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Mapping a medical curriculum using a learning objectives database - Lessons learned at the University of Munich

Mapping a medical curriculum using a learning objectives database - Lessons learned at the... A curriculum map gives an overall overview about a curriculum and what is taught where, when and how. At the medical faculty of the Ludwig-Maximilians-University in Munich (LMU) a curriculum mapping tool based on learning objectives was introduced some years ago. Since that time teachers could document the learning objectives of their courses in a standardised way. In this article we describe the status quo of our efforts and the challenges to implement such learning-objective-based curriculum map that reflects the overall curriculum at our faculty. KEYWORDS: Learning Objectives, Curriculum Mapping, Curriculum Mapping Tool Background A curriculum mapping is a process by which teachers document their courses and then share and examine their curricula for gaps, overlaps and redundancies [1]. Curriculum mapping is an increasingly used tool in undergraduate and postgraduate medical education. For example the medical faculty of the University of Columbia implemented a curriculum map for the internal medicine residency based on topics and examination objectives [2]. The University of Arizona College of Pharmacy developed a graphical curriculum map and examined concordance of the intended, delivered and received curriculum [3]. Also the AAMC Curriculum Management & Information Tool (CurrMIT) provides a database tool for all medical schools in the US and Canada containing curriculum information such as objectives, resources and teaching methods [4]. This database is used by Medical Schools like for example the West Virginia University School of Medicine to create a map of their curriculum [5]. At the medical faculty of the Ludwig-Maximilians-University in Munich (LMU) despite many successful efforts of curricular reformation and modernization at the during recent years there was no curriculum map available and learning objectives were still collected heterogeneously or not collected at all. If they were captured and made public, the technical and didactical format and granularity varied and there was no standardization. For many resources, such as E-learning materials, that were embedded into the curriculum, there were no learning objectives assigned. Also, the learning objectives assessed in an exam were often not documented and not correlated to the objectives taught in the courses. This made it almost impossible to get an overall overview about the curriculum and assess what was taught where, when and how - information that can be retrieved from a curriculum map [6]. To overcome this problem and build a curriculum map a web-based learning objectives database to collect and publish the learning objectives of the curriculum and build a curriculum map was introduced some years ago[7]. This tool enables teachers to enter and publish their learning objectives and prerequisites which can be connected to catalogue entries of standard learning objectives catalogues (e.g. Swiss catalogue of learning objectives [8]) and assign those to their courses. Using this standardization of including catalogues allows analysis of the curriculum based on these catalogues. Conclusions about inconsistencies or non-covered learning objectives can be drawn. A pilot study has been conducted in occupational medicine that went along with a curricular change [9]. It revealed that the database is a useful tool to create a curriculum map and analyse it. It provided a useful medium to start discussion among teachers about the curriculum. The collaboration with the involved teachers was fruitful and they were interested and highly motivated. Thus, the next step was the integration of the tool and the workflow of collecting learning objectives in a standardized way into the curricular routine. In the following we describe the current status of our curriculum mapping process and our experiences when introducing the software into the curricular routine and how we further adapted it to meet the needs of the users. Methods and Results During the introduction of the database teachers were informed and tutorials were offered to train them and their staff members on how to enter the learning objectives for their courses. During the first months after the introduction the collection of learning objectives made good progress, many teachers hired student assistants to help them enter their data. However afterwards this tool was rarely used and the learning objectives have almost never been updated since then. As a result of a survey among teachers and students who used it, complaints were expressed especially about the complexity of the user interface and functionalities. A following Delphi driven process among faculty staff and students representatives revealed a detailed list of deficiencies and feature requests. These request were discussed and prioritized by an interdisciplinary committee and the implementation details were decided. According to the requests of faculty staff and students the tool was reimplemented and adapted in terms of didactical concept, data structure, layout and navigation. The change of the data structure made it possible to simplify the analysing functionality. Concept/Data structure The concept of the database and the data structure were simplified compared to the first version, due to the fact that teachers complained about high complexity. It is still based on a three-layer model of learning opportunities such as lectures or seminars, learning objectives and catalogue entries, but most of the parameters, such as a classification of learning objectives into core/optional were removed. On the other hand we introduced, in addition to exams and face-to-face learning opportunities the assignment of any other kind of teaching material with learning objectives. For example virtual patients, podcasts or teaching videos. Apart from the curricular courses, self-study becomes more and more important for students for example in the context of problem-based (PBL) courses. Therefor we also explicitly enable the capturing of learning objectives that the learners have to learn in self study. Figure 1. Exemplary structure of the connection between learning opportunities (a seminar and a virtual patient), the learning objectives and the catalogue entries. Accessibility/Navigation The learning objectives are accessible through the learning management system Moodle [10] which provides all teaching materials for the students. Users can access the learning objectives from each course in Moodle without having to login again. To display the learning objectives the graph is converted into a tree model (see Figure 2). Figure 2. Screenshot of user interface of learning objectives database. Teacher's view with buttons for adding, editing and deleting. The user interface allows also the pdf download of the learning objectives for a course or a semester. A search function allows searching for one or more search terms over all nodes. The layout has been completely redesigned by a web designer to meet the suggestions made by teachers and students. Technical implementation As underlying data structure the curriculum is modelled as a directed graph. The nodes represent the learning opportunities, learning objectives and catalogue entries. The directed edges represent the connections between learning opportunities and learning objectives and learning objectives and catalogue entries. The direction gives information about whether a learning objective is a prerequisite of a course/exam or is taught during this course. The search functionality that has been implemented is Lucene [11] based, the SingleSignOn interface is based on the SCORM activity in Moodle. The modelling of the curriculum map as a directed graph allows curriculum planers to analyse the curriculum and identify gaps, overlaps, discrepancy between teaching and assessment and timing inconsistencies. This analysis is based on the edges to the catalogue entries. The graph can be exported in formats (e.g. as geography markup language - gml) that can be imported into graphical representation and analysing tools, such as Gephi [12]. This updated version of the database has been introduced for winter term 2011/12 and made available to all students and teachers. Currently 3300 learning objective (=nodes) with 2404 connections (=edges) to catalogue entries have been entered. 670 of these learning objectives have no connection to a catalogue entry, 2530 have a mean value of 1.1 assigned catalogue entries. The learning objectives are assigned to 218 face-to-face learning opportunities (about 30% of all curricular face-to-face activities) and 90 E-learning resources. The learning objectives have been written by the teachers themselves. For the curriculum map this means that it reflects the declared curriculum - what is assumed that the students learn [6]. Despite the complete remodelling of the database the acceptance of teachers in using the database and entering their learning objectives is still low. Discussion The curriculum map composed in the described way can be used in various scenarios. First of all it represents the curricular structure and can support and document curricular changes and enhance discussion about the curriculum among faculty members and students. Also it gives learners an overview about was is taught where, when and how as described by Harden [6]. In a next step this would allow them to choose their favourite method of teaching, if learning objectives are covered in different courses or materials. Other usage scenarios could be to use the database to extract core areas of a curriculum or even to compare curricula with each other, similar to the approach the CurrMit database offers [4]. However, an important prerequisite for this would be a complete and up to date representation of the learning objectives of the curriculum, including the connections to the catalogue entries. For content domains in which no standard catalogue exists this tool could provide the basis to build up such a catalogue. The current data show that the learning objectives often have not been connected to any catalogue entry, which makes it impossible to analyse. One can discuss about the need for entering learning objectives, instead of assigning catalogue entries directly to learning opportunities, which would reduce some of the complexity of the tool. At the current stage for our setting we are reluctant to allow this, because it would require a catalogue that is self-explaining and detailed enough to enable students to understand what they are expected to learn. For the catalogues integrated for our curriculum this is not the case. However, the development of a German national catalogue, which would meet these requirements and could make the selfentered learning objectives obsolete, is under development [13]. This would also mean a major time saving for teachers. And it would also make it obsolete to solve problems like the heterogeneous granularity of entered learning objectives or privileges of who can edit or update the learning objectives, that have been entered. Despite the involvement of staff and students in the development process and the adaption to the teachers' needs as suggested by Harden [6], the acceptance to use this tool is still low in many content domains. So far, the reasons remain unknown and need to be further assessed. However, our experience showed that for courses where many teachers are involved without a responsible head of staff, the collecting of learning objectives becomes more difficult. This is in accordance with Hardens recommendation that there should be an academic leader who coordinates the mapping process. Harden also mentions that teachers might find such a curriculum map threatening because of its complexity and they may see it as a threat to their autonomy [6]. Outlook The next steps to enhance acceptance of faculty staff were discussed in a faculty meeting and it was decided that the 6 heads of content domains will be responsible for the collecting of learning objectives. There will be another offer for training and student staff will made available to support teachers. The aim is to have collected all learning objectives before the start of the next term. A curriculum map is a dynamic, ever changing document that needs to be updated regularly to reflect curricular changes [1]. Therefore teachers will be reminded twice a year to check their learning objectives and update them if necessary. Apart from that a feedback system for students will be introduced, so that they can comment on the learning objectives assigned to a course. This will give them the opportunity to give feedback about whether the learning objectives have been covered in the way it was indicated by the teacher. An indicator of potential differences between the taught and the tested curriculum - what students actually learn - can be the mapping of the taught and assessed learning objectives taking also into account the test results of the students. Summary Many efforts, such as developing and adapting a web-based database for learning objectives, have been undertaken to map the curriculum at the Medical faculty of the LMU in Munich during the recent years. However, there are still challenges to face like defining the granularity of entries or the reluctance of some teachers. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Bio-Algorithms and Med-Systems de Gruyter

