obe from curriculum to instructional plan
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Outcome-Based Education: from Curriculum to
Instructional PlanningErlyn A. Sana, PhD
NTTCHP Interuniversity Workshop
Cherry Blossoms Hotel, May 7, 2014
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Background of OBE (Davis, 2003)
In the US, OBE had its roots in pre-university education. Reports were
appreciated that it was inappropriate to fix the time for study and
expect variable learning results from students. What was needed was
a uniform standard that all students would be expected to achieve
and that all would be given time to achieve.
The State Board of Education, Pennsylvania shifted to OBE in 1992.
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Pioneer OBE Schools
1. English National Board of Nursing, Midwifery and Health Visiting, 1991
2. Brown University, Rhode Island, 1996
3. Dundee Medical School, University of Dundee, Scotland, United
Kingdom, 1997
4. Association of American Medical Colleges, 1998
5. Accreditation Council for Graduate Medical Education, US, 1998
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Major references
World Health Organization, 2010; TransformativeScale up of Health Professional Education, 2011
Frenk, Chen, et al., 2010. Health Professionals for a new century. The Lancet, Vol. 376, pp.1923-58
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Other References
1. Harden, Crosby, and Davis. (1999). AMEE Guide No. 14: Outcome-based education: Part I. an introduction. Medical Teacher. Vol. 21, No. 1, pp. 7-14.
2. Smith & Dollase. (1999). AMEE Guide No. 14: Outcome-based education: Part 2: Planning, implementing, and evaluating a competency-based curriculum. Medical Teacher. Vol. 21, No. 1, pp. 15-21.
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Other References
3. Harden, Crosby, Davis, & Friedman. (1999). AMEE Guide No. 14: Outcome-based education. Part 5: From competency to meta-competency: a model for the specification of learning outcomes. Medical Teacher. Vol 21, No. 1, pp. 546-552.
4. Malan. (2000). The new paradigm of outcome-based education in perspective. Journal of Family Ecology and Consumer Sciences. Vol. 28, pp. 22-28.
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Other References
5. Davis. (2003). Outcome-based education. JVME. 30 (3). Pp 227-232.
6. Commission on Higher Education. CHED Memorandum Order No. 46, series of 2012.
7. CHED OBE Framework Implementing Guidelines, 2014.
8. Sana, Atienza, Abarquez, et al. (2010; 2013). Teaching and learning in the health sciences. Quezon City: UP Press.
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Session Objectives
1. Differentiate outcome-based education (OBE) from other curriculum tracks in health sciences education,
2. Explain the basic features, strengths, weaknesses, and organizational implications of OBE in the context of transformative learning,
3. Explain OBE framework in ones own curricular setting.
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General Steps in Curriculum Planning & Development (Sana, editor, 2010, 2013)
Educational Questions
1. Where are we now?
2. Where are we going?
3. How do we get there?
4. How do we know we
have arrived?
