Educational Program

Curriculum

Curriculum details a planned educational experience. The curriculum must be structured to optimize resident educational experiences, the length of these experiences, and supervisory continuity [CPR IV.C.1]. In order to create, implement, and enhance curriculum, faculty should (1) conduct needs assessment, (2) secure resources, (3) create competency-based goals and objectives, (4) employ effective educational strategies, (5) conduct reliable and objective summative and formative evaluation, and (6) provide frequent and meaningful feedback. Program aims, which focus on program and institutional leaders’ key expectations for the program, are also integral part of curriculum.

Program Aims

Population Health Management Curriculum

Recommended Reading

  • Kern DE, Thomas PA, Hughes MT. Curriculum Development for Medical Education: A Six-Step Approach. Baltimore: The Johns Hopkins University Press; 2009.

Goals and Objectives

Goals: broad, intangible, and abstract descriptions of a destination (where you want to go)

Objectives: specific, measurable, achievable, realistic, and timely target of learning (how you get there)

The Objectives require five basic elements: Who? How much? How well? What? and By when? (e.g., the Gynecology curriculum for internal medicine residents: By the end of the gynecology curriculum, residents will be able to demonstrate, at least once, the appropriate technique, as defined on a check sheet, for obtaining a Pap smear and cervical cultures)

Don’t forget!: When developing goals and objectives, carefully review the data from formative and summative evaluations as well as Milestones. A high frequency of deviation in these data suggests the need for curricular change/improvements that will trigger the need for writing new goals and objectives or revising the existing goals and objectives.

Types of learning objective: learner objectives (cognitive, affective, psychomotor domains) and process objectives. Sometimes the term “learner objectives” is used interchangeably with “outcome objectives.”

  • Learner Objectives – Cognitive domain (“knowledge” objectives): There is a hierarchical level of knowledge, from simple factual knowledge (e.g., a definition of a certain term) to a higher level of cognitive functioning (e.g., problem-solving and clinical decision making). The faculty usually specify the highest-level objective expected of the learner. Bloom’s Taxonomy describes the hierarchy of mental skills.
  • Learner Objectives – Affective domain (“attitudinal” objectives): Affective domain is referred to as attitudes, values, beliefs, biases, emotions, or role expectations that can affect a learner’s learning or performance. Affective objectives are implicit in most educational programs in GME.
  • Learner Objectives – Psychomotor domain (“skill” or “behavioral” objectives): Psychomotor domain considers specific psychomotor tasks or actions that may involve hand or body movements, vision, hearing, speech, or the sense of touch. Learner objectives for the psychomotor domain must indicate whether learners are expected simply to achieve the ability to perform the skill or to incorporate the skill into their continuing behavior.
  • Process Objectives: In addition to learner objectives, process objectives, which indicate the degree of participation expected from the learners, can be added. (e.g., By the end of this academic year, 90% of PGY-3 residents will have participated in a critical incident root cause analysis.)

Miller’s Pyramid helps faculty identify learner objectives’ domains and prerequisite knowledge to achieve higher order thinking skills and autonomous clinical practice.

Structured Didactic Activities (Educational Strategies)

Educational strategies provide the means by which curriculum’s objectives are achieved. Educational strategies involve both content (the specific materials to be included in the curriculum) and methods (the ways in which the content is presented). To create an optimal learning experience, the faculty should consider employing multiple teaching strategies (e.g., lectures, problem-based learning, demonstration) and maintaining congruence between objectives and educational methods (e.g., if the objective is a psychomotor domain, methods should include demonstration).

Flipped Classroom (UW CLIME): One of the strategies that could be valuable for GME is “flipped classroom.” In flipped classroom, residents read the materials (e.g., books, watching the instructional videos) at home, in advance of class. During the class, trainees work through problems, engage in collaborative learning, and demonstrate skills. The core of flipped classroom is to maximize the learning resource, time.

Educational Strategies*
Strategies for cognitive objectives: relevant for ACGME Competency-Medical Knowledge [IV.B.1.c)]

Educational methods to achieve cognitive objectives include, but are not limited to, lectures, readings, programmed learning (programmed textbook/software that present material in organized sequential fashion), team-based learning (a combination of reading, testing, discussion, and collaboration to achieve higher order cognitive learning objectives), learning projects, problem-based learning, discussion, small group learning, frequent feedback on performance, and artificial models and simulation.

