Dasar-dasar Pengembangan Kurikulum Pendidikan Dokter Titi Savitri Prihatiningsih Bagian Pendidikan Kedokteran Fakultas Kedokteran Universitas Gadjah Mada Definisi Kurikulum Kurikulum pendidikan tinggi adalah seperangkat rencana dan pengaturan mengenai isi, bahan kajian maupun bahan pelajaran serta cara penyampaian dan penilaian yang digunakan sebagai pedoman penyelenggaraan kegiatan belajar-mengajar di perguruan tinggi Definisi Kurikulum The curriculum is all the experiences that students have under the guidance of the university Asas Pengembangan Kurikulum Asas Filosofis Asas Sosiologis Asas Psikologis Asas Pengorganisasian Asas yuridis Komponen Kurikulum Tujuan Materi Penilaian Proses Belajar Mengajar Langkah-langkah Pengembangan Kurikulum Model Tyler (1949) Tentukan tujuan pendidikan yang akan dicapai Pengalaman belajar apa yang dapat diberikan agar tujuan tersebut tercapai Model Warwick (1975) Susun kurikulum yang paling ideal Pertimbangkan segala sumber yang ada Identifikasi hambatan atau kendala Modifikasi kurikulum ideal dengan mempertimbangkan hambatan Disain cetak biru kurikulum dan perhatikan struktur, ruang lingkup, urutan dan keseimbangan Model Warwick (1975) Persiapkan materi pembelajaran Disain proses belajar-mengajar yang efektif dengan memperhatikan cetak biru kurikulum Model Hilda Taba (1962) 1. Menentukan tujuan pendidikan: Merumuskan tujuan umum Mengklasifikasi tujuan Merinci tujuan (mis. Pengetahuan, ketrampilan, dll) Merumuskan tujuan dalam bentuk spesifik Model Hilda Taba (1962) 2. Menseleksi pengalaman belajar Relevansi dengan kenyataan sosial Keseimbangan ruang lingkup dan kedalaman Variasi pengalaman belajar Penyesuaian dengan minat dan kebutuhan mahasiswa Model Hilda Taba (1962) 3. Pengorganisasian materi dan kegiatan belajar mengajar Menentukan pengorganisasian kurikulum Menentukan urutan atau sequence Menentukan integrasi Menentukan fokus pembelajaran Model Hilda Taba (1962) 4. Evaluasi hasil kurikulum Menentukan kriteria penilaian Menyusun program evaluasi yang komprehensif Menentukan teknik pengumpulan data Menentukan penafsiran data evaluasi Menterjemahkan evaluasi ke dalam kurikulum Harden (2000) 1. 2. 3. 4. 5. Identifying the need Establishing the learning outcome Agreeing the content Organizing the content Deciding the educational strategy Harden (2000) 6. Deciding the delivery methods 7. Preparing the assessment 8. Communication about the curriculum 9. Preparing the educational environment 10. Managing the study programme Kurikulum baru HARUS diujicoba Langkah ujicoba kurikulum 1. 2. 3. 4. 5. Menyusun bahan ujicoba Melakukan ujicoba kurikulum Revisi dan konsolidasi Review kurikulum yang telah disusun Pelaksanaan Competency-based Medical Education Competency is an action performed to a specific standard under specific condition Competencies (a cognitive perspective) “Competence embraces the structure of knowledge and abilities” (Messick, 1984) “Competence rests on an integrated deep structure (understanding) and on the general ability to coordinate appropriate internal cognitive, affective and other resources necessary for successful adaptation” (Wood & Powers, 1987) There are enabling factors for competence Competencies (a cognitive perspective) Competence derives from possession of a set of relevant attributes such as knowledge, skills and attitudes, called competencies a competency is a combination of attributes underlying some aspect of successful professional performance (Gonczi et al, 1993) Competence in an area therefore requires a specific set of prerequisite competencies Competency is … A complex set of behaviour built on the components of knowledge, skills and attitudes Differences between Content-based/Structure/Process-based and Competency-based Educational Programme Driving factor Curriculum Structure/Contentbased Content-knowledge acquisition Competency-based Outcome-knowledge application Driving force for process Teacher Learner Path of learning Non-hierarchical Hierarchical Differences between Content-based/Structure/Process-based and Competency-based Educational Programme Structure/Contentbased Competency-based Responsibility for content Teacher Student and teacher Goal of educational encounter Knowledge acquisition Knowledge application Typical assessment tool Single subjective measure Multiple objective measures Differences between Content-based/Structure/Process-based and Competency-based Educational Programme Structure/Contentbased Competency-based Assessment tool Proxy Authentic (mimic real task of professional) Setting for evaluation Removed Direct observation Evaluation Non-referenced Criterion-referenced Differences between Content-based/Structure/Process-based and Competency-based Educational Programme Structure/Contentbased Competency-based Timing of assessment Emphasis on summative Emphasis on formative Program completion Fixed time Variable time Curricular Design for CBE 1. Competency identification 2. Determination of competency components and performance levels 3. Competency evaluation 4. Overall assessment of the process Examples of performance levels 1. 2. 3. 4. 5. Novice Beginner Competent Proficiency Expert 1. 2. 3. Beginning level Intermediate level Advanced level 1. Melihat/tahu 2. Melakukan di bawah supervisi 3. Melakukan mandiri Outcomes (areas of competence) Educating Doctor Curriculum Development Competencies Knowledge, Skills, Attitudes Roles and Functions of Health Professional Competencies required for performance of roles/functions Knowledge, skills, attitudes for acquisition of competencies Assess Roles and Functions of Health Professional Assess Competencies required for performance of roles/functions Assess Knowledge, skills, attitudes for acquisition of competencies Elements of CBME (1) 1. 2. Competencies to be achieved are carefully identified, verified and made public in advance Criteria to be used in assessing achievement and the conditions under which achievement will be assessed are explicitly stated and made public in advance Elements of CBME (2) 3. The instructional program provides for the individual development and evaluation of each of the competencies specified 4. Assessment of competency takes the participant’s knowledge and attitudes into account but requires actual performance of the competency as the primary source of evidence Elements of CBME (3) 5. Participants progress through the instructional program at their own rate by demonstrated the attainment of the specified competencies Characteristics of CBME (1) 1. 2. 