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Principles for curriculum development
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Principles for Curriculum Development
Hirotaka Onishi, MD, MHPE
International Research Center for Medical EducationGraduate School of Medicine, the University of Tokyo
Textbooks
What Did You Learn in the Last Class?
Goals of Medical Education Begin with patient/society needs Balance between basic sciences, clinical
studies, and clinical practice Balance of knowledge, attitude, and skills Not only recalling information but also using
it to solve problems (deep knowledge)
Educational System
Elementary School 6 yrs
Junior High School 3 yrs
High School 3 yrs
University 4 yrs (Medical, Dental, Pharmaceutical Curriculum 6 yrs)
Medical Career
Medical School 6 yrs
Postgraduate Training 2 yrs
Fellowship 3-5? Yrs
Continuing Medical Education
Name of Medical Education for Each Career Level in Japan
Undergraduate Medical
Education
Preparatory Subjects
Basic Sciences
Clinical Medicine
Postgraduate Medical
Education
Residency
Fellowship
Entrance Exam
CAT
License Exam
Major Changes in Medical Education Curricula
1. Until 1850: Basically OJT (on-the-job training) Basic science was not developed widely
2. 1850~1950: Discipline-based curriculum Microbiology, Physiology, Public health…
3. 1950s~60s: Organ-system-based curriculum Cardiology, Gastroenterology… Basic science and clinical medicine are integrated
4. 1970s~: PBL ( problem-based learning ) Faculty-resource-intensive
5. 2000~: Outcome-based education
Innovative CurriculumThe SPICES model
Harden, 1984
Systematic Traditional
Student-centred Teacher-centred
Problem-based Passive acquisition
Integrated Discipline-based
Community Hospital-based
Elective Standardized
Systematic Opportunistic
Why Outcome-based Education? Information explosion Changing public expectation Accountability Informing curriculum decisions Integrating teaching and assessment Planning the continuum of education
Framework of Outcome-based Education
Educational Environment
Support
Assessment
How to learn(Methods)
What to learn(Contents)
Medical Students
Educational Outcome
Examples of OBE (1) 6 outcomes of Postgraduate training:
ACGME (Accreditation Council for Graduate Medical Education) ACGME Outcome Project: http://www.acgme.org/Outcome/
Patient Care Medical Knowledge Practice-Based Learning and Improvement Interpersonal and Communication Skills Professionalism Systems-Based Practice
Examples of OBE (2)(CanMEDS 2000, 1996)
Examples of OBE (3)
IIME (Institute for International Medical Education):
GMER (Global Minimum Essential Requirements) in medical education
Med Teach 2002, 24, 130–135
ClinicalSkills
Population Health
Scientific Foundations
Professional Values,
Attitudes
Critical Thinking
Information Management
Communication Skills
Examples of OBE (4)The Scottish Deans’ Medical Curriculum Group’s Three circle model (Simpson et al. Med Teach 2002, 24, 136-143)
Medical informatics
Patient management
Patient investigation
Clinical skills
Communication
Practical procedures
Health promotion and disease prevention
Personal development
Role of the doctor within the health service
Attitudes, ethical understanding and
legal responsibilities
Decision-making skills and clinical reasoning and judgement
Basic, social and clinical sciences and underlying
principles
What the
doctor is able to do
Points of OBE Integrated competencies (e.g.
critical thinking and professionalism) are more clearly targeted.
Assessment for comprehensive performance is more emphasized
Nowadays “competency” is often used instead of “outcome” if mentioned for curriculum
(e.g. competency-based curriculum)
Quality Assurance of Medical Education in Japan
Admission policy Combination of nationwide achievement test and schools’
own examination (most have interview) Diploma (graduating) policy
No external examiner, schools’ own policy Institutional systems for quality assurance
Not specific National standards for quality assurance
Guidelines for curriculum: Nationwide core curriculum + Common Achievement Test (for 4th year)
Quality assurance for undergraduate clinical teaching is difficult to implement
Accreditation System in Japan In 2002, the Higher Education bureau, MOE
declared the amendment of the 3rd paragraph of Article 69 of the School Education Act.
All the universities have to undergo self-evaluation process and accreditation by a certified body every 7 years.
This has become effective since 2004. No specific accreditation system for medical
education
Program Accreditation in Japan Post-graduate professional schools (Law,
Business, Accounting, and Midwifery) must undergo self-evaluation and take external “program evaluation” by accreditation bodies every 5 years according to the School Education Act.
Program certification only to only post-graduate professional schools.
Pharmaceutical Education Accreditation in Japan Japan Accreditation Board for Pharmaceutical
Education (JABPE) is now starting self-evaluation. Full-scale external evaluation will start in 2012. After 2012, all pharmacy schools will take accreditation.
Program certification by JABPE is voluntary activities. They are non-governmental bodies. These activities aspire their educations to be fit to their global standards.
Why Accreditation? To assure the standardized medical
education To prepare for practitioners’ mobility to
another country
In 2010 ECFMG states that all the examinees must graduate from internationally accredited medical schools after 2023
Group Discussion What was the model of the curriculum
you have experienced or known? Any idea of which direction health
professional education curricula goes.