Lectures can be designed to be engaging and interactive. A combination of mini-lecture, think-pair-share, problem-solving exercise, case discussion, group discussion, and instructional video clips can be incorporated into the lecture. For help with this strategy, see the 2.5 hour video, “The ways and hows of active learning in a large classroom setting” (UW CLIME)

Strategies for affective objectives: relevant for ACGME Competency-Professionalism [IV.B.1.a)]

Techniques that promote openness, introspection, and reflection can help attitudinal change. Reflection on experience and reading, feedback on performance, role models, role-plays, artificial models and simulation, real-life experiences, discussion, small group learning, team-based learning, and standardized patients can be used to achieve affective objectives. Role-model health professionals can help change attitudes by demonstrating successful approaches to a particular problem.

Strategies for psychomotor objectives: relevant for ACGME Competency-Patient Care and Procedural Skills [IV.B.1.b)]; Interpersonal and Communication Skills [IV.B.1.e]

Methods commonly used to achieve psychomotor objectives include supervised clinical experience, simulations, artificial models, role-plays, standardized patients, and audio/visual review of skills. In order to ensure psychomotor objectives are met, it is critical to create safe and supportive learning environment where (1) faculty-residents rapport is nurtured, (2) explicit recognition and reinforcement of the resident’s strengths are provided, and (3) feedback on deficiencies are provided in a factual, nonjudgmental, and positive manner. When employing role-playing, faculty must alleviate residents’ potential discomforts by establishing ground rules.

Strategies to promote Practice-Based Learning and Improvement [CPR VI.B.1.d]

PBLI competency can be promoted through independent learning projects, individualized learning plans, learning portfolios, role modeling, training in teaching skills, and metacognitive skills (monitoring their own learning).

PBLI encourages self-directed learning, which means learners are active. These active learners can learn things more efficiently, retain that knowledge better, and use it more effectively than passive learners. In order for successful self-directed learning to take place, there should be sufficient protected time for the activity, clear communications of expectations to the learner, required products (e.g., presentations, reports), and sufficient mentoring and supervision.

Strategies to promote Systems-Based Practice [CPR IV.B.1.f]

This competency overlaps with the Interpersonal and Communications Skills competency [IV.B.1.e]. Methods that can be used to help develop Systems-Based Practice include inclusion of other health professionals on health care teams, providing feedback on costs of care, case conferences focused on cost-effectiveness and quality of care, opportunities to work in disease management programs, redesigning teaching services toward multidisciplinary integration, and participation in quality improvement and safety teams.

*Kern DE, Thomas PA, Hughes MT. Curriculum Development for Medical Education: A Six-Step Approach. Baltimore: The Johns Hopkins University Press; 2009.

Scholarship

 

UW Statistical Consulting Services

free consulting service, provided by Biostatistics and Statistics, is offered during UW academic quarters (not during Final Exam week).  This service is part of a graduate course for Biostatistics and Statistics in which the graduate students are the primary consultants under the guidance of faculty instructors.

Learn more and request a consult on the Departments of Biostatistics and Statistics website.

Writing for Educational Journals

Materials from a Journal of Graduate Medical Education Sponsored Workshop, March 2, 2013, at at the 2013 ACGME Conference, are reproduced below with permission from the presenting members of the JGME Editorial Board: Monica Lypson, MD, MHPE; Deb Simpson, PhD; Larry Opas, MD; Gail Sullivan, MD, MPH, JGME Editor in Chief; Ingrid Philibert, PhD, MBA, JGME Executive Managing Editor.

 

Workshop Materials

Work-in Progress Checklist for Education Papers: Checklist to guide the development process for educational scholarship papers.
Writing Steps Checklist: Checklist to guide the actual writing of the paper from reading the author guidelines to formulating the abstract; developing the introduction, methods, results, and discussion sections.
Education Research Resources: Resources on the following topics: “Getting Started,” “Curriculum Development,” “Qualitative Approaches,” “Surveys,” Writing and Reviewing.”
Courses, Medical Education Websites, Journals, Timelines: On Line Courses for Reviewing Skills (not specific to medical education); Websites (i.e., BEME, MedEdPortal); Education Journals to Consider—A list of approximately 10 medical education journals (e.g., Academic Medicine, JGME, Medical Teacher); Calendar for Education Abstract Submissions

Tables and Figures

TABLE 1. Modified Newcastle-Ottawa Scale – for quantitative studies
TABLE 2. Medical Education Research Quality Instrument – for quantitative studies
FIGURE. Kirkpatrick’s Levels of Evaluation
TABLE 3. Best Evidence in Medical Education Global Scale
TABLE 4. Grid for Critical Appraisal of Qualitative Research Articles – for qualitative studies

Educational Research and Writing

Brief guides, articles and resources on medical education scholarship, research, and writing.

