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Goals and Objectives

Hirotaka Onishi MD, MHPE

International Research Center for Medical EducationGraduate School of Medicine, the University of Tokyo

Curriculum Development 6-step Approach (Kern)

1. Problem identification and general needs assessment

2. Needs assessment for targeted learners

3. Goals and objectives

4. Educational strategy

5. Implementation

6. Assessment or evaluation

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Goals and objectives Goals

Broad and general objectives Closely related with outcomes, aims,

mission of the school… Objectives

Specific and measurable objectives Better to identify targeted behavior Closely related with what should be

assessed

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Ex) Goals & Objectives of Ob/Gyn for Internal Medicine Residents

Goal (or broad educational objective) Internal medicine residents develop the knowledge,

attitudes, and skills necessary to diagnose, manage, and appropriately refer women who present to primary care settings with gynecologic needs or complaints

Specific measurable objective By the end of the gynecology curriculum, each

resident will have demonstrated, at least once, the appropriate technique, as defined on a check sheet, for obtaining a Pap smear and cervical cultures.

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Benjamin Bloom He divided educational objectives into

cognitive, affective and psychomotor domains and several levels for each. Cognitive – knowledge Affective – attitude Psychomotor – skills Sometimes these domains are called KAS

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Domains and Levels

Cognitive Affective PsychomotorKnowledge Receiving Imitation

Comprehension Responding Manipulation

Application Valuing Precision

Analysis Organizing Articulation

Synthesis Characterizing Naturalization

Evaluation

Mastery Learning(Benjamin Bloom, 1971)

Require well- defined learning units organized into smaller, sequentially organized learning objectives. Easy Difficult Simple Complex

Learners are provided frequent and specific feedback by using diagnostic, formative tests designed to correct mistakes along his/her learning pathway.

Each learner must master each learning unit before proceeding to the next.

Ex) Kumon’s math program

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Multiple Levels? Too detailed taxonomy levels will not

help education and learning. Ultimate aim of education – behavioral

change (performance level). Not only the skills but attitude and basic knowledge is needed.

Relationship among Taxonomy

Performance

Higher Cognitive

Attitude

Recall levelCognitive

skills

Organization of a Curriculum

Curriculum

Goal

Objective

Objective

Objective

Goal

Objective

Objective

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Mission

Undergraduate Medical Education Mission StatementFaculty of Medicine, The U of Tokyo

The University of Tokyo School of Medicine serves Japan and the world by contributing new knowledge through research and providing an exemplary education to medical students who will become future leaders in the life sciences, clinical research, and the clinical practice of medicine. To prepare our graduates for the major challenges they will face, we seek to support their professional development as physicians with creative and inquiring minds, an appreciation of the principles of medical practice, and a sound foundation in both the scientific and humanistic aspects of medicine.

Examples from a Smoking Cessation Curriculum for Residents

Cognitive By the end of the curriculum, each resident will be

able to list the five-step approach to effective smoking cessation counselling.

Affective By the end of the curriculum, each primary care

resident will rank smoking cessation counselling as an important and effective intervention by primary care physicians (>3 on a 4-point scale).

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Psychomotor (skill) During the curriculum, each primary care resident

will demonstrate in role-play a smoking cessation counseling technique that incorporates the attached five steps.

Psychomotor (performance) By 6 months after completion of the curriculum,

each primary care resident will have negotiated a plan for smoking cessation with ~60% of his/her smoking patients or have increased the percentage of such patients by >20% from baseline.

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How to Write Objectives By when who will do how much of what

by the end of the curriculum each resident will demonstrate at least one time appropriate technique of Pap smear

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Ex) Medical Education Course for International Cooperation

By when who will do how much of what

by the end of the course each student will describe two actual processes of curriculum development

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Taxonomy Objectives and contents may be categorized

into knowledge, attitude and skills. Cognitive domain: 2 levels – recall (knowledge),

application (problem solving) Affective domain: attitude knowledge required Psychomotor domain: 2 levels – skill, performance Performance requires knowledge, attitude & skill

Taxonomy makes it easier to optimize delivery and assessment tools

Ex: Cognitive Objective By the end of the neurology curriculum,

the learner will describe in writing a cost-effective approach to the initial evaluation and management of patients with dementia

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Inappropriate verbs Appropriate verbs

know, understand list, define, distinguish, describe

Ex: Affective Objective By the end of the HIV curriculum

all residents will have identified attitudes and beliefs regarding HIV patients who are drug addicts

all residents will have discussed with their colleagues and attending physicians how these might influence their management of such patients

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Inappropriate verbs Appropriate verbs

appropriate, internalize rate as valuablerank as important

Ex: Skill Objective By the end of the curriculum, all medical

students will have demonstrated proficiency in assessing alcohol use by utilizing all four of the CAGE* questions with one simulated and one real patients.

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Inappropriate verbs Appropriate verbs

know how demonstrate

*Cage: (1) cut-down, (2) annoyed by criticism, (3) guilty feeling and (4) eye-opener

Ex: Performance Objective All students who have completed the

curriculum will routinely (>80% of time) use the CAGE questions to assess their patients’ alcohol use

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Levels of Evaluation Focus

Benefit to patients

Organisational change

Behaviour change

Acquisition of knowledge and skills

Modification of attitudes and perceptions

Learners’ reactions

Kirkpatrick’s 4 levels

Level 4

Level 3

Level 2

Level 1

Patient Objective Whenever developing a curriculum,

consider patient/society level of objectives Ex) 1 year after the medical interview

curriculum for alcohol dependency annual number of patients participating in alcoholics anonymous will be increased

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Small Group Exercise Define a course of your selection,

targeted learners and period of the course

Set goals and objectives after analyzing k/a/s and patient objectives

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