learning experiences be organized?How can the effectiveness of these experiences be evaluated?
20 Goals and Objectives Goals: Overall outcomes Objectives: Criteria by which the educational materials are selected and the content is outlined. Based on:ValuesNeedsLearnerSociety
21 Objectives = The Desired Educational Ends The changes in learner behavior/attitudesNot what the teacher doesNot a content listNot a vague abstraction but concrete change
22 Behavioral and Attitudinal Aspects of Objectives Understanding of the important facts and principlesFamiliarity with the sources of informationAbility to interpret dataAbility to apply principlesAbility to interpret results of investigationBroad and mature interests
23 Selecting Educational Experiences Real and attainableSatisfying to the learnerMultiple and reinforcing
24 Organization of Educational Experiences SequencingIncreasing complexity, if needed (graduated responsibility)Reinforcing
25 Implementation Political support for program Procurement of resources (room, standardized patients, etc)Piloting, if possibleIntroductionBarriers to implementation
26 Evaluation of the Curriculum Multi-source evaluation of theWritten CurriculumEducational MilieuAdministration of the CurriculumFacultyLearner
27 Exercise 2Review the sample e-learning module and consider the following questions:What competency-based goals and objectives could this module address?If we were to use this module as a springboard, what additional learning experiences could we combine with this module to develop a competency-based curriculum?How would you sequence the learning experiences, including the use of this module?How would you evaluate the effectiveness of your new curriculum in teaching the desired competencies?
28 SummaryResident learning need not be bounded by program-specific curricula.Rather than develop completely from scratch, look for pre-existing practices and content that can be leveraged.Look across programs for best practices.Look at the institutional level for resources.
29 Questions? Feel free to contact us: Bardia Behravesh, MA –Alice Edler, MD, MA, MPH –
30 Basics of Kern Iterative, Action Research Approach Assumes that you are starting denovo with needs assessmentMulti-directional InteractionsGood for denovo curriculum planning at the program level
32 Example Problem Identification: Needs of Targeted Learners provision of care to HIV-AIDS positive patientsNeeds of Targeted LearnersFor Family Practice residentsPreventative care for HIV infected patientsAvoidance of HIV-AIDS, homosexual and substance abuse patients in generalDevelopment of Goals and Objectives
33 Example (continued) Educational Strategies Content Methods Use of ARV drugsCultural competency with substance abuse patientsMethodsUse of ARV drugs: didactics followed by test for learning and comprehensionCultural competency with substance abuse patients: role play, Standardized patients
34 Pro’sCan start from nothingBest used with homogenous set of learners