Twelve tips for using the Understanding by Design® curriculum planning framework.

BACKGROUND: Health professions faculty engaged in curriculum planning or redesign can struggle with developing courses or programs that align desired learner outcomes, such as competencies to be applied in a clinical setting, with assessment and instruction. AIMS: Our medical school implemented the Understanding by Design (UbD) framework to achieve alignment of outcomes, assessments and teaching during the renewal of our four-year curriculum. This article shares our strategies and practices for implementing UbD with teams of faculty curriculum developers. DESCRIPTION: The UbD framework is a 'backward' approach to curriculum development that begins by identifying learner outcomes, followed by the development of assessments that demonstrate achievement of competencies and concludes with the design of active learning experiences. UbD emphasizes the development of deep understandings that learners can transfer to novel contexts. CONCLUSIONS: We found UbD to be a flexible, adaptable approach that aligns program and course-level outcomes with learner-centred instruction and principles of competency-based medical education and assessment.

Evaluating the quality of learning-team processes in medical education: development and validation of a new measure.

BACKGROUND: Measurement of the quality of team processes in medical education, particularly in classroom-based teaching settings, has been limited by a lack of measurement instruments. Therefore, the purpose of this study was to develop and test an instrument to measure the quality of team interactions. METHOD: The authors created 30 items and reduced these to 18 items using factor analysis. They distributed the scale to 309 second-year medical students (RR = 95%) in a course that used teams and measured internal consistency, validity, and differences in scores between teams. RESULTS: Cronbach's alpha for the scale was 0.97. Team ratings were variable, with a mean score of 95.7 (SD 8.5) out of 108. Team Performance Scale (TPS) scores correlated inversely with the spread of peer evaluation scores (r = -0.38, P = .003). Differences between teams were statistically significant (P < .001, eta = 0.33). CONCLUSIONS: The TPS was short, had evidence of reliability and validity, and exhibited the capacity to distinguish between teams. This instrument can provide a measure of the quality of team interactions. More work is needed to provide further evidence of validity and generalizability.

Internists training medical residents in pelvic examination: impact of an educational program.

BACKGROUND: Pelvic examination is an important component of the primary care of women by internists, but training beyond medical school is rare. DESCRIPTION: We created an internist-run educational program for 1st-year medical residents in pelvic examination. The program consisted of 4 weekly patient-care sessions with 2 to 3 patients seen by each resident each session. Internists supervised each exam and gave real-time feedback and utilized a skills-assessment checklist during the first and last exams of the program to give comprehensive, formative feedback. EVALUATION: We evaluated the program using a self-assessment questionnaire concerning pelvic examination competency and attitudes, which utilized a 5-point Likert scale and was administered prior to, and 3 months after, the program. A total of 37 participants completed the program and reported improvements in competency and a trend toward an increased likelihood of performing exams. CONCLUSIONS: This program, in which internists trained medical residents in pelvic examination, utilized real patients, improved participants self-assessed competency, and may increase the likelihood of residents performing pelvic examination in primary care.

An evidence-based domestic violence education program for internal medicine residents.

BACKGROUND: Domestic violence (DV) is prevalent but often unrecognized, and it is a challenge to teach. This article presents an evidence-based DV education program for medical residents and incorporates it into a women's medicine curriculum. DESCRIPTION: An initial 3-hr seminar included video and case discussion, literature review, and role play. Participants then actively screened patients for 2 weeks and returned for a follow-up discussion session. The program was well received. EVALUATION: Six to 12 months after the intervention, key features questions were utilized to measure ability to correctly suspect DV in patient situations. Residents who had not attended the program served as controls. Three of the 8 questions were suspicious for abuse. Fifty-four percent of respondents in the intervention group correctly suspected DV in at least 2 out of 3 questions compared with 20% of controls (p = .02). CONCLUSIONS: An evidence-based DV education program was well received and helped correctly suspect DV.