More on Outcome-based Education

See also Outcome-based Education: AMEE Guide No. 14; AMEE Education Guides Extended Summaries

The March 2002 issue of Medical Teacher (v. 24 no. 2) contains an editorial and several articles relating to outcome-based education. In his editorial for this issue, Professor Harding concludes:

Outcome-based education as an educational approach is still in its infancy in medical training. Whether the approach fulfils its early promise remains to be seen. The news to date, however, is encouraging and where it has been implemented outcome-based education has had a significant and beneficial impact. Clarification of the learning outcomes in medical education helps teachers, wherever they are, to decide what they should teach and assess, and students what they are expected to learn. If outcome-based education is to fulfil its great potential in medical education, work is needed to reach agreement on appropriate learning outcomes for the different phases of medical education internationally and on the most appropriate models for communicating the outcomes leading to the introduction of an outcome-based approach in practice. The papers in this issue make valuable contributions to this task. [See below. All are available by subscription only.]

Harden RM. Developments in outcome-based education [editorial]. Med Teach 2002;24:117-120. PubMed Full Record   Related Articles   

Harden RM. Learning outcomes and instructional objectives: is there a difference? Med Teach 2002;24:151-155. Abstract: Learning outcomes are broad statements of what is achieved and assessed at the end of a course of study. The concept of learning outcomes and outcome-based education is high on today's education agenda. The idea has features in common with the move to instructional objectives which became fashionable in the 1960s, but which never had the impact on education practice that it merited. Five important differences between learning outcomes and instructional objectives can be recognized: (1) Learning outcomes, if set out appropriately, are intuitive and user friendly. They can be used easily in curriculum planning, in teaching and learning and in assessment. (2) Learning outcomes are broad statements and are usually designed round a framework of 8-12 higher order outcomes. (3) The outcomes recognize the authentic interaction and integration in clinical practice of knowledge, skills and attitudes and the artificiality of separating these. (4) Learning outcomes represent what is achieved and assessed at the end of a course of study and not only the aspirations or what is intended to be achieved. (5) A design-down approach encourages ownership of the outcomes by teachers and students. PubMed Full Record    Related Articles   

Bloch R, Burgi H. The Swiss catalogue of learning objectives. Med Teach 2002;24:144-150. Abstract: PBL philosophy may challenge the need for explicit and specific educational objectives in medical education. From a practical point of view, however, such objectives are essential to achieve a close overlap between learning, teaching and assessment. Since the 1970s medical licensing in Switzerland has been based, among other things, on passing a uniform, centrally prepared MCQ exam for the graduates of all five Swiss medical schools. The need for a set of jointly developed learning, teaching and assessment objectives has become apparent. The Joint Conference of Swiss Medical Schools has therefore charged a small taskforce with the development of such a catalogue. This paper describes the background, process and results of this work. PubMed Full Record    Related Articles 

Schwarz MR, Wojtczak A. Global minimum essential requirements: a road towards competence-oriented medical education. Med Teach 2002;24:125-129. Abstract: With the growing globalization of medicine and the emerging concept of a 'global profession of physicians', the issue of the essential competences that all physicians must possess becomes sharply focused. If defined, these competences would help indicate what teachers are supposed to teach, what students are expected to learn and what educational experiences all physicians must have. The 'minimum essential competences' that all graduates must have if they wish to be called physicians were identified by the Institute for International Medical Education (IIME), sponsored by the China Medical Board of New York, through working groups of educational and health policy experts and representatives of major international medical education organizations. In the first phase of the project, seven domains have been identified that define the knowledge, skills, professional behavior and ethics that all physicians must have, regardless of where they received their general medical training. Appropriate tools to assess each of the domains have been identified. In the second phase of the project the 'global minimum essential requirements' (GMER) will be implemented experimentally in a number of Chinese medical schools. The aim of the third phase will be to share the outcomes of this educational experiment, aimed at improving the quality of medical education, with the global education community. PubMed Full Record      Related Articles  

Global minimum essential requirements in medical education [Institute for International Medical Education]. Med Teach 2002;24:130-135. Abstract: The process of globalization is increasingly evident in medical education and makes the task of defining global essential competences required by 'global physicians' an urgent matter. This issue was addressed by the newly established Institute for International Medical Education (IIME). The IIME Core Committee developed the concept of 'global minimum essential requirements' ('GMER') and defined a set of global minimum learning outcomes that medical school students must demonstrate at graduation. The 'Essentials' are grouped under seven broad educational domains with a set of 60 learning objectives. Besides these 'global competences', medical schools should add national and local requirements. The focus on student competences as outcomes of medical education should have deep implications for curricular content as well as the educational processes of medical schools. PubMed Full Record     Related Articles 

Simpson JG, Furnace J, Crosby J, Cumming AD, Evans PA, Friedman BD, Harden RM, Lloyd D, McKenzie H, McLachlan JC, McPhate GF, Percy-Robb IW, MacPherson SG. The Scottish doctor–learning outcomes for the medical undergraduate in Scotland: a foundation for competent and reflective practitioners. Med Teach 2002;24:136-143. Abstract: This paper describes a set of learning outcomes that clearly define the abilities of medical graduates from any of the five Scottish medical schools. The outcomes are divided into 12 domains that fit into one of three essential elements for the competent and reflective medical practitioner. PubMed Full Record     Related Articles  

And then there is the AMEE Guide #25, published in 2003:

Shumway JM, Harden RM. AMEE Guide No. 25: The assessment of learning outcomes for the competent and reflective physician. Med Teach 2003;25:569-584. Abstract: Two important features of contemporary medical education are recognized. The first is an emphasis on assessment as a tool to ensure quality in training programmes, to motivate students and to direct what they learn. The second is a move to outcome-based education where the learning outcomes are defined and decisions about the curriculum are based on these. These two trends are closely related. If teachers are to do a better job of assessing their students, they need an understanding of the assessment process, an appreciation of the learning outcomes to be assessed and a recognition of the most appropriate tools to assess each outcome. Assessment tools selected should be valid, reliable, practical and have an appropriate impact on student learning. The preferred assessment tool will vary with the outcome to be assessed. It is likely to be some form of written test, a performance test such as an OSCE in which the student's competence can be tested in a simulated situation, and a test of the student's behaviour over time in clinical practice, based on tutors' reports and students' portfolios. An assessment profile can be produced for each student which highlights the learning outcomes the student has achieved at the required standard and other outcomes where this is not the case. For educational as well as economic reasons, there should be collaboration across the continuum of education in test development as it relates to the assessment of learning outcomes and in the implementation of a competence-based approach to assessment. PubMed Full Record    Related Articles     Full Text