Mapping a medical curriculum using a learning objectives database - Lessons learned at the University of Munich

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Publisher
de Gruyter
Copyright
Copyright © 2012 by the
ISSN
1895-9091
eISSN
1896-530X
DOI
10.2478/bams-2012-0020
Publisher site
See Article on Publisher Site

Abstract

A curriculum map gives an overall overview about a curriculum and what is taught where, when and how. At the medical faculty of the Ludwig-Maximilians-University in Munich (LMU) a curriculum mapping tool based on learning objectives was introduced some years ago. Since that time teachers could document the learning objectives of their courses in a standardised way. In this article we describe the status quo of our efforts and the challenges to implement such learning-objective-based curriculum map that reflects the overall curriculum at our faculty. KEYWORDS: Learning Objectives, Curriculum Mapping, Curriculum Mapping Tool Background A curriculum mapping is a process by which teachers document their courses and then share and examine their curricula for gaps, overlaps and redundancies [1]. Curriculum mapping is an increasingly used tool in undergraduate and postgraduate medical education. For example the medical faculty of the University of Columbia implemented a curriculum map for the internal medicine residency based on topics and examination objectives [2]. The University of Arizona College of Pharmacy developed a graphical curriculum map and examined concordance of the intended, delivered and received curriculum [3]. Also the AAMC Curriculum Management & Information Tool (CurrMIT) provides a database tool for all medical schools in the US and Canada containing curriculum information such as objectives, resources and teaching methods [4]. This database is used by Medical Schools like for example the West Virginia University School of Medicine to create a map of their curriculum [5]. At the medical faculty of the Ludwig-Maximilians-University in Munich (LMU) despite many successful efforts of curricular reformation and modernization at the during recent years there was no curriculum map available and learning objectives were still collected heterogeneously or not collected at all. If they were captured and made public, the technical and didactical format and granularity varied and there was no standardization. For many resources, such as E-learning materials, that were embedded into the curriculum, there were no learning objectives assigned. Also, the learning objectives assessed in an exam were often not documented and not correlated to the objectives taught in the courses. This made it almost impossible to get an overall overview about the curriculum and assess what was taught where, when and how - information that can be retrieved from a curriculum map [6]. To overcome this problem and build a curriculum map a web-based learning objectives database to collect and publish the learning objectives of the curriculum and build a curriculum map was introduced some years ago[7]. This tool enables teachers to enter and publish their learning objectives and prerequisites which can be connected to catalogue entries of standard learning objectives catalogues (e.g. Swiss catalogue of learning objectives [8]) and assign those to their courses. Using this standardization of including catalogues allows analysis of the curriculum based on these catalogues. Conclusions about inconsistencies or non-covered learning objectives can be drawn. A pilot study has been conducted in occupational medicine that went along with a curricular change [9]. It revealed that the database is a useful tool to create a curriculum map and analyse it. It provided a useful medium to start discussion among teachers about the curriculum. The collaboration with the involved teachers was fruitful and they were interested and highly motivated. Thus, the next step was the integration of the tool and the workflow of collecting learning objectives in a standardized way into the curricular routine. In the following we describe the current status of our curriculum mapping process and our experiences when introducing the software into the curricular routine and how we further adapted it to meet the needs of the users. Methods and Results During the introduction of the database teachers were informed and tutorials were offered to train them and their staff members on how to enter the learning objectives for their courses. During the first months after the introduction the collection of learning objectives made good progress, many