1. Workshop on “Emerging Trends in Curriculum Development”
Dr. Syed Hasan Shoaib

2. 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

3. LEARNING OUTCOMES
Focus is on product model where focus is on the ultimate outcome

4. 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.

5. 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.

6. The Five Star Doctor Learning Outcomes Examples of
An article published by Dr. Charles Boelen in WHO journal of “changing medical education and medical practice”
Learning Outcomes
Examples of

7. What is five star doctor?
Care provider
Decision maker
Communicator
Community leader
Manager
Learning Outcomes
Examples of

8. What is seven star doctor?
Care Provider
Decision-maker
Communicator
Community Leader
Manager
Researcher
Life-long Learner
Learning Outcomes
Examples of

9. What is Tomorrow’s Doctor?
The doctor as a scholar and scientist
The doctor as professional
The doctor as a practitioner
Learning Outcomes
Examples of

10. 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?

11. CURRICULUM
What it is?

12. 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 12

13. 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

14. 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.

15. COURSE IS A SUBSET OF CURRICULUM
In Nutshell:
COURSE IS A SUBSET OF CURRICULUM

16. 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

17. Aim: PMDC wants that the students at the end of MB. B. S
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

18. SPICES Model Student-centered Problem-based Integrated Community-based
Teacher-centered
Info. gathering
Discipline-based
Hospital-based
Standard Programs
Apprenticeship
Student-centered
Problem-based
Integrated
Community-based
Electives
Systematic

19. CURRICULUM PERSPECTIVES

20. OBJECTIVE Discuss the different perspectives of curriculum Traditional
Behaviourism
Cognitivism
Constructivism
Pragmatism

21. Traditional
Learning which focuses on transmission of discrete pieces of information

22. ASSUMPTIONS Knowledge needs to be transmitted-from teacher to student
Recitation is instrumental to learning

23. Design
Emphasis is on delivery of isolated and disconnected content of subject matter
Is mainly teacher centered

24. Teaching Emphasizes rote memorization
Focuses on assigning and listening to students recitations

25. 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

26. 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.

27. 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

28. 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

29. Cognitivism
Cognitive theory defines learning as "a semi- permanent change in mental processes or associations."
Jerome Bruner

30. 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”  

31. 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

32. 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

33. 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

34. 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.

35. DESIGN Focus is on authentic tasks, experiences and settings
Emphasizes problem solving and understanding

36. 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.

37. 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

38. 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

39. 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

40. 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

41. 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

42. THANK YOU

43. What? Where? Why? How? Who? When? Dr. Syed Hasan Shoaib
Department of Medical Education
Shalamar Medical and Dental College

44. Overview Learning Outcome: Demonstrate the process of PBL PBL Why?
What?
Where?
How?
Who?
When?

45. PBL can be used as:
Curriculum OR
Teaching Methodology

46. 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.

47. 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.

48. Why Problem Based Learning (PBL)?
New areas of development for medical professionals
Why Problem Based Learning (PBL)?
5 Decision-maker 6 Communicator 7 Community Leader 8 Manager 9 Researcher 10 Life-long Learner 11 Problem Solver

49. Why Problem Based Learning (PBL)?

50. Problem Based Learning
PBL - what is it?

51. 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

52. 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.

53. Problem-based learning
The Relative Proportion of Problem-Solving to Problem-Based Learning Changes as the Curriculum Progresses
Time in the curriculum
Problem solving
Problem-based learning
Branda

54. PBL - Process EVALUATE Read the problem Brainstorm- hypothesize
Identify learning issues
Read the problem
Research-Learn (2-7 days)
Return-Reread-Report-Review
Brainstorm- hypothesize
Next Scenario
EVALUATE

55. “Tutor ”
Traditional Tutorial
“Students”

56. “Tutor ”
PBL Tutorial
“Students”

57. 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.

58. 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

61. 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.

62. 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.

63. 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.

64. 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.

65. An important part of PBL is the learning between sessions

66. 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.

67. 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.

68. 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

69. 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.

70. 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

71. 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.

72. 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.

73. 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

74. 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 in- depth 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.

75. 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 clear learning issues.
Review various references.
Apply the knowledge to the discussed problem and to other situations.
Provide and receive feedback on self and group function.

76. Conclusion
Problem Based Learning can provide you with a learning process that is knowledgeable, informative, motivating and full of enjoyment.

77. TEN Questions to ask when planning a course or curriculum BY R. M
TEN Questions to ask when planning a course or curriculum BY R.M. Harden Medical Education 1986, 20(4):

78. 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.

79. 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.

80. 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.

81. 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”.

82. 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.

83. 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.

84. 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?

85. 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).

86. 4) How should the content be organized?
Spiral curriculum:
As the student moves on through different experience there is value in re- visiting previous learning to re- explore and extend it.

87. 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.

88. 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.

90. 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.

91. 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).

92. 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 size;
The availability of local facilities; and
Staff experience in the various techniques.

93. 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

94. 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.

95. 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.

96. 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?

97. Harden’s Ten questions is an essential tool for course planning
Conclusion
Harden’s Ten questions is an essential tool for course planning

98. THANK YOU