3. Competencies are carefully selected Supporting theory is integrated with skill practice. Essential knowledge is learned to support the performance of skills Detailed training materials are keyed to the competencies to be achieved and are designed to support the acquisition of knowledge and skills Characteristics of CBME (1) 1. Competencies are carefully selected 2. Supporting theory is integrated with skill practice. Essential knowledge is learned to support the performance of skills 3. Detailed training materials are keyed to the competencies to be achieved and are designed to support the acquisition of knowledge and skills Characteristics of CBME (2) 4. Methods of instruction involve mastery learning, the premise that all participants can master the required knowledge or skill provided sufficient time and appropriate training methods are used Characteristics of CBME (3) 5. Participants’ knowledge and skills are assessed as they enter the program and those with satisfactory knowledge and skills may bypass training or competencies already attained. 6. Learning should be self-paced Characteristics of CBME (4) 7. Flexible training approaches including large group methods, small group activities and individual study are essential components 8. A variety of support materials including print, audiovisual, and simulations keyed to the skills being mastered are used 9. Satisfactory completion of training is based on achievement of all specified competencies. Characteristics of CBME (5) Evaluation is focused on the measurement of the mastery of information and skills. Criterion-referenced should be used Implications for using CBME (1) 1. Organizations must be committed to providing adequate resources and training materials 2. Audiovisual materials need to be directly related to the written materials 3. Training activities need to match the objectives Implications for using CBME (2) 4. Continuous participant interaction and feedback must take place 5. Trainers must be trained to conduct competency-based training courses 6. Individuals attending training must be prepared for CBT as this approach is likely to be very different. Design activities for CBME (1) 1. Identification of specific clinical performance or clinical skills (e.g. CPR, etc) 2. Identification of the conditions under which the clinical performance or clinical skills must be demonstrated (e.g. using simulators, role plays, etc) 3. Development of the criteria or standards to which the skills must be performed Design activities for CBME (2) 4. Development of the competency-based learning guides and checklists which list each of the steps and sequence required to perform each skills or activity 5. Development of the reference manuals which contain the essential, need-to-know information related to the performance or skills to be developed Design activities for CBME (3) 6. Development of the models to be used during training 7. Development of training objectives which outline what the participant must do in order to master the clinical performance or clinical skills 8. Development of course outlines which match a variety of training methods and supporting media to course objectives Design activities for CBME (4) 9. Development of course syllabi and schedules which contain information about the course and which can be sent to participants in advance so they are aware of details concerning the course. Delivery and Evaluation Activities for CBME using a clinical skill as an example 1. Administration of a precourse questionnaire to assess the participants’ knowledge and attitudes about course content 2. Administration of precourse skill assessments using model to ensure participants possess the entry level skills to complete the course successfully and role plays to determine the level of their communication skills 3. Delivery of the course by a trainer/facilitator using an interactive and participatory approach 4. Transfer of skills from the instructor to the students through clinical counselling skill demonstrations using slide set, videotapes, models, role plays and finally clients 5. Development of the students’ skills using a humanistic approach, which means participants acquire the skills and then practice until competent using anatomic models and role plays 6. Practice of the skills following the steps in the learning guide until the participant becomes competent at performing the skills During this time, the trainer functions as a coach providing continous feedback and reinforcement to participants. Only when participants are assessed and determined to be competent on a model do they work with clients 7. Presentation of supporting information and theory through interactive and participatory classroom session using a variety of methods and audivisuals 8. Administration of midcourse test to determine if the participants have mastered the new knowledge associated with clinical skills 9. Guided practice in providing all components of the clinical performance 10. Evaluation f each participant’s performance (i.e. knowledge, attitudes, practice and clinical skills) with clients. The evaluation by the trainer using performancebased test. The participant is either qualified or not qualified as a result of knowledge, attitude and skills assessments. 11. Presentation of a statement of qualification which identifies the specific clinical performance the individual is qualified to provide Learning principles underlying CBME (1) 1. Learning is most productive when the student is ready to learn. The Clinical teacher should create a climate that will nurture motivation 2. Learning is most effective when it builds on what the students already knows or has experienced Learning principles underlying CBME (2) 3. Learning is most effective when students are aware of what they need to learn 4. Learning is made easier by using a variety of training methods and techniques 5. Opportunities to practice skills initially is in controlled or simulated situations are essential for skill acquisition and for develoment of skill competency Learning principles underlying CBME (3) 6. Repetition is necessary to become competent or proficient in a skill 7. The more realistic the learning situation, the more effective the learning 8. To be effective, feedback should be immediate, positive and nonjudgemental. Key Words Relevant- task oriented – participatory – friendly – varied – built on past experience Faculty members must be genuinely interested in teaching and must be trained in interactive method From teacher-oriented to learner oriented, including self-paced learning and assessment Key Words Changing from narrow-discipline oriented teaching to a problem-solving approach Moving from lecture-oriented teaching to experiential and interactive learning Changing the medical teacher’s role to a coach of student learning Thank You