Educational Decisions1. Needs assessment
2. Formulation of curricular vision, goals, objectives
3. Selection of content, teaching-learning strategies, instructional resources
4. Evaluation
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Educational Decisions in Instructional Design Context
1. Needs assessment
2. Formulation of curricular vision, goals, objectives
3. Selection of content, teaching-learning strategies, instructional resources
4. Evaluation
Instructional Context1. Situational analysis: Curricular
goals, characteristics of teachers, leaners, resources, constraints
2. Session objectives for students to acquire
3. Topics, activities, instructional media
4. Assessment: blueprint, tests, measurement
Educational Decisions
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Comparison of the different curricula in the Health Sciences
Educational decisions Science-based curriculum(Frenk. Chen, et al, 2010)
Problem based(Gallagher & Gallagher, 2013)
Competency-based curriculum
(Peralta, 2013)
Needs assessment Purely based on the traditional sciences, disciplines
Based on common cases and problems encountered in professional practice
What society needs not only from one profession and HRH but also in terms of structures
Curricular objectives Science-based Identifying and solving problems, decision making
Competencies required by the professions
Content, teaching-learning activities, resources, etc
Theoretical, in large groups, teacher-centered
Integrated basic & clinical sciences, learning in small groups, student-led, problem-centered
Content based on institutional VMG, eclectic, systems approach, integrated
Evaluation Mainly by summative written examinations
Formative & summative, variety of ways
Formative & summative, varied but sometimes process-centered
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Statement of the problem
1. Glaring gaps & striking inequities in health persist between and
within countries,
2. Poor people in developing countries continue to have common
infections, malnutrition, and maternity-related health risks, which
have long been controlled in more affluent populations,
3. Mismatch of professional competencies to patient and population
priorities because of fragmentary, outdated, and static curricula
producing ill-equipped graduates from underfinanced institutions
Social
accountability
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Transformative Scale up of the Education of Health Professionals (WHO, 2011)
Driven and informed by population health needs,
transformative scale up means delivering
educational reforms that address not only the
quantity, but also the quality and relevance of
health care providers in order to achieve
improvements in population health outcomes.
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Key components of the educational system (Frenk, Chen, et al., 2010)
Institutional DesignSystemic levelStewardship & governanceFinancingResource generationService provision
Organizational levelOwnershipAffiliationInternal structure
Global levelStewardshipNetworks & partnerships
Structure
Instructional Design
Criteria for admissionCompetenciesChannelsCareer pathways
Process
ContextGlobal-Local
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Institutional Reforms1. Nurture a culture of critical
inquiry2. Establish joint planning
mechanisms3. Expand from academic
centers to academic systems
4. Link through networks, alliances, and consortia
Structure
Instructional Reforms1. Adopt a CBC (Lancet)
OBE (WHO)2. Promote inter-
professional & trans-professional education
3. Exploit the power of IT4. Harness global
resources and adapt locally
5. Strengthen educational resources
6. Promote new professionalism
Process
Reforms to transformative scale up of HPEd(GCSA, 2010, WHO, 2011, Frenk, Chen, et al., 2010)
Interdependence
in EducationTransformative
Learning
Proposed
outcomes
ContextGlobal-Local
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Refers to clearly focusing and organizing everything in the education system around what is essential for all students to be able to do successfully at the end of their learning experiences. This means starting with a clear picture of what is important for students to be able to do, then organising the curriculum, instruction and assessment to make sure that learning ultimately happens (Spady, 1994).
What is outcome-based education (OBE)?
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1. An approach to education in which decisions about the
curriculum are driven by the outcomes the students
should display by the end of the course.
2. The educational outcomes are clearly specified and serve
as bases in deciding on all other curricular elements.
OBE defined(Harden, Crosby, & Davis 1999)
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What is outcome-based education?
Educational decisions OBE
Needs assessment Multi-stakeholder consultations on what society, various industries, professions, and institutions require from their
personnel; transforming these into learning outcomes
Curricular objectives Conversion of LOs into competency standards, then reformulated as learning objectives
Content, teaching-learningactivities, resources, etc
Breakdown of these LOs, competency standards into specific subjects per year levels with own learning objectives; intensive use of simulations, practicum, on the job training, application of knowledge , skills, attitudes (KSA) to particular workplace contexts
Evaluation of achievement Formative & Summative assessments for students; regular monitoring and performance evaluation of teachers and schools, dissemination of results to stakeholders
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Basic differences between input- and outcome-based education paradigms
(CHED OBE Guidelines, 2014)
Dimension Input-Based (Instruction)
Paradigm
Learning (outcome-based)
paradigm
Vision and
purposes
Deliver instruction Produce learning
Criteria for
success
Quality of entering students
Quality & quantity of resources
Enrolment & revenue growth
Quality of exiting students Quantity & quality of
outcomes
Aggregate learning growth, efficiency
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Basic differences between input- and outcome-based education paradigms
Dimension Input-Based (Instruction)
Paradigm
Learning (outcome-based)
paradigm
Teaching-learning
structure
Classes start, end at same time
Per department/discipline End of course assessment Degree=accumulated credits
Learning held constant, time varies
Cross disciplines Pre-, during, post-course
assessment
Degree=demonstrated KSA
Learning theory Knowledge exists out there, comes in chunks
Learning is teacher-controlled
Knowlege exists in each persons mind & experience
Learner-centered
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Steps in developing OBE programs (Davis, 2003)
1. Identification of the type of health professional that the country needs
2. Identification of the outcomes of the educational process
3. Identification of curriculum content
4. Organization and sequencing of content
5. Identification of appropriate educational strategies
6. Identification of teaching methods
Higher Order Thinking Skills
(HOTS)=Culture of critical inquiry
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Steps in developing OBE programs (Davis, 2003)
