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465

[H2]Populate the framework with the agreed learning outcomes 466

The desired outcomes should be established for each of the framework domains. For example, 467

in relation to practical procedures, a decision has to be taken as to which procedures should 468

be included and in relation to communication skills, which aspects of communication and the 469

level of mastery required at the completion of the education programme.

470

[H2]Prepare a grid or preferably a curriculum map relating the learning outcomes to 471

the phases and courses in the curriculum 472

It is important to recognise that OBE does not stop with the specification of the learning 473

outcomes. The content of the curriculum and the aspects addressed in each stage of the 474

curriculum must be determined by the expected learning outcomes (Figure 3.2). How each 475

course contributes to the exit learning outcomes should be specified and the milestones or 476

what is expected of a student at each phase of the curriculum should be determined.

477

[FIGURE 3.2 NEAR HERE]

478

[H2]Prepare a grid or curriculum map identifying for each learning experience the 479

expected learning outcomes 480

Learning outcomes should be specified for all learning experiences including lectures, 481

tutorials, problem-based learning sessions, practical classes, clinical experiences or work in a 482

simulation laboratory. The work may be completed over a period of time with responsibility 483

given to the individual in charge of the session.

484

[H2]Relate the assessment to the learning outcomes 485

Prepare a grid or curriculum map identifying how each learning outcome is assessed at the 486

different stages in the curriculum, e.g. through a written assessment, an OSCE or as part of a 487

portfolio assessment. As discussed in Chapters 17, 18, and 19 important advances have been 488

made in the assessment of outcomes such as professionalism, attitudes and team working. The 489

case study from the University of Colorado illustrates how the assessment of trainees was 490

built round the ACGME competencies for paediatrics residents and the milestones in the 491

move from novice to master.

492

[H2]Arrange a faculty development programme 493

It is essential to engage the faculty in the specification of learning outcomes and in the 494

implementation of an OBE approach. The concept of OBE will be new to many faculty and 495

faculty must be involved and made familiar with the approach and with the learning outcome 496

framework and how the course for which they are responsible contributes to this.

497

[H1]Take-home messages 498

• The principal focus for medical education should be on the product and the desired 499

learning outcomes rather than on the programme structure and education process.

500

Quite simply, outcome-based and competency-based education means clearly 501

focussing and organising the educational programme around what are deemed to 502

be the essential competencies and abilities for the learner at the end of the 503

educational programme.

504

• Outcome-based education is a powerful education strategy that should be used as a 505

focus for curriculum planning, as a means of making informed discussions about 506

the approaches to teaching and learning be adopted and as a basis for the 507

assessment of students/trainees and of the education programme itself. This means 508

starting with a clear picture of what is important for the healthcare professional to 509

be able to do and then organising the curriculum, learning opportunities, and 510

assessment to make sure that this learning happens.

511

• OBE is at the cutting edge of curriculum development and an understanding of the 512

expected learning outcomes can contribute to our appreciation and success of 513

newer approaches to medical education such as team-based learning and 514

interprofessional education.

515

• OBE is not a magic bullet that on its own can address the problems facing medical 516

education. As with all developments or tools and as illustrated in the case studies, 517

how it is implemented and how staff are engaged with the process matters.

518

• OBE requires a regular revision of the curriculum to ensure that competencies 519

outlined continue to meet the needs of the student, profession, and wider 520

community.

521

[H1]References 522

ACGME Paediatric Milestones, Online. Available HTTP:

523

http://www.acgme.org/acgmeweb/Portals/0/PDFs/Milestones/320_PedsMilestonesProject.pdf 524

(accessed 10 April 2014).

525

Australian Government Tertiary Education Quality and Standards Agency (2012) Online.

526

Available HTTP: http://www.teqsa.gov.au/ (accessed 28 March 2013).

527

Bédard, D. and Béchard, J.P. (2009) Quelques conditions pour un curriculum en 528

développement au supérieur, D. Bédard and J.P. Béchard (dir) Innover dans l’enseignement 529

supérieur (Chapter 15), Paris: Presses Universitaires de France.

530

Bowden, J.A. (1995) Competency-based education: neither a panacea nor a pariah. Paper 531

presented to TEND 97, Abu Dhabi, April 6-8. Online. Available HTTP:

532

http://crm.hct.ac.ae/events/archive/tend/018bowden.html (accessed 10 April 2014).

533

Faculty of Medicine, University of Airlangga (2012) Summary of Tracer Study. Unpublished.

534

Frenk, J., Chen, L., Bhutta, Z. A., et al. (2010) Health professionals for a new century:

535

transforming education to strengthen health systems in an interdependent world. Lancet. 376, 536

1923-58.

537

General Medical Council, Tomorrow’s Doctors (2009). Online. Available HTTP:

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http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors_2009_foreword.asp 539

(accessed 29 April 2014).

540

Grant, J. (1999) The incapacitating effects of competence: a critique. Advances in Health 541

Sciences Education : Theory and Practice 4(3): 271-7.

542

Harden, R.M. (2002) Learning outcomes and instructional objectives: is there a difference.

543

Medical Teacher 24: 151-5.

544

Harden, R.M. (2007) Learning outcomes as a tool to assess progression. Medical Teacher 29, 545

678-82.

546

Harden, R.M., Crosby, J.R., and Davis, M.H. (1999) From competency to meta-competency:

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A model for the specification of learning outcomes. Medical Teacher 21(6): 546-52.

548

Harden, R.M. and Stamper, N. (1999) ‘What is a spiral curriculum?’ Medical Teacher 21(2), 549

141-3.

550

Harris, R., Guthrie, H., Hobart, B. and Lundberg, D. (1995) Competency-based education and 551

training: between a rock and a whirlpool. Melbourne; Macmillan Education, Australia.

552

Indonesian Medical Council (2006) The National Standards Competencies of Indonesian 553

Medical Doctors .Jakarta: Indonesian Medical Council.

554

Indonesian Medical Council (2012) Standard for Indonesian Medical Education. Jakarta:

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Indonesian Medical Council.

556

O’Keefe, M., Henderson, A., and Pitt, R. (2011) Learning and Teaching Academic Standards 557

Statement for Health Medicine and Veterinary Science, Australian Learning and Teaching 558

Council. Online. Available HTTP: http://www.olt.gov.au/resources (accessed 28 March 559

2013).

560

Smith, S.R. and Dollase, R. (1999) Planning, implementing and evaluating a competency-561

based curriculum. AMEE Education Guide No. 14 Part 2, Medical Teacher, 21(1), 15-22.

562

Stufflebeam, D.L. (2003) The CIPP model for evaluation, T. Kellaghan et D.L. Stufflebeam 563

(dir.), International handbook of educational evaluation (Chapter 3). Boston: Kluwer.

564

ten Cate, O. (2005) Entrustability of professional activities and competency-based training.

565

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566

Zaini, Rania G., Bin Abdulrahman, Khalid A., Al-Khotani, Abdulaziz A., Al-Hayani, Abdol 567

Monem A., Al-Alwan, Ibrahim A., and Jastaniah, Saddig D. (2011) Saudi Meds: A 568

competence specification for Saudi medical graduates. Medical Teacher, 33(7), 582-4.

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