teachers hired student assistants to help them enter their data. However afterwards this tool was rarely used and the learning objectives have almost never been updated since then. As a result of a survey among teachers and students who used it, complaints were expressed especially about the complexity of the user interface and functionalities. A following Delphi driven process among faculty staff and students representatives revealed a detailed list of deficiencies and feature requests. These request were discussed and prioritized by an interdisciplinary committee and the implementation details were decided. According to the requests of faculty staff and students the tool was reimplemented and adapted in terms of didactical concept, data structure, layout and navigation. The change of the data structure made it possible to simplify the analysing functionality. Concept/Data structure The concept of the database and the data structure were simplified compared to the first version, due to the fact that teachers complained about high complexity. It is still based on a three-layer model of learning opportunities such as lectures or seminars, learning objectives and catalogue entries, but most of the parameters, such as a classification of learning objectives into core/optional were removed. On the other hand we introduced, in addition to exams and face-to-face learning opportunities the assignment of any other kind of teaching material with learning objectives. For example virtual patients, podcasts or teaching videos. Apart from the curricular courses, self-study becomes more and more important for students for example in the context of problem-based (PBL) courses. Therefor we also explicitly enable the capturing of learning objectives that the learners have to learn in self study. Figure 1. Exemplary structure of the connection between learning opportunities (a seminar and a virtual patient), the learning objectives and the catalogue entries. Accessibility/Navigation The learning objectives are accessible through the learning management system Moodle [10] which provides all teaching materials for the students. Users can access the learning objectives from each course in Moodle without having to login again. To display the learning objectives the graph is converted into a tree model (see Figure 2). Figure 2. Screenshot of user interface of learning objectives database. Teacher's view with buttons for adding, editing and deleting. The user interface allows also the pdf download of the learning objectives for a course or a semester. A search function allows searching for one or more search terms over all nodes. The layout has been completely redesigned by a web designer to meet the suggestions made by teachers and students. Technical implementation As underlying data structure the curriculum is modelled as a directed graph. The nodes represent the learning opportunities, learning objectives and catalogue entries. The directed edges represent the connections between learning opportunities and learning objectives and learning objectives and catalogue entries. The direction gives information about whether a learning objective is a prerequisite of a course/exam or is taught during this course. The search functionality that has been implemented is Lucene [11] based, the SingleSignOn interface is based on the SCORM activity in Moodle. The modelling of the curriculum map as a directed graph allows curriculum planers to analyse the curriculum and identify gaps, overlaps, discrepancy between teaching and assessment and timing inconsistencies. This analysis is based on the edges to the catalogue entries. The graph can be exported in formats (e.g. as geography markup language - gml) that can be imported into graphical representation and analysing tools, such as Gephi [12]. This updated version of the database has been introduced for winter term 2011/12 and made available to all students and teachers. Currently 3300 learning objective (=nodes) with 2404 connections (=edges) to catalogue entries have been entered. 