Twitter Weekly Updates for 2010-07-26

SAAHE keynote – How to construct a medical curriculum that matters

Presentation by Professor Herman von Rossum.

In preclinical years, you insert learning stimuli from the context of application (i.e. a clinical environment) into the educational learning environment. In clinical years, you insert education moments into the healthcare environment

In constructing a curriculum, you must first determine the health needs of a society, then determine the tasks of the doctors. From the tasks, what are the required competencies (knowledge, skills, behaviour) → final requirements of the programme

students → metamorphosis → doctor → fills health needs of society

Curriculum philosophy:

  • Competency orientated
  • Task driven
  • Learning in context
  • Teaching facilitates the learning
  • Assessment guides the learner and evaluates the outcome

Medical curricula have evolved over time:

  • Discipline or system based, (knowledge of teachers define content)
  • Thematic or integrated (teachers co-ordinated and optimised content for students)
  • Problem solving / skills lab (learning process of student became the issue)
  • Patient used as stimulus for learning moments, hybrid programmes (what is the right mix?)
  • Outcome orientated, learning in context, healthcare learning environment (competencies and learning stimuli in relevant context)

How do you translate the philosophy and structure / framework into a programme? Define the programme (e.g. CanMEDS, Tomorrows Doctors) using a blueprint determined by authority (final outcome is a legal guideline)

How do you design the learning path? Should view the pathway at a macro level (the course or the degree), a meso level (semesters), and micro level (weekly, educational structures) → real patients are introduced into the learning process at the basic structural level, and used as context for exploring concepts during that week. This would be a major challenge for us, without a link to a teaching hospital.

What “tasks in practice” (theory and practical) can be formulated from the clinical conditions, competencies and concepts involved?

One of the major differences in medical education compared to our curriculum is that the doctors can implement curricular activity directly on the wards. We can’t pull students off block to attend to these issues.

Hard concepts are “developed in dialogue” between students and clinicians

Learning rhythm: stimuli (patient introduction) → learning (engagement with patient and colleagues) → reflection on the process (in tutorials with roles rotating between students)

How do you develop a narrative between teachers and clinicians to construct learning tasks with patients? Involves meeting with patients and family to construct the problem, and content cleared with stakeholders (informed consent).

In addition to working through the actual problem-based case, the staff also provide students with a list of questions specific to the condition, that require them to follow up and in some cases, make personal reflections on the narrative.

How can you insert an educational moment in a healthcare setting? Apparently the healthcare setting must be “transformed” into an educational setting. How do you do this?

How do you select suitable healthcare events (intake, intervention, follow-up, discharge) to transform into an educational moment? What can be learned at each of these events? How do you lead one educational moment into the next?

We need to think long and hard about a better integration of clinical practice / events into our curriculum. We do suffer from the lack of partnership with a teaching hospital and having ready access to patients. How can this be addressed?