Research Toolkit: A toolkit for health research in partnership with practices and communities

INSTRUMENTS: SURVEYS, INTERVIEWS, OTHERS
Sullivan GM. A Primer on the Validity of Assessment Instruments. J Grad Med Educ. 2011; 3(2):119-120.
Rickards G, Magee M, Artino Jr AR. You Can’t Fix by Analysis What You’ve Spoiled by Design: Developing Survey Instruments and Collecting Validity Evidence. J Grad Med Educ. 2012;4(4): 407-410.
Magee C, Rickards G, Byars LA, Artino Jr AR. Tracing the Steps of Survey Design: A Graduate Medical Education Research Example. J Grad Med Educ. 2013;5(1):1-5.
Willis GB, Artino Jr AR. What Do Our Respondents Think We’re Asking? Using Cognitive Interviewing to Improve Medical Education Surveys. Journal of Graduate Medical Education: J Grad Med Educ. 2013;5(3):353-356.
Artina AR. AM Last Page: Avoiding Five Common Pitfalls of Survey Design. Acad Med. 2011; 86(10): 1327.

 

EDUCATION RESEARCH
Sullivan GM. Deconstructing Quality in Education Research. J Grad Med Educ. 2011; 3(2):121-124.
Sullivan GM. Getting Off the “Gold Standard”: Randomized Controlled Trials and Education Research. J Grad Med Educ. 2011; 3(3):285-289.
Sullivan GM, Sargeant J. Qualities of Qualitative Research: Part I. J Grad Med Educ. 2011; 3(4):449-452.
Sargeant J. Qualitative Research Part II: Participants, Analysis, and Quality Assurance. J Grad Med Educ. 2012; 4(1):1-3

 

EFFECT SIZE
Sullivan GM, Feinn R. Using Effect Size—or Why the P Value Is Not Enough. J Grad Med Educ. 2012; 4(3):279-282.
Sullivan GM. FAQs About Effect Size. J Grad Med Educ. 2012; 4(3):283-284.

 

INSTITUTIONAL REVIEW BOARD (IRB) REVIEW
Sullivan GM. Education Research and Human Subject Protection: Crossing the IRB Quagmire. J Grad Med Educ. 2011;3(1):1-4.
Sullivan GM. IRB 101. J Grad Med Educ. 2011;3(1):5-6.

 

ON WRITING AND PUBLISHING
Sullivan GM. Writing Education Studies for Publication. J Grad Med Educ. 2012; 4(2):133-137.
Lypson M, Philibert I. Residents and Authorship: Rights, Obligations, and Avoiding the Pitfalls. J Grad Med Educ. 2012; 4(2):138-139.
Sullivan GM. Publishing Your Education Work in the Journal of Graduate Medical Education. J Grad Med Educ. 2010;2(4):493-495.

 

SCHOLARSHIP
Simpson D, Meurer L, Braza D. Meeting the Scholarly Project Requirement–Application of Scholarship Criteria beyond Research. J Grad Med Educ. 2012; 4(1): 111-112.
Meurer LN, Diehr S. Community-Engaged Scholarship: Meeting Scholarly Project Requirements While Advancing Community Health. J Grad Med Educ. 2012; 4(3): 385-386.

 

Contact Us

Incho Lee

Incho Lee, PhD

Director of Education
Phone: 206.685.0252
Email: ilee@uw.edu

Resource Links

UW CLIME

Faculty Development

JGME

Academic Medicine

JAMA

Full access available to journals through the UW Library

Contact Us

Incho Lee

Incho Lee, PhD

Director of Education
Phone: 206.685.0252
Email: ilee@uw.edu

Resource Links

UW CLIME

Faculty Development

JGME

Academic Medicine

JAMA

Full access available to journals through the UW Library