EndCare – An Erasmus + Project17th/18th March, 2016

Prof Pierre Mallia

The Curriculumwhat we mean for

Erasmus

What is Erasmus+

• An EU programme for education and training

• Proposal therefore is not only discussion and teaching of bioethics issue.

• The proposal is to address the needs for particular groups (patients, doctors, nurses, trainers) in the implementation of accepted end of life care

• To understand problems and issues and to address them through a curriculum

Amongst outcomes

• Development of a curriculum for various categories.

• Academic output through articles, research, and book

• Final document

• Summer schools – these will be used as a learning experience throughout the 3-year period and then as a tool for the future

Suggested journals/publication houses

• MHEP

• IAEE

• Medical journals

• Elsevier/Kluwer

• Radcliff

Our Curriculumtowards a common understanding of what

we mean in this group

• Proposal to use UNESCO as a basis

• Day-release courses

• Curricula ‘evolve’ (McEvoy, P)

• Feedback from summer schools, plus

• Identification of problem areas and how to address

Curriculum is a process

• Defining goals

• Planning

• Implementing

• Reviewing

• Refining

• All these by subgroup

What it is

• A peculiar animal

• Lively understanding of underlying educational philosophy

• ‘this animal is versatile; it experiences growth and may be influenced by student feedback’

• Definition: Curriculum = method + content

• It is not only a syllabus (imparting the philosophy of end of life can be done in one hour – we are not re-inventing the wheel)

Student centredeness(and not teacher centredness)

• Assessment affects not just what is learned but how it is learned.

• ‘The purpose of learner-centred approach is to make learning as effective as possible’(Ibid.)

• Broad aims lend themselves better to formative assessment and learning processes which emphasize interaction

Implications of learner-centred approach

• Methods which are interactive

• Group learning

• Needs of individual (e.g. conflict nurses may fel with Doctor’s decision)

• ‘Hidden Curriculum’ (Neighbour, R.)

• Emphasise development of skills

• Expert input – to supplement

• Training group participates in assessment and feedback

Clinical Ethics

An interaction between:

• Bioethics / philosophy

• Medical knowledge

• Communication skills and conflict resolution

Also:

• Medical Leadership

• Law etc

Where does it comes from?

• At the base there is a theoretical layer (what we know)

• Strategic planning

• Aims to develop rather than perfect course from scratch

• A team activity – course organisers

• Mission statement

Mission statement (Weston, 1986)

• Aim

• To assist participants to improve their emotional and intellectual understanding of all aspects of whole-person medicine and how to practice it.

• Objective

• To reate a peer-learning community where emotional and intellectual learning can occur; to provide educational activities not available eslewhere; and to produce a curriculum based on the agreed needs of the participants.

What goes in? (Samuel, 1990b)

• Facts

• Factual learning (new material)

• ‘Knowledge is information that works’ (Neighbour, R.)

• Concepts• Self-responsibility

• Respect for patient autonomy

• Ability to respond with empathy to patients’ needs

• Values• No such thing as value-free medicine (Samuel)

• Foster values that are appropriate (Aim of this project)

• Personal discovery about beliefs

Note on objectives

• Aims are things you can’t measure. Objectives are things you can measure. (Grundlund, 1978)

• Objectives are measured as OUTCOMES

• Finite manageable objectives

• That doctors and nurses are able to understand the moral teachings of their culture with regard to end-of-life management, including futile treatment, extraordinary treatment etc

• That HCPs meet the needs of patients and families and communicate in time

• That conflict amongst HCPs is tackled with good Medical Leadership skills

• That stakeholder groups understand needs and outcomes (spiritual advisors, patients, politicians(

Trainers’ workshop

• Important process in the curriculum development

• Identify learning areas and tasks

• Discussion of needs which come out of day-release courses

• Trainers should take part in day-release courses as resource persons

• To learn facilitative rather than didactic learning

Evaluation cycle

• What did the learners think of it?

• What did I think of it?

• What did the resource person think of it?

• Was it worth it?

• What should be done differently next time?

• How valid are the responses to these questions (trainees may suppress feelings to avoid conflict). More valid by specific questions:

• Identify two things you learned from today’s presentation

• In what way o you feel differently towards…?

• In what way will today’s presentation influence your actions

Concluding guidelines (McEvoy)

• Where possible, the curriculum should:

• Be learner sensitive

• Sample the curriculum rather than cover it

• Explore knowledge concepts and values

• Have a statements of aims and objectives and assessment methods

• Variety of educational methods

• Be participatory (involving preparation and presentation)

• Involve resource persons who are well briefed about their role and the methods being used.

Thank You