Introduction[edit | edit source]
Practical components of the curriculum include the learning domains, objectives, assessments, learning activities and instructional delivery methods.
The curricular plan should address diverse topics to encompass all elements of a profession. Organizations have created educational frameworks that can be used as a guide. Here, we will describe three examples of frameworks including the World Health Organization’s Rehabilitation Competency Framework, the World Physiotherapist Education Framework, and the Canadian Alliance for Speech Language Pathologists. The educational models are similar in that they all cover the diverse responsibilities of a rehabilitation professional, which must be considered to ensure the curriculum is sufficiently comprehensive. The following sections represent the summary of curriculum components from around these frameworks with their salient features. You can review the standards used to create this summary in the Sources Section below.
Educational Frameworks[edit | edit source]
World Health Organization[edit | edit source]
The World Health Organization’s Rehabilitation Competency Framework organizes learning domains into five categories: Practice, Research, Management and Leadership, Learning and Development, and Professionalism. Practice includes activities necessary for establishing working relationships, clinical assessments, planning rehabilitation, delivering interventions, communication and decision making. Research includes generation, dissemination, and integration of research. Management and leadership includes teamwork, strategic thinking, management, service development and evaluation, and resource management. Learning and Development includes professional development of a rehabilitation worker. Professionalism includes professional integrity, collaboration, safety and quality of care that enable a professional role. This framework is useful because it thoughtfully encompasses the unique roles and responsibilities of a rehabilitation provider regardless of type of rehabilitation professional and practice setting.
World Physiotherapist Education[edit | edit source]
Professional associations also have educational frameworks such as the World Physiotherapist Educational framework. The domains in the World physiotherapy education system include physiotherapy assessment and intervention, ethical and professional practice, communication, evidence-based practice, interprofessional teamwork, reflective practice and lifelong learning, quality improvement, and leadership and management.
Canadian Alliance for Speech Language Pathologists[edit | edit source]
National Health Systems such as the Canadian Alliance of Audiologist and Speech Language Pathologist Created the National Speech-Language Pathology Competency Profile. The learning domains in the Canadian educational system include the roles of the expert clinician, communication, collaboration, advocacy, scholarship, manager and professional. Each of these frameworks have competencies written within the domains that can be used as a starting point for writing learning objectives.
Learning Objectives[edit | edit source]
Learning objectives are a critical element of the curriculum. Learning objectives guide instructors to formulate assessment procedures, learning activities, and teaching strategies. Learning objectives should have 4 elements: audience, behavior, condition and degree. The first part, the audience is the student, but the level of the student should be considered.
The second part, the behavioral component, should be selected carefully according to the domain of learning (cognitive, psychomotor, and affective) and the hierarchy of learning (i.e.: knowledge, application, and synthesis). Benjamin Bloom created a tool for educators called Bloom’s Taxonomy of Educational Objectives which is a classification tool that organizes student expectations or behaviors into levels of learning. This tool has been revised and updated, but the hierarchy of learning remains consistent across the models. The domain of learning, in the learning objective, guides the instructor to the manner in which the student will be assessed. If the behavior in the learning objective is “Identifies”, then it follows that the student could be assessed with a multiple choice examination. If the behavior in the learning objective is “Compares”, then the assessment will probably have to be a short answer or essay response. If the behaviors is “conduct a clinical evaluation”, then the student should be assessed with a performance based assessment. If the behavior in the learning objective is in the affective domain such as “appreciates”, then the assessment will likely need to be a reflection or discussion to convey the appreciation. Aligning the assessment procedures to the learning objectives ensures that the student’s are evaluated in a planned manner . The third part of a learning objective, the condition refers to the setting or environment the learner is expected to perform. This most common settings that students would perform include classroom, clinical and community settings. Identifying the setting is useful because this guides the instructors and students on where practice should take place.
Finally, the last part of the learning objective, the degree guides the reader to the expected level the student will perform. It is likely that a first year student would need a lot of support and supervision from a clinical supervisor or instructor, whereas a student in their final year could perform with much greater independence. Scales of independence have been described using percentage of support from an instructor (75% support, 50% support, or 25% support). Recently scales of entrustment have been developed. These scales range from level 1 (in collaboration with a supervisor) to level 3 (with supervision available and being double-checked) to highest level 6 (autonomous with remote monitoring) . Creating learning objectives that have all four elements: audience, behavior, condition and degree guides the instructor to formulate assessment procedures, learning activities, and teaching strategies.
Assessments[edit | edit source]
Assessments can be categorized into two types: summative and formative evaluations. It is important to distinguish between these two categories because they have different purposes. Summative assessments are designed to measure student learning. Summative assessments usually occur at the end of a course, clinical experience or program. Summative assessments are useful indicators on the effectiveness of the instruction. Formative assessments are designed to guide student learning. They can be useful to the learner because they can direct the student on gaps in knowledge and readiness to progress to new levels of learning. Assessments can also be categorized according to the domain of learning: Cognitive, Psychomotor, and Affective domain; where cognitive domain is the understanding of information, psychomotor domain is the performance of a skill, and affective domain is the emotional aspect of learning. Assessments in the cognitive domain often include reading, writing and speaking. Examples of assessments include multiple choice examinations, essays, and presentations . Assessments in the psychomotor domain are performance based and can include skill checks, practical examinations, and objective structured clinical examinations (OSCI). Affective domain assessments are often the most challenging to create. Assessments in the affective domain can include reflections, participation in discussions, or presentation of several reflective activities.
