Faculty Curriculum Retreat

1. Faculty Curriculum Retreat 6 September 2008

2. Key points to be covered • UGC and University’s OBA initiative • SLO framework - what is it and why do we need it • SLO from the teacher’s perspective • Evaluation of SLO’sand teaching • Student Views • What we need to do next

3. Outcome Based Approaches in Tertiary Education University Grants Councilis promoting Outcome-based approached to teaching and learning and has set up a task force with 2 members from each UGC-funded institution.CUHK’s OBA plan was submitted to the UGC in April 2007 and noted by the senate committee on teaching and learning in June 2007 UGC initiative on OBA in higher education

4. The OBA Road-Map Each program/faculty is required to submit a “road-map” • Program Level descriptors of Outcomes • Analysis of the strengths and challenges faced in implementing • How the OBA has built into the 3-3-4 plan • Details of specific strategies • Prioritization of these strategies • Detailed proposal of the work • Clearly defined and described monitoring mechanisms • Plans for addressing the 2012 University entrance Senate Committee on Teaching and Learning, CUHK UGC initiative on OBA in higher education

5. SLO Task Force was set up - Develop or adopt a generic outcomes framework Generate,define,refine outcomes and their evaluation The OBA Road-Map A Teaching Development Grant was awarded to each Program/Faculty to support the development of the OBA -road map and to facilitate its implementation Kevin Mo Shekhar Kumta Teaching and Learning Resource Centre UGC initiative on OBA in higher education

6. A Learning Outcome Framework • A mechanism upon which to attach further information, which might include “where and how” learning outcomes are delivered in a curriculum, • together with descriptors of resources, including materials that might be shared. • A mechanism for curriculum analysis and development. Medical education is constantly evolving in response to developments in medicine and healthcare. Curriculum managers and developers can establish pathways for responding to such changes, which may be important for a single school, or mutually important for many schools.

7. The Scottish Doctor Consensus Statement - from 5 Scottish Medical Schools Medical Educational Reform Tomorrow’s Doctors GMC 1999 Recommendations and principles about teaching, learning and assessment, together with reference to the statutory framework and responsibilities that UK schools have in respect to delivering medical education The “Scottish Doctor” sets out to establish a consensus about the learning outcomes for undergraduate medical education in the five Scottish Schools, and to agree a common framework or cataloguing process.

8. Pillars I II III Understanding Professional Attitudes & Responsibility Required Knowledge Understanding & Clinical Skills Required Professional Skills & Personal Development D1 D7 D12 T1-10 T48-51 D2 T11-14 D8 D13 T52-59 Domains D3 T15-20 D9 T 75-77 T60-65 D4 T 78-80 T21-38 D10 T66-68 D5 T39-40 D11 T69-74 D6 T42-47

9. Pillars I II III Understanding Professional Attitudes & Responsibility Required Knowledge Understanding & Clinical Skills Required Professional Skills & Personal Development D1. Understanding processes in Basic, Social and Clinical Science D7. Medical Informatics D12. Meeting Theoretical and Legal Determinants D2. Demonstrating Clinical Skills D8. Decision Making Skills, Clinical Reasoning & Judgment D13. Personal Determinants Domains D3. Undertaking Patient Investigations D9. Communication Skills D4. Patient Management D10. Management Skills D5. Practical Procedures D11. The Role of the Doctor within Society D6. Health Promotion & Disease Prevention

10. Pillar 1: Required Knowledge, Understanding and Clinical Skills(Domain 1 Theme 1)

11. Outcomes - A Teacher’s Perspective What capabilities you want your students to acquire? Does the environment facilitate this goal ? Expectations Opportunity Performance Are they meeting specified targets ?

12. Learning Outcomes • Outcomes should be expressed in a form which enables learners to know at the commencement of a course what is it they are expected to achieve in relation to • Subject content • Skills • To what degree of proficiency Knowledge Capability The standard Think Core ! Expressing these in terms of student behaviors makes it easier for students and teachers to understand

13. Student feedback Written Material Handbook Outlines Review of Teaching Draft SLO’s Refined SLO’s Input from Teachers Coordinators Reference Texts Reviewed by Teachers SLO Evaluation SLO Framework Web-site How is our work-flow

14. Contextual statements of expected student behaviors in terms of knowledge, skills and attitudes, following the completion of a given clinical module • Orthopaedics • Surgery • Colorectal, CT-Surgery, PRS & Burns • A&E Medicine • Family Medicine • Anesthesia • Intensive Care

15. assess joint movements accurately**, • identify effusions and synovial hypertrophy, • detect joint instability*, • identify deformity and limb length discrepancy • evaluate the functional status of the extremity including gaitin a given patient………. } At graduation students are expected to be competent in musculoskeletal examination Competence in Musculoskeletal Examination ** Identify 5 degree loss of movement * Grade II or more

