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SES09: Teaching the Competencies: Thinking Outside-of-the-Box

SES09: Teaching the Competencies: Thinking Outside-of-the-Box. 2010 ACGME Annual Education Conference Bardia Behravesh, MA & Alice Edler, MD, MA, MPH Department of Graduate Medical Education. Session Objectives.

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SES09: Teaching the Competencies: Thinking Outside-of-the-Box

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  1. SES09: Teaching the Competencies: Thinking Outside-of-the-Box 2010 ACGME Annual Education Conference Bardia Behravesh, MA & Alice Edler, MD, MA, MPH Department of Graduate Medical Education

  2. Session Objectives • Identify innovative teaching methods used by your residency programs and share them across programs. • Leverage existing resources within your institution to teach the ACGME General Competencies. • Use a systematic curriculum design approach to develop curriculum.

  3. Background • In 2008, Stanford GME conducted a needs assessment with the goal of identifying ways in which it could better serve its residency programs. • 63 of 75 Program Directors responded to an online survey. • Following the survey, 69 of 75 Program Directors were interviewed.

  4. Findings • 46% of respondents requested centralized teaching of the competencies (i.e. delivered by the Dept of GME). • 23% of respondents requested more information about educational techniques and resources. • 19% of respondents requested web-based learning modules that teach the competencies.

  5. Goals • Identify educational techniques and resources to share across programs. • Identify avenues for centrally teaching the competencies (including the utilization of web-based learning modules).

  6. Goal 1: Techniques & Resources • Initial approach: Searched the web for teaching and evaluation methods (best practices) to post to the Dept of GME web site. • Challenges: • Limited resources available online • Cost • Thinking Outside-of-the-Box: Which programs are currently using innovative methods to teach the core competencies (i.e. what ideas can we borrow from our own programs and share across all programs)?

  7. Program Innovations • Solicited voluntary submission of innovative teaching strategies by Program Directors. • Flagged innovative teaching strategies during internal program reviews. • Collected strategies into a spreadsheet and posted to the Dept of GME web site.

  8. Exercise 1 • Review the learning activities described in the handout. • Using the blank fields, describe an innovative activity developed by your own program that you could potentially share with other programs within your institution.

  9. Goal 2: Centralized Education • Initial approach: Looked at developing and/or purchasing web-based learning modules. • Challenges: • In-house development is costly. • Off-the-shelf solutions do not fit needs exactly. • Customization of off-the-shelf solutions difficult/costly. • Thinking Outside-of-the-Box: What existing content (already available at our institution) can we leverage to teach the competencies?

  10. Regulatory Compliance Training • Stanford satisfies various regulatory requirements through the use of online training. • Topics include: • Patient Rights • HIPPA • Emergency Codes • Quality Management • Cultural Diversity • Residents are required to complete the modules on a yearly basis.

  11. Mapping Content to Competencies • Determined what web-based learning modules were available. • Used a spreadsheet to map the modules to the competencies. • Posted spreadsheet to the Dept of GME web site.

  12. Mapping Content to Competencies

  13. E-learning as a “springboard” • A web-based learning module should not be thought of as PRIMARY and SUFFICIENT for competency education. • Pre-existing curriculum can act as a springboard for additional learning. • Partner the goals and objectives of the pre-existing curriculum with those of additional learning activities.

  14. Systematic Curriculum Development • Two commonly used curriculum design approaches in medical education: • Tyler’s principles for curriculum and instruction • Tyler R, “ Basic Principles of Curriculum and instruction” Chicago, University of Chicago Press, 1949 • Kern’s six step approach to curriculum development • Kern D, Thomas P, Howard D, Bass E, “Curriculum Development for Medical Education”, Baltimore, Johns Hopkins University Press 1998

  15. Pro’s of Tyler Rationale • Simple and straight forward • Starts with Goals and Objectives • Good for institutional curriculum development • Good for modification of pre-existing curriculum • Teacher-oriented

  16. Tyler’s Four Questions • What educational purposes should the curriculum seek to attain? • What learning experiences should be selected to achieve these goals and objectives? • How should these learning experiences be organized? • How can the effectiveness of these experiences be evaluated?

  17. Goals and Objectives • Goals: Overall outcomes • Objectives: Criteria by which the educational materials are selected and the content is outlined. Based on: • Values • Needs • Learner • Society

  18. Objectives = The Desired Educational Ends • The changes in learner behavior/attitudes • Not what the teacher does • Not a content list • Not a vague abstraction but concrete change

  19. Behavioral and Attitudinal Aspects of Objectives • Understanding of the important facts and principles • Familiarity with the sources of information • Ability to interpret data • Ability to apply principles • Ability to interpret results of investigation • Broad and mature interests

  20. Selecting Educational Experiences • Real and attainable • Satisfying to the learner • Multiple and reinforcing

  21. Organization of Educational Experiences • Sequencing • Increasing complexity, if needed (graduated responsibility) • Reinforcing

  22. Implementation • Political support for program • Procurement of resources (room, standardized patients, etc) • Piloting, if possible • Introduction • Barriers to implementation

  23. Evaluation of the Curriculum • Multi-source evaluation of the • Written Curriculum • Educational Milieu • Administration of the Curriculum • Faculty • Learner

  24. Exercise 2 • Review the sample e-learning module and consider the following questions: • What competency-based goals and objectives could this module address? • If we were to use this module as a springboard, what additional learning experiences could we combine with this module to develop a competency-based curriculum? • How would you sequence the learning experiences, including the use of this module? • How would you evaluate the effectiveness of your new curriculum in teaching the desired competencies?

  25. Summary • Resident learning need not be bounded by program-specific curricula. • Rather than develop completely from scratch, look for pre-existing practices and content that can be leveraged. • Look across programs for best practices. • Look at the institutional level for resources.

  26. Questions? • Feel free to contact us: • Bardia Behravesh, MA – bbehrave@stanford.edu • Alice Edler, MD, MA, MPH – aedler@stanford.edu

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