Episode 1 - Mark Lillicrap
Curriculum
Cheryl:
00:00:04
Welcome to the podcast from Cambridge University Medical Education Group or CUMEG for short. This is a podcast from the University of Cambridge Clinical School focusing on medical education. We discuss a range of topics that medical educators are dealing with. I'm your host, Cheryl France, Head of CUMEG.
00:00:24
Today, I would like to introduce Dr Mark Lillicrap, Associate Professor of Medical Education Practice at the University of Cambridge Clinical School. Mark is also a Consultant Rheumatologist.
Welcome, Mark. It's wonderful to have you with us.
Mark:
00:00:38
Nice to be with you today.
Cheryl:
00:00:40
I think it would be really useful if you could start out by telling us a little bit more about yourself and about your roles.
Mark:
00:00:46
Okay. So, yes, as you say, I'm the Associate Professor of Medical Education Practice here at the University of Cambridge. That role includes a number of other educational roles. So the main one is I'm the Sub Dean for the curriculum. So I oversee the curriculum here at the University of Cambridge Clinical School, not the pre-clinical course, which is one slightly separately here in Cambridge. I also look after graduate course admissions. I also help run staff development programmes all within that role.
And then I'm also a Rheumatology Consultant here in Cambridge. So I've got a clinical role as well as my academic role.
Cheryl:
00:01:23
Brilliant. So today we'd like to talk more about your academic role, if we could, please.
So I thought it would be really helpful if we could talk more about medical education and the curriculum specifically. So I'd like to understand why a curriculum is so important. And as this is your speciality, I think you're the one that could really enlighten us.
Mark:
00:01:45
Yes, that's fine. Yeah. So curriculum, it's over the decades, it's been a term that's been variously described and it's sometimes slightly difficult to pin down, exactly, what do you mean by a curriculum? How does a curriculum differ from a syllabus?
I quite like J.M. Genns definition from the mid-1990s that the curriculum is everything that happens in relation to the education programme, so that encompasses the whole experience within an educational programme. So you've got the formal curriculum, you've got the informal curriculum, you've got the hidden curriculum and it encompasses all of those different elements.
Cheryl:
00:02:26
And that makes sense actually, when you think about it, you want something that's going to be all encompassing and not just a piece of paper that says this is what we do.
Mark:
00:02:34
Yes.
Cheryl:
00:02:35
Because there's a lot more, particularly in medical education.
Mark:
00:02:38
Yes.
Cheryl:
00:02:39
To what students need to learn.
Mark:
00:02:41
Exactly. And the curriculum that everything that happens is slightly contrasted with the concept of a syllabus which is really around a sort of document as to what you might learn within a particular subject area that a subject lead might define, defining predominantly what they're going to teach within that particular course. Whereas in some ways, the curriculum is more around what are your students going to learn during the course of the of the programme.
Cheryl:
00:03:10
And that's quite important. At the end of the course, or in this case a medical training, you need to understand what your students are going to learn, which is not insignificant.
Mark:
00:03:21
Yeah, absolutely.
Cheryl:
00:03:23
So could you tell us more about if you were a university who's either starting from scratch or thinking, you know what, we really need to change what we do, how we do it; how would they go about that?
Mark:
00:03:37
Okay, so the first thing you really need to think about is your values, your aims. I've been involved with two curriculum designs here in Cambridge, one in 2005, one in 2015, where we’ve redesigned our curriculum. And the start point is really getting your team together to start thinking about what is it that you do? What's your unique skill set? What does your community need? What is your university anticipating? What are the strengths of your course? What do you expect a graduate of your programme to look like? How would you describe that to somebody? Because you need to have some overall aims that you're that you're moving towards.
And really the first stage in curriculum design is working out what those overall aims are and that links in with what are the values of the course that we might pick up on later in terms of what is a hidden curriculum. But that process often involves your faculty or the teaching staff. It may involve lay representatives from your local community, it may involve students, both past students and present students, all of whom can contribute to that discussion in terms of defining what a what are your aims here and where we going? Because you need that foundation before you move into the curriculum itself, because the danger otherwise is you just get your enthusiastic teachers who like doing their teaching sessions on their pet area and then be maybe fantastically good at it. But if you try and build your curriculum around a series of people who like teaching and are enthusiastic about their area, you don't really have an endpoint in mind. And that's where the risk becomes. It's what you deliver that drives the structure rather than the outcomes, which is really what you want to do and you want to link your outcomes with your aims.
Cheryl:
00:05:28
And that makes a lot of sense because you might miss some really big components because you may not have that enthusiastic person that's able to teach X course. So it does make sense and I think it's good that you've talked about encompassing perhaps students, the community as well as your educators, because it is a big thing to be taking on.
Mark:
00:05:50
Yes.
Cheryl:
00:05:51
And so you need to make sure that you get input from different areas.
Mark:
00:05:55
Yes. And you need to be explicit about exactly what you're doing and be able to describe that to people.
So they're your aims. So once you've described your aims, you probably have an idea in your mind at that point about what a graduate of your programme might look like. And so the next step is really to think about, Well, what are your learning outcomes? How could you now describe in a bit more detail what that graduate's going to look like? And that's the process of writing what's called intended learning outcomes or what's shorthand, the ILO's for your program.