Learning activities and teaching strategies[edit | edit source]
The learning activities and teaching strategies should be designed to prepare the student for the assessment, and hopefully the assessments are aligned with the learning objectives. Learning activities should incorporate authentic practice opportunities with feedback on student performance. Learning activities that incorporate the authentic experience have much greater student engagement. For students in rehabilitation education programs, the most authentic experience is serving clients in a professional way with supervision. Inviting clients to participate in classroom activities can be challenging for instructors. Other options of authentic experiences can include using a video recording of a patient client interaction or simply creating a written case. Instructors can add authenticity to these learning activities by recording an actual session of a rehabilitation provider with a client or writing a clinical case using organization structure consistent with documentation systems. Selecting learning activities that allow students to practice roles of the professional in an authentic way, enhances student engagement.
Learning activities can be structured using a scaffolding technique. Scaffolding is when the teacher creates a structure to organize a more complex topic. This can help the student keep complex topics organized when applying information. In rehabilitation education, the most common scaffolding technique is the therapy examination form. The student-examiner is instructed to perform an examination, and uses the form as a guide to remember to ask about the medical history, perform screening tools, and gather specific examination data. The idea is to help organize the student’s performance into a structure. Using this strategy, teachers can create forms or tools for students to use when applying information.
Learning activities are most useful when the student receives feedback on their performance. Feedback allows the student to adjust their performance during the learning process. Feedback can take multiple forms including low stakes quizzes, interactive games where students must quickly recall answers, or discussions of complex cases. Answering incorrectly can guide students to their learning gaps or errors in thinking. In team based learning, students practice recall of information on an individual quiz called an individual readiness assurance test, then the students have the opportunity to collaborate on the same test as a team. Allowing the students to collaborate in this way, allows students to participate in peer instruction. The key to this type of learning is the immediate feedback and clarification by the instructor to correct errors in thinking. In a similar way, the Master Adaptive Learner uses the learning steps of plan, learn, assess, and adjust. During the assessment phase, the emphasis is on feedback provided to the learner. This is crucial to allow the learner to adjust their performance to become safe, effective, and efficient.
Instructional Methods[edit | edit source]
Instructional methods can vary from instructor focused (objectivist approaches using lectures or reading to gain knowledge), to student focused (constructivist and connectivism where students use inquiry based learning strategies to gain knowledge). Aligning the instructional technique to the topic can be determined based on the amount of student time allotted to the topic, number of acceptable answers within the topic, and amount of clinical reasoning required in the professional.
Topics that have a limited amount of student time, number of acceptable answers and clinical reasoning align well with direct instruction techniques such as listening, observing, and reading. Topics that have more time, diversity of acceptable answers, and require clinical reasoning in the profession align with student inquiry based learning such as problem based learning, team based learning, and case based learning.
Instructor delivery methods can vary from in person learning, distance based learning, and hybrid education. In person learning is the most common form of instruction, but this type of instruction requires access to individuals with specific expertise. For programs that have a gap in expertise, it may be useful to consider distance based or hybrid education as an alternative. Distance based learning usually relies on both an independent learning activity combined with a virtual meeting (using technology) to provide students with an opportunity for clarification with the instructor. The independent learning activity can include reading, listening to a recorded lecture, observing a healthcare provider, or practicing skills with a peer. The independent learning activity is important, because the time with the instructor is limited and valuable. This allows most of the instructor’s time to be spent clarifying concepts from the learning activity. Hybrid education incorporates the benefits of both distance based learning and in person learning. In hybrid education, there is a combination of independent learning, virtual meetings, followed with an in person learning activity.
Sources[edit | edit source]
- Bloom B Taxonomy of Educational Objectives.
- A Taxonomy for Learning, Teaching, and Assessing: A Revision of Bloom's Taxonomy of Educational Objectives.
- Exploring the introduction of entrustment rating scales in an existing objective structured clinical examination.
- A systematic review of the factors–enablers and barriers–affecting e-learning in health sciences education.
References[edit | edit source]
- Larkin BG, Burton KJ. Evaluating a case study using Bloom's Taxonomy of Education. AORN J. 2008 Sep;88(3):390-402.doi: 10.1016/j.aorn.2008.04.020. PMID: 18790101.
- Bloom B Taxonomy of Educational Objectives. New York, NY: Longman; 1956.
- Anderson LW, Krathwohl DR, Airasian PW, et al. A Taxonomy for Learning, Teaching, and Assessing: A Revision of Bloom's Taxonomy of Educational Objectives. New York, NY: Addison Wesley Longman; 2001.
- Holzhausen Y, Maaz A, März M, Sehy V, Peters H. Exploring the introduction of entrustment rating scales in an existing objective structured clinical examination. BMC Medical Education. 2019 Dec;19:1-9.
- Regmi K, Jones L. A systematic review of the factors–enablers and barriers–affecting e-learning in health sciences education. BMC medical education. 2020 Dec;20(1):1-8.