16. Generic statements of knowledge, skills and qualities expected in a graduate from the MBChB programme Surgery Medicine Course, module, panel, Year-wise outcomes II III IV V I Integrated Basic and clinical sciences Clinical modules

17. Pillars II III I D1 IV V II III I D2 Surgery D3 Integrated Basic and clinical sciences D4 Clinical modules D5 D6 Medicine Specify Outcomes at point of curriculum delivery Curricular mapping Themes Themes Themes

18. Pillar 3: Understanding Professional Attitudes and Responsibilities(Domain 12 Theme 75-77 / Domain 13 Theme 78-80) SLO web-site Search P3 D12 T-76

19. Contextual Outcomes Generic Framework Sincere Thanks to Jenny Fang, Raymond Chu and the MIT team Alex Yung of the Learning Resource Centre.

20. Pillar 1: Required Knowledge, Understanding and Clinical Skills(Domain 4 Theme 21 - 38)

21. Pillar 1: Required Knowledge, Understanding and Clinical Skills(Domain 5 Theme 39-41 / Domain 6 Theme 42-47) Search P1D5

22. Clinical reasoning Practical procedures Pillar Domain Theme

23. Examples of OBA in other medical schools

24. To evaluate basic cognitive, reasoning skills, and clinical aptitudes required of physicians entering medical practice in Canada Patient Presentation Model • Obtain pertinent information • Perform necessary physical examination • Order appropriate investigations • Arrive at a reasonable diagnosis • Formulate short and long term management plans Rationale ÷ objectives ÷ communication skills ÷ history ÷ examination ÷ investigations ÷ clinical decision making ÷ management skills ÷ health maintenance ÷ critical appraisal ÷ health economics ÷ law and ethics Objectives expressed in behavioral terms and reflect the council’s expectations of a competent physician in the supervised practice of medicine

25. } OSCE Short Cases Sample MCQ’s ITU Critical care Seriously Ill patient Respiratory failure Airway management & Obstruction COAD management Pnuemonia Knowledge History History Examination Examination Investigations Investigations Management

26. We can assist teachers! Help you express or refine outcome statements Help with a review of existing teaching outlines and stated objectives Help tie-in assessments to outcomes Enable you to gather evidence whether outcome expectations are indeed being met !

27. Blue Print Matrix for the MBChB Examination in Surgery - 2008 Examples of how assessments may be planned to evaluate SLO

29. SLO-Assessment linkage

30. SLO-Assessment linkage Rheumatoid Arthritis Given the history and presenting clinical features, of a typical patient with RA, students should be able to interpret radiographs to the extent that they can explain the underlying pathological process that results in joint destruction……

31. The next phase………. • I need your support • Will help you define & refine outcome statements • Will facilitate input onto the SLO framework • Outcome expectations must be communicated to students • We must solicit feedback - from S&T’s • Eventually outcomes need to be integrated into the teaching cycle - • teaching- outcome evaluation - realignment

32. New Outcome Based Initiatives • Concerns regarding student performance in Final Year exams • (2006-2007) • ECG interpretation skills • Radiographic interpretation skills • Particularly skeletal radiographs • Special investigations (CT, MRI) Interpretation = Reading (a skill) + Reasoning

33. Experience Novice Competent Expert Pattern Recognition Recognition primed decision making (RPD) • Distinguishes the expert from the novice • RPD enables intuitive decision making through the recognition of critical features. • Transition from competence to expertise may be hastened by training that targets the “recognition” aspect. • Recognition may be facilitated through the development of a systematic approach to the reading of radiographs, and ECG tracings • Decision making must be supported by clinical reasoning Training & deliberate practice

34. Outcome Expectations : Arrythmias and Life threatening Cardiac problems Students are expected to recognize STEMI and Non-STEMI on a 12-lead ECG & formulate an appropriate management plan But we do not want students to guess. Instead we want to encourage a systematic approach

35. Select the appropriate clinical management for that given clinical presentation Weekly ECG reading Quiz Med-3 and Med-5 students in Medicine-Cardiology Students to select appropriate items from a standard Checklist covers the essential components required for a proper reading of an ECG tracing FACS based Web-site Login is monitored

36. 306 Students 4480 logins - 20 cases January 1 , 2008 to September 1, 2008

37. Skeletal radiology 2 Training CD’s 1 Tutorial - 3 hours Pre-test Post-test Year 3/5 students are expected to interpret radiographs of patients presenting with common musculoskeletal complaints to a degree that are able to ……..Identify key anatomical landmarks Identify and describe the location and displacement of fractures Distinguish aggressive and non aggressive lesions………

38. Student feedback Teaching Expected outcomes Review of Teaching Outcome Evaluation Year -3 Year -5