So you've defined your overall aims and now we work towards, let's break that down into the learning outcomes that you want for your course. And some of those will be derived from those discussions. And so you'll utilise the discussions and agreement that you've got from your students, lay involvement, faculty to define those. But there's also external governance of that as well and most countries have some sort of governance of their education in terms of quality assurance of the process. Here in the UK, we have the General Medical Council, the GMC, and they produced documentation and the World Federation of Medical Schools. Most countries will have an organisation that oversees the quality of education to ensure that you're meeting the required standards.
In terms of the General Medical Council, they produce a helpful document called Outcomes for Graduates, which gives you a framework for learning outcomes. They defined 152 of them, broken down into three broad areas. So there's something about your professional values, your professional skills and your professional knowledge. And then within each of those areas, there's five or six different domains within each of those outcome areas. When you're designing a curriculum, yes, you want your internal things that are of local relevance to your community, your school, your university. But you also want to make sure you're linking in with the national standards such as the GMC outcomes.
Cheryl:
00:08:10
Yes. Which is really important for and as you say, in different countries, there might be different standards or different outlooks, but I think it's useful to have those because as we said earlier, you could potentially miss something out.
Mark:
00:08:23
Yeah.
Cheryl:
00:08:24
If you don't kind of have a tick box to say yes, we have covered X subjects.
Mark:
00:08:27
Yeah. And those things like the kind of Medical Council's outcomes for graduates is universally available. So, you know, if you're a new school and you're starting from scratch, you've at least got a baseline you can start with so that the General Medical Council does define 152 outcomes within their documentation. You may have some additional outcomes that are of relevance to your community, to your school, to your university that you also want in there. Locally, we have about 270 learning outcomes with which we describe our course, but that process is iterative, so you keep going back over it. And so it's a fantastic opportunity for a group of educators when you're either doing a new curriculum or doing a curriculum redesign to have those discussions. You know, does this describe what we're hoping to do? And it's usually a really productive process.
And once you've got your learning outcomes that provides your foundation and John Biggs back in, I think it was back in the 1980s, described this process of what's called constructive alignment. So you define your learning outcomes and once you define your learning outcomes, that tells you what the what the learner should be learning during your programme.
So the next bit is to think, okay, so how are they going to learn that? And that's where you start thinking about what are your teaching and learning activities. If you're a student working through the course, how's that going to look? What's your experience as a student going to be like in terms of learning? And sometimes you might break that down into different blocks in terms of different phases, different years, different modules, different courses. But that's all about how the learners learn in the more formal curriculum, what you think that they should be learning from your intended learning outcomes. And you need to map those to make sure there aren't gaps. So as you pointed out, you need to know that you're not missing something. And that's why having the intended learning outcomes first enables you to ensure that the student experience maps to that and you cover all your intended learning outcomes and you can task your teachers your theme leads, your year leads, module leads with identifying which of those intended learning outcomes are going to map to what you're doing. So you're not just delivering a teaching session because you're fascinated by some small print area, your teaching team are thinking about am I covering the areas that we're going to need to cover in order that we achieve the aims of the course and the intended learning outcomes of the course?
And then the third bit of big C's constructive alignment is actually how can you tell now if a student has learnt it? And that's where assessment maps to your learning outcomes. So assessment is still part of your curriculum in terms of everything that happens within an education programme, going back to Genn's original definition but you use the intended learning outcomes to do what's called blueprinting of your assessment so that you can make sure that that the assessments are assessing whether or not your students have learned what you think they ought to be learning and your whole program makes coherent sense.
Cheryl:
00:11:38
Yes. And that, you've explained that really well, but it also sounds like an enormous amount of work.
Mark:
00:11:45
Yeah
Cheryl:
00:11:45
But I also thought it was really interesting. If we go back when you mentioned the General Medical Council's, different areas that are covered.
Mark:
00:11:53
Yes.
Cheryl:
00:11:45
You know, professionalism, for example, is on there. And I think that's really important that it's not just about learning about the body and about the disease profile so I think that's really good to highlight.
Mark:
00:12:07
Yes. So Benjamin Bloom, Chicago based educational theorist, got together a group of American educationalists to have a look at, well, what do we mean by learning? And he describes three broad domains. You've got a cognitive domain, you've got a psychomotor domain, you've got an effective domain, which you can shorthand as knowledge, skills and attitude and GMC frame their outcomes in those key three areas. What's your professional knowledge? What are your professional skills and what are your professional attitudes and behaviours? And it's a helpful way of conceptualising what you're doing in the curriculum because again, coming back to the enthusiastic teacher who just wants to deliver their lecture on their interest area, the danger is that becomes a very knowledge-based structure and that's not what we're aiming at. If you come back to our aims, you know, when we're looking at the aims of a programme to produce effective professional doctors who can provide high quality health care, then you need to think about all three areas.
Cheryl:
00:13:09
I think that's really helpful because. Maybe to the layperson, a doctor just needs to have the knowledge to deliver something. But actually, do you want a doctor who can just regurgitate what a book said? No, not really.
