Curriculum design

Kieran Walsh,
Editor,
BMJ Learning.

Curriculum design - OR how to avoid
It has been realised for many years that an
undergraduate course such as this suffers
from the chronic disorder curriculopathy.
Jean-Jacques Guilbert


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


Curriculum - three levels
Planned curriculum

Delivered curriculum

Experienced curriculum



Curriculum - planned curriculum


We will run 5 case based interactive
tutorials on respiratory medicine




Curriculum - delivered curriculum



4 tutorials happened and one was on
cardiorespiratory medicine as the tutor did
not understand exactly what he was
supposed to do




Curriculum - experienced curriculum



Only half of the students came to one
tutorial as there was confusion regarding
the timetable. At another tutorial there was
limited interaction as the tutor had more of
a lecture style


Curriculum hidden in there

The hidden curriculum

what students learn as they experience the
gap between what we say and what we
actually do. Jodi Skiles
Powerful
Transmits values through role modelling
Never stated but everyone understands


Curriculum design

Curriculum --- health services


Curriculum four elements
Content

Teaching and learning strategies

Assessment processes

Evaluation processes.
Curriculum design models
Prescriptive
What curriculum designers should do
How to create a curriculum

Descriptive
What curriculum designers actually do
What a curriculum covers


Curriculum design prescriptive model

Objectives based

Educational purposes?

Educational experiences to reach purposes?

Organise educational experiences?

Evaluate if purposes being reached?



Curriculum design prescriptive model

Objectives based

Educational purposes defining these is the
most important step

BUT objectives especially behavioural
objectives can be restrictive

Objectives based model fallen from
favour



Curriculum design prescriptive model

Outcomes based

Starts with the outcomes you want
students to obtain



Curriculum design prescriptive model

Outcomes based

Statement example: students will
competently assess and manage patients
with asthma

Popular
Focuses on what students do (rather than
staff)
BUT dont be too restrictive/reductionist



Curriculum design descriptive model

Situational model

Situation/context
Thoroughly and systematically analyse the
situation in which they work for its effect on
what they do in the curriculum.
External and internal factors



Curriculum design descriptive model

Situational model

1. Situational analysis
2. Statements of intent
3. Content
4. Assessment
5. Evaluation
6. Return to 1

All steps linked. None decided until all
decided.



Curriculum reform

changing a curriculum more difficult than
moving a graveyard. August Swanson

Initial students through new curriculum
testing it

Controlled trials probably not the best way

Can be expensive, disruptive, harmful, time
consuming


Curriculum reform why it can fail

Stakeholder management
Stakeholders mismanaged or forgotten
Staff
Students
Patients
Public

Curriculum design curriculum maps

Show links between the elements of the
curriculum
Means of clear display
Structure for the organisation of the
curriculum
Mapped to computer databases
Curriculum design maps
More transparent to stakeholders
the teacher, the student, curriculum
developers, the profession, the public

Shows links between the different
elements of the curriculum
Content assessment
Curriculum design maps
No gaps

No overlapping

Holistic approach to care by showing links
between different learning outcomes
Curriculum design maps
The problem our faculty faces is how to
reconceptualise the subject matter in a way
that eliminates redundancy, creates a smooth
transition between courses, and demonstrates
the conceptual interrelationships the faculty
hope students will develop as a result of
integrated, meaningful learning.

Edmondson 1993
Curriculum design windows on the map
The expected learning outcomes
Curriculum content or areas of expertise covered
Student assessment
Learning opportunities
Learning location
Learning resources
Timetable
Staff
Curriculum management
Students
Preparing a curriculum map
Assess needs
Scope the task
Establish the links
Populate the windows
Decide the format for the map
Think of the past, present and future
Decide on access to the map
Familiarize staff and students with the map
Plan to evaluate and update the map as necessary
Allocate responsibility for the map

Harden 2001
Curriculum design cost benefit
Curriculum design is expensive
Planning
Organising
Running
Assessing
Evaluating
Good curriculum design has tangible benefits
Better reputation for your medical school
Better applicants to your medical school
Better and happier faculty
Better graduate doctors
Better and safer healthcare
No gaps, no overlaps in educational delivery
Everyone knows whats going on
External inspections passed
Curriculum design cost benefit

Curriculum design is expensive

Need to balance considerable costs with tangible
benefits

If balance done well, it will
Be cost effective
Deliver ROI to your institution

References
Prideaux D. ABC of learning and teaching in medicine: Curriculum design. BMJ
2003;326:268-270

Tyler R. Basic principles of curriculum and instruction. Chicago: Chicago University
Press, 1949

EDMONDSON, K.M. (1993) Concept mapping for the development of medical curricula,
paper presented at the Annual Meeting of the American Educational Research Association,
Atlanta, Georgia.

R.M. HARDEN. AMEE Guide No. 21: Curriculum mapping: a tool for transparent and
authentic teaching and learning. Medical Teacher, Vol. 23, No. 2, 2001

Gale R, Grant J. Cost benefit analysis of curriculum design for medicine. In: Cost
effectiveness in medical education. Walsh K (ed). Radcliff 2010.








References / Bibliography




Walsh K (ed). Cost effectiveness in medical education. Radcliffe: Abingdon, 2010.

Walsh K. Interprofessional education online: The BMJ Learning experience. Journal of
Interprofessional Care, Volume 21, Issue 6 December 2007, pages 691 - 693

Schroter S, Jenkins D, Playle R, Walsh K, Probert C, Kellner T, Arnhofer G, Owens D. Evaluation of
an online Diabetes Needs Assessment Tool (DNAT) for health professionals: a randomised
controlled trial. Trials 2009, 10:63

Walsh K, Rutherford A, Richardson J, Moore P. NICE medical education modules: an analysis of
cost-effectiveness. Educ Prim Care. 2010 Nov;21(6):396-398.