CURRICULUM DEVELOPMENT FOR MEDICAL EDUCATION This page intentionally left blank CURRICULUM DEVELOPMENT FOR MEDICAL EDUCATION A S I X - S T E P A P P R O A C H Third Edition Edited by Patricia A. Thomas, MD David E. Kern, MD, MPH Mark T. Hughes, MD, MA Belinda Y. Chen, MD The Johns Hopkins Faculty Development Program The Johns Hopkins University School of Medicine Baltimore, Maryland JOHNS HOPKINS UNIVERSITY PRESS | BALTIMORE © 1998, 2009, 2016 Johns Hopkins University Press All rights reserved. Published 2016 Printed in the United States of America on acid-free paper 2 4 6 8 9 7 5 3 1 Johns Hopkins University Press 2715 North Charles Street Baltimore, Maryland 21218-4363 www.press.jhu.edu Library of Congress Cataloging-in-Publication Data Curriculum development for medical education : a six-step approach / edited by Patricia A. Thomas, David E. Kern, Mark T. Hughes, Belinda Y. Chen. — Third edition. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4214-1851-3 (hardcover : alk. paper) — ISBN 1-4214-1851-7 (hardcover : alk. paper) — ISBN 978-1-4214-1852-0 (pbk. : alk. paper) — ISBN 1-4214-1852-5 (pbk. : alk. paper) — ISBN 978-1-4214-1853-7 (electronic) — ISBN 1-4214-1853-3 (electronic) I. Thomas, Patricia A. (Patricia Ann), 1950– , editor. II. Kern, David E., editor. III. Hughes, Mark T., editor. IV. Chen, Belinda Y., 1966– , editor. [DNLM: 1. Curriculum. 2. Education, Medical—methods. W 18] R834 610.71'173—dc23 2015008459 A catalog record for this book is available from the British Library. Special discounts are available for bulk purchases of this book. For more information, please contact Special Sales at 410-516-6936 or To the many faculty members who strive to improve medical education by developing, implementing, and evaluating curricula in the health sciences This page intentionally left blank Contents Preface ix List of Contributors xi Introduction Patricia A. Thomas and David E. Kern 1 One Overview: A Six-Step Approach to Curriculum Development David E. Kern 5 Two Step 1: Problem Identifcation and General Needs Assessment Eric B. Bass and Belinda Y. Chen 11 Three Step 2: Targeted Needs Assessment Mark T. Hughes 29 Four Step 3: Goals and Objectives Patricia A. Thomas 50 Five Step 4: Educational Strategies Patricia A. Thomas and Chadia N. Abras 65 Six Step 5: Implementation Mark T. Hughes 102 Seven Step 6: Evaluation and Feedback Brenessa M. Lindeman and Pamela A. Lipsett 121 Eight Curriculum Maintenance and Enhancement David E. Kern and Patricia A. Thomas 168 Nine Dissemination David E. Kern and Eric B. Bass 184 Ten Curriculum Development for Larger Programs Patricia A. Thomas 208 Appendix A Example Curricula 235 Essential Resuscitation Skills for Medical Students Julianna Jung and Nicole A. Shilkofski 236 viii Contents Teaching Internal Medicine Residents to Incorporate Prognosis in the Care of Older Patients with Multimorbidity Nancy L. Schoenborn and Matthew K. McNabney 246 Longitudinal Program in Curriculum Development David E. Kern and Belinda Y. Chen 257 Appendix B Curricular, Faculty Development, and Funding Resources Patricia A. Thomas and David E. Kern 273 Index 289 Preface Curriculum Development for Medical Education: A Six-Step Approach has been widely used by educators in the health professions for the past 17 years. Since its pub- lication, the editors have presented the model to medical educators in North America, as well as in Africa, Asia, the Middle East, and South America. The book has been translated into both Chinese and Japanese. Our assumption that medical educators would “beneft from learning a practical, generic, and timeless approach to curriculum development that can address today’s as well as tomorrow’s needs” has been sup- ported by the book’s readership and requests for related courses and workshops. Readers may question why a new edition was needed within fve years of the sec- ond edition. Unbeknownst to the editors at the time, the second edition was published at the dawn of a turbulent era in medical education. The past fve years have seen a wave of calls for reform, new accreditation standards, and regulatory guidelines, which are noted in the Introduction and are cited repeatedly in the third edition. The century- old paradigm of “2 + 2” basic science and clinical clerkship predoctoral model, the hos- pital-based residency model, and even discipline-based (e.g., medicine, nursing, and pharmacy) education have been challenged. As health care delivery is rapidly changing, there is wide consensus that medical education needs to adapt. In the United States, the triple aims of the Affordable Care Act—better health care access, higher quality, and lower cost—have become the goals of new competency-based frameworks. The sci- ence of learning has further matured with the partnering of cognitive science and neu- roscience; the implications of this understanding of learning have modifed approaches to education. Technology, in addition to its impact in health care delivery, has made information and learning more accessible worldwide with innovations such as massive open online courses (MOOCs) and the Kahn Academy. High-fdelity simulation and virtual reality for education and training have also become more robust and effcacious. These are just some of the changes driving unprecedented curriculum development and renewal across the medical education continuum. The editors chose three themes to emphasize in the latest revision of the book: competency-based education, including milestones and the entrustable professional activities (EPAs) as an assessment tool; interprofessional education; and educational technology. We have emphasized these themes within the presentation of the six steps as well as in the examples used to apply the concepts. Acknowledging the tremendous growth in medical education publication and dissemination, we especially researched the published literature for examples. References have been extensively updated. Several chapters deserve specifc mention. Chapter 2, Problem Identifcation and General Needs Assessment, incorporates the contemporary demands for change dis- cussed above. Chapter 3, Targeted Needs Assessment, includes more detail on how to increase response rates to surveys. Chapter 4, Goals and Objectives, has an elaborated discussion of competency-based education and integrates the concept of competency