670 of these learning objectives have no connection to a catalogue entry, 2530 have a mean value of 1.1 assigned catalogue entries. The learning objectives are assigned to 218 face-to-face learning opportunities (about 30% of all curricular face-to-face activities) and 90 E-learning resources. The learning objectives have been written by the teachers themselves. For the curriculum map this means that it reflects the declared curriculum - what is assumed that the students learn [6]. Despite the complete remodelling of the database the acceptance of teachers in using the database and entering their learning objectives is still low. Discussion The curriculum map composed in the described way can be used in various scenarios. First of all it represents the curricular structure and can support and document curricular changes and enhance discussion about the curriculum among faculty members and students. Also it gives learners an overview about was is taught where, when and how as described by Harden [6]. In a next step this would allow them to choose their favourite method of teaching, if learning objectives are covered in different courses or materials. Other usage scenarios could be to use the database to extract core areas of a curriculum or even to compare curricula with each other, similar to the approach the CurrMit database offers [4]. However, an important prerequisite for this would be a complete and up to date representation of the learning objectives of the curriculum, including the connections to the catalogue entries. For content domains in which no standard catalogue exists this tool could provide the basis to build up such a catalogue. The current data show that the learning objectives often have not been connected to any catalogue entry, which makes it impossible to analyse. One can discuss about the need for entering learning objectives, instead of assigning catalogue entries directly to learning opportunities, which would reduce some of the complexity of the tool. At the current stage for our setting we are reluctant to allow this, because it would require a catalogue that is self-explaining and detailed enough to enable students to understand what they are expected to learn. For the catalogues integrated for our curriculum this is not the case. However, the development of a German national catalogue, which would meet these requirements and could make the selfentered learning objectives obsolete, is under development [13]. This would also mean a major time saving for teachers. And it would also make it obsolete to solve problems like the heterogeneous granularity of entered learning objectives or privileges of who can edit or update the learning objectives, that have been entered. Despite the involvement of staff and students in the development process and the adaption to the teachers' needs as suggested by Harden [6], the acceptance to use this tool is still low in many content domains. So far, the reasons remain unknown and need to be further assessed. However, our experience showed that for courses where many teachers are involved without a responsible head of staff, the collecting of learning objectives becomes more difficult. This is in accordance with Hardens recommendation that there should be an academic leader who coordinates the mapping process. Harden also mentions that teachers might find such a curriculum map threatening because of its complexity and they may see it as a threat to their autonomy [6]. Outlook The next steps to enhance acceptance of faculty staff were discussed in a faculty meeting and it was decided that the 6 heads of content domains will be responsible for the collecting of learning objectives. There will be another offer for training and student staff will made available to support teachers. The aim is to have collected all learning objectives before the start of the next term. A curriculum map is a dynamic, ever changing document that needs to be updated regularly to reflect curricular changes [1]. Therefore teachers will be reminded twice a year to check their learning objectives and update them if necessary. Apart from that a feedback system for students will be introduced, so that they can comment on the learning objectives assigned to a course. This will give them the opportunity to give feedback about whether the learning objectives have been covered in the way it was indicated by the teacher. An indicator of potential differences between the taught and the tested curriculum - what students actually learn - can be the mapping of the taught and assessed learning objectives taking also into account the test results of the students. Summary Many efforts, such as developing and adapting a web-based database for learning objectives, have been undertaken to map the curriculum at the Medical faculty of the LMU in Munich during the recent years. However, there are still challenges to face like defining the granularity of entries or the reluctance of some teachers.

Journal

Bio-Algorithms and Med-Systemsde Gruyter

Published: Jan 1, 2012

There are no references for this article.