1. Curriculum Development for Outcome Based Learning
Zilvinas Dambrauskas
2012

3. Goals Why are we responsible to society? What society expects from us?
What are we doing really well?
What could we do better?
What are the possible solutions?

4. Why are we responsible to society?
The public is educated, inquisitive and demanding:
system is very expensive, funds are limited - the system must be efficient and cost-effective;
professional services must be based on current scientific evidence;
it is expected that in the future the quality of services, patient treatment outcomes, and the general public health indicators will improve.

5. What society expects from us?
The future (present?) doctors will:
have a good theoretical and practical expertise
have excellent interpersonal skills
be able to work in teams
to use the resources wisely
have other attributes (altruism, responsibility, making ethical decisions, etc.)
be able to work effectively in a constantly changing environment (society's expectations, scientific innovation)

8. Best teaching practice Improved teaching outcomes

10. What are we doing right? À Define “Fundamental Knowledge” E=mc2 ­
Teach the
Fundamentals
Test for
Knowledge of Ã
Hope for
the Best

11. What are we doing right? ECG Auscultation Palpation X-Ray À ­ ® Ã
Define
Teach the
Assess the
Hope for
“Fundamental
Fundamentals
Clinical Skills
the Best
Clinical Skills”

12. Courtesy of Ronald Harden

13. Courtesy of Ronald Harden

14. Courtesy of Ronald Harden

15. What needs our attention?
“The only way to get somewhere, you know, is to figure out where you’re going before you go there.”
—— John Updike, Rabbit Run, 1960
“It is a highly questionable practice to label someone as having achieved a goal when you don’t even know what you would take as evidence of achievement.”
——R. F. Mager, Preparing Educational Objectives, 1962

18. What needs our attention?
What do current recommendations suggest?
Traditional teaching and subjects are of value
More emphasis on general skills
Most important is the synthesis between the general and specific knowledge and/or skills.

19. What needs our attention?
The Accreditation Council for
Graduate Medical Education (ACGME):
Specific medical knowledge
Patient care and nursing
Learning and development in the workplace
Interpersonal skills
Professionalism
Health system orientated medical practice
The Tuning Project (Medicine), The Tomorrow’s Doctor, The Scottish Doctor...

21. Good curriculum
Students should acquire the skills and knowledge as determined by the curriculum
Students and residents move to the next study level only when they are ready enough
Curriculum allows for timely identification of insufficient knowledge or skills
Graduates will be able to work independently

22. Good curriculum Well-balanced Comprehensive but not overloaded
Promoting growth
Student centered
Focus on learning

25. External factors

26. External factors
Internal factors

29. Good assessment Good assessment drives learning process
Feedback is an essential element
The criteria for success are known in advance

30. Good assessment Transparent evaluation system
Combines formative and summative assessment;
Study and evaluation must be a uniform system
Examinations must be diverse and complex

31. Teaching and learning strategy
Curriculum
content
PBL
Evaluation
process
Assessment
Teaching and learning strategy

34. Teacher Content Competences Skills Knowledge Clear Aims Goals Outcomes
Appropriate
Subjects
Clinical skills
Professionalism
Teaching
Methods
Practical training
Role model
Implementation
Timing
Feasibility
Explicit
Blocks/units
PBL, etc.
Feedback
Students
Teachers
Stakeholders

43. Other possible solutions
Introduce new training and evaluation systems:
objective structured clinical situations / exams
use of dummies and decoy
simulators for training and practical skills
simulated patients
e-learning
practical training

45. Is it working? Evidences?

46. Is it working? Evidences?
Obvious advantages
Changes in learning behavior: autonomy, better and faster acquisition of practical skills;
Clear recommendations for students
Studies and tests are closer to reality
Changes can be assessed quantitatively and qualitatively

47. Is it working? Evidences?
No adverse changes
National exam results the same or better
No negative feedback from students or teachers
Requires limited financial and human resources (at least in the beginning)

48. Is it working? Interesting?
Initial assessment using ABCDE approach
Diagnosis
Initial treatment 

49. Is it working? Interesting?
Wound
Rash

50. Is it working? Interesting?
Assessment using ABCDE approach

51. Is it working? Interesting?
Diagnosis and initial treatment      
Practical skill performance:

52. Questions? ?

53. Summary We are responsible to society for medical education
Society has clear expectations, and this is an important factor driving the changes
Many of the theoretical knowledge and practical skills we teach really well
In studies and surveys of faculty, staff, employers and patients show what needs to be done better or just differently
We know our way... So now we just need to reach our destination ...