7. Decisions on how the students will be assessed and the curriculum evaluated
8. The educational environment
9. Management and administration of the curriculum
10. Communication of the curriculum to all stakeholders.
Levels 1-4 (Kirkpatricks) Assessment &
Evaluation
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Framework of Outcome-Based Learning (CHED Implementation Handbook, 2014)
Institutional Vision, Mission, & Goals
Program Outcomes (Curriculum map)
Institutional Outcomes (Competencies of ideal graduates)
Course Outcomes
Assessment & evaluationLearning environment:
content & methodology
Teaching-learning systems
CourseDesign
Stan
dar
ds
and
De
man
ds
Social, e
nviro
nm
en
tal con
textDriven and informed by population health needs,
transformative scale up means delivering educational reforms that address not only the quantity, but also the
quality and relevance of health care providers in order to achieve improvements in population health outcomes.
(WHO, 2011)
Framework of Outcome-Based Learning, CHED Implementation Guidebook, 2014
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How pioneer schools developed their learning outcomes
English National Board of Nursing, Midwifery and Health Visiting, 1991
Brown University, Rhode Island, 1996
University of Dundee Medical School, United Kingdom, 1997
Association of American Medical Colleges, 1998
Accreditation Council for Graduate Medical Education, US, 1998
Multi-stakeholders consultation
Technical Working Groups, multi-stakeholders consultation and Delphi Technique
Recommended by the ACGME
Nominal group technique
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Criteria for specification of outcomes (Harden, Crosby, Davis, & Friedman, 1999)
1. Reflect the VMG of the institution
2. Are clear and unambiguous
3. Are specific and addressed defined areas of competence
4. Are manageable in terms of the number of outcomes
5. Are defined at an appropriate level of generality
6. Assist with development of enabling outcomes
7. Indicate the relationship between different outcomes
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Brown University(Smith & Dollase, 1999)
A. Type of doctor: Care provider, decision-maker, communicator, manager, community-minded
B. Learning outcomes:
1. Effective communication
2. Basic clinical skills
3. Using basic science in the practice of medicine
4. Diagnosis, management, and prevention
5. Lifelong learning
6. Self-awareness, self-care and personal growth
7. The social and community contexts of health care
8. Moral reasoning and clinical ethics
9. Problem solving
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Status of LOs in various health sciences (Technical Committees in HPEd)
1. Nursing: through the help of Dean Edna O. Imperial (ADPCN)
2. Pharmacy: through Dean Imelda G. Pena (PACOP)
3. Allied Medical Fields (OT, PT, SP): through Dean Cecille D. Licuan(DLSHSI)
4. Other fields: still in progress
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TCME Accomplishments (As of October 2013)
Type of doctor
1. General medical practitioner
2. Leader/manager
3. Researcher
4. Educator
5. Social advocate/mobilizer
Learning Outcomes1. Clinical competence
2. Communication skills
3. Management of research findings
4. Inter professionalism
5. Appreciation of systems approach to health care
6. Personal and continuing professional development
7. Adherence to professional and ethical practice
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Sample curriculum map of aCollege of Medicine
Vision:
Mission:
Goals:
Year level and courses
LO1 LO2 LO3 LO4 LO5 LO6 LO7
YL1 GE
YL1 Basic Sciences
YL1 Others
LO1:Clinical competence; LO2: Communication skills; LO3: Management of research findings; LO4: Inter
professionalism; LO5: Appreciation of the systems approach to health care; LO6: Personal & continuing
professional development; LO7: Adherence to professional & ethical practice
Scale: I: introduced; P: Practiced; D: Demonstrated