Mark:
00:13:23
Absolutely. You want your doctor to have those communication and interpersonal skills. You want them to be able to have those cognitive approaches, which would be around diagnosis and management decisions that they've tested out in a safe environment within a sort of undergraduate program so that they can move into the postgraduate domain knowing they've got that skill set.
Cheryl:
00:13:44
Absolutely.
Mark:
00:13:45
You need your doctor to know how to safely prescribe treatment, to know how to utilise the information that they've got, investigations, evidence base effectively. So yes, they need the knowledge and it's you know, you can't run a program without the professional knowledge, but you also need the professional skills and particularly importantly, you need the values and behaviours and you need to be explicit about those attitudes and behaviours. What are the values that you are expecting in terms of your students, as they move through.
Cheryl:
00:14:16
And that's really helpful. So then when you're writing your intended learning outcomes, those are just as important?
Mark:
00:14:22
Absolutely. Yes.
Cheryl:
00:14:24
As your content knowledge.
Mark:
00:14:22
Yes. So I mean, if you looked at the General Medical Council, the GMC outcomes, they've got 56 outcomes that relate to professional values and behaviours, they've got 44 that relate to knowledge, they've got 52 that relate to skills.
Cheryl:
00:14:39
So interesting.
Mark:
00:14:40
Yes. So I actually the values and behaviours actually underpin everything that we do and a lot of that understanding of the importance of your values and behaviours comes out of the sort of sociological understanding of what exactly is education doing and that, you know, if you went back to people like the French sociologist, Emile Durkheim, who viewed very much that what was happening with education is it's a sort of functional thing. You're trying to produce some sort of homogeneity in terms of the sort of social order with your with your education program that was picked up by people like Pierre Bordeaux, in terms if you've got this sort of field in which you were at the habitus, and the danger is that if you don't articulate the values and the behaviours and the expectations that your curriculum embodies, then there'll be a hidden curriculum and you'll have un-spoken values and assumptions and all the dangers that people like Bordeaux picked up in terms of perpetuating hierarchies, dominance, all that sort of concerns around racism in medical education. If you don't articulate the values, then you risk it being a hidden process and much of what we do with values and behaviours is about making transparent and explicit the professional attitudes and values that would otherwise be hidden.
Cheryl:
00:16:06
That's really useful. And we have had a discussion about racism in medical education. So that kind of highlights, again, why that's important that you have it at the start as one of your fundamental intended learning outcomes.
Mark:
00:16:19
Absolutely.
Cheryl:
00:16:20
Is that you don't have this hidden.
Mark:
00:16:22
Yes.
Cheryl:
00:16:23
Curriculum.
Mark:
00:16:25
Yeah. Because, you know, a student, moving through a curriculum is developing a professional identity. They're working out who they are. What does it mean to be a doctor? And that process of personal identity formation is a core part of your curriculum, and you need to support your students in those developments. But what you don't want is for you to find that there are various unconscious biases that your curriculum is perpetuating because of the way that you've structured it, because you've not thought about it.
And that brings us back to that starting point of defining what are your values? What are your aims? Have you discussed that with your local community, with lay representatives, with students? Because it's through those discussions that you lay the foundations that ensure that your intended learning outcomes are appropriate for your aims. Then you can start mapping your teaching and learning activities and your assessment onto those learning outcomes.
Cheryl:
00:17:20
And thinking about that, do you sometimes revisit those as a as a team to say, actually, have we; do we have some bias somewhere or, you know, let's just be critical of ourselves? Are we getting it right?
Mark:
00:17:35
Yeah. So, for learning outcomes to be an effective tool, they need to be dynamic. You need to be revisiting. You need to keep them in the discussions so that people have an idea as to which learning outcomes are they delivering and identifying, you know, as things change, as things evolve; do we need to change our learning outcomes? And that's as I say, that's that sort of iterative process of ongoing development of your learning outcomes. Absolutely.
Cheryl:
00:18:05
Yeah, that makes sense. Yeah, it makes sense. So it's not just at the beginning. Tick, we've done it. It's an integrative process where you have to go back and think about this again and again to make sure.
Mark:
00:18:18
So it might involve you having to change your intended learning outcomes, but equally, you might have to change your taught curriculum, your teaching and learning activities. So like most medical schools around the world, you know, we went through this incredibly rapid phase at the start of the COVID pandemic, of having to redesign our curriculum on more than one occasion. And most schools will have had a similar process. In that situation, you don't change your intended learning outcomes. They are your foundation, but you change your teaching and learning activities. And so you have to modify the activities that you're delivering. You're changing, you know, the programs of study, you're changing the resources, but you're making sure that as you change them as a fairly rapidly in response to COVID, that they still map to your intended learning outcomes and that you can still map everything and there aren't gaps where actually, because we've had to change that, we can no longer fulfil our intended learning outcomes.
So it's all three elements and yes, it's dynamic and it has to be responsive because we don't live in a static environment.
Cheryl:
00:19:26
No; and I'm sure during that COVID period where we had to change things quickly, there was a risk of leaving things out. And how do you revisit those, particularly when we were not in contact, with one another in contact with one another, it was only core, core