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Sample decision matrix of curriculum map of the College of Medicine (YL4)
Learning outcomes Introduced in
the course (I)
Practiced with
supervision (P)
Demonstrated without
supervision (D)
Decision
1. Clinical competence 2 10
2. Communication skills General: 10 General: 2 To patients: 12
3. Management of research
findings
10 2
4. Inter professionalism 1 2 9
5. Appreciation of systems
approach to health care
9 2 1
6. Personal & continuing professional development
3 9
7. Adherence to professional & ethical practice
12
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Philippine Qualification Standards
Level ofeducational qualification
Basic Education Technical/Vocational Education
Higher Education
8 Doctoral (PhD)
7 Post-baccalaureate
6 Bachelors
5 Diploma
4 NC IV
3 NC III
2 Grades 11-12 NC II
1 Grades 1-10 NC I
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ASEAN 2015: ASEAN Economic Community
Objectives: Build ASEAN as a:
1. Single market production base
2. Highly competitive economic region
3. Region of equitable economic development
4. Region fully integrated into the global economy
www.business-in-asia.com/asia/asean_economic_community.html
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Selected Professions that will be pilot tested in 2015 (ILO 2006)
Professional Expectations
Engineering Accountancy Medicine Dentistry Nursing Architecture
Autonomy
Responsibility & accountability
Complexity
Workplace environment
Choice and range of contingencies
Discretion and judgment
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Special Competencies that are expected in the 21st century education of the health
professionals
1. Evidence-based practice of the profession
2. Cultural competence (minimum of 6 units of foreign language and cultural studies in the new curriculum)
3. Information and communication technology
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Framework of Outcome-Based Learning (CHED Implementation Handbook, 2014)
Institutional Vision, Mission, & Goals
Program Outcomes (Curriculum map)
Institutional Outcomes (Competencies of ideal graduates)
Course Outcomes
Assessment & evaluationLearning environment:
content & methodology
Teaching-learning systems
CourseDesign
Stan
dar
ds
and
De
man
ds
Social, e
nviro
nm
en
tal con
text
Learner-centered
Experiential learning
Teacher as facilitator
Holistic Work based Quality standard
Framework of Outcome-Based Learning, CHED Implementation Guidebook, 2014
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Sample of outcome-based Lesson Plan (From Flexnerian Physiology Curriculum)
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Cognitive (Knowledge) Domain
Psychomotor (Skills) Domain
Affective (Attitudinal) Domain
Synthesis Origination Characterization
Evaluation Complex overt response Organization
Analysis Mechanism Valuing
Application Guided response
Comprehension Set Responding
Recall Perception Receiving
Institutional Reform
1. Nurture a culture of critical inquiry
Higher Order Thinking Skills (HOTS)
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Transformational Learning Theory (Mezirow, 1996)
1. A uniquely adult, abstract, idealized, and grounded in the nature of human communication.
2. It explains that learning is a process of using a prior interpretation to construe a new or revised interpretation of the meaning of ones experience in order to guide future action.
Institutional Reform
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Common themes of Transformational Learning Theory (Mezirow, 1996)
1. Centrality of experience
2. Critical reflection
3. Critical reflection of assumptions
Institutional Reform
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Common themes of Transformational Learning Theory (Mezirow, 1996)
1. Centrality of experience
2. Critical reflection
3. Critical reflection of
assumptions
Experience must be socially constructed to be deconstructed and acted upon.
Teachers may consciously disrupt the learners world view
Institutional Reform
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1. Centrality of experience
2. Critical reflection
3. Critical reflection of
assumptions
Distinguishing characteristic of adult learning
Reflection is the apperceptiveprocess by which we change our minds literally and figuratively.
Institutional Reform
Common themes of Transformational Learning Theory (Mezirow, 1996)
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1. Centrality of experience
2. Critical reflection
3. Critical reflection of
assumptions
Critical reflections of assumptions (CRAs) are critique of habits of the mind based on logical, ethical, ideological, social, economic, political, ecological, or spiritual aspects of experience underlying a problem defined by a learner.
Institutional Reform
Common themes of Transformational Learning Theory (Mezirow, 1996)
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1. Centrality of experience
2. Critical reflection
3. Critical reflection of
assumptions
Critical self-reflection of assumptions (CSRAs), are subjective reframing of a given view, and essential in developing perspective transformation.
Institutional Reform
Institutional Reform
Common themes of Transformational Learning
Theory (Mezirow, 1996)
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Learning Quadrants in Transformational Learning (Mezirow, 1978 cited by Atienza, 2013)
Disorienting Experience
Critical Reflection
ActionRational Dialogue
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Common themes of Transformational Learning Theory & Experiential Learning Cycle (Mezirow, 1996; Kolb, 1984)
Transformational learning Experiential learning cycle
Disorienting Experience
Critical Reflection
ActionRational Dialogue
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Reflections of students on their Community Drugstore and Hospital Pharmacy Internship Program
Written by Shiela Marie J. Nacabu-an, Faculty of UP College of Pharmacy
Thesis completed for the degree of Master of Health Professions Education, NTTCHP, UP Manila, 2014
Respondents: 36 3rd year BSPh students in Community Drugstore internship and 33 4th year BSPh students in Hospital Pharmacy rotation
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Transformative Learning Experiences of BSPhstudents during their Community Drugstore Internship
New constitution of common drugs like antibiotics
Dealing with Senior citizens Different roles of
pharmacists , eg, seldom counselling of patients
Reinforcement given by the preceptor
Continuous reflection as encouraged by logbooks and diaries
Exposure to all facets of community drugstores
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Transformative Learning Experiences of BSPhstudents during their Hospital Pharmacy Internship
Different roles of pharmacists in the hospital, eg conducive to patient counselling
Appreciating pharmacy as science with leadership role
Reconciling pharmacy in the classroom with hospital practice
Promotion of HOTS
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2. Establishment of joint planning mechanisms, (WHO, 2011; Frenk, et al., 2010)
Institutional Reform
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2. Establishment of joint planning mechanisms: The School of Health Sciences
Institutional Reform
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2. Establishment of joint planning mechanisms: The School of Health Sciences
Institutional Reform
Source: Destura, S. SHS Updates as of April 4, 2014
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3. Shift from academic centers to an academic system (WHO, 2011; Frenk, et al., 2010)
Institutional Reform
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3. Expansion from Academic Centres to Academic Systems
A new structure where products of the culture of critical inquiry are not just produced repeatedly, but also disseminated, enriched, and further shared with the public
Nurturing a culture of critical inquiry
Production of new knowledge, services,
technology, etc
TeachingResearchService
Intellectual PropertyResource Sharing
Institutional Reform
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4. Linkage through networks, alliances, & consortia
1. Partnerships among governments, civil society organizations, business, and media groups.
2. Activate the power of ICT to reach to the far flung areasTE
Govern-ments
Civil society
Business
Media
Other partners
Schools
Institutional Reform
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Vision for a new era of professional education (Frenk, Chen, et al., 2010)
Transformative
LearningInterdependence
in Education
Equity in Health
Individuals Population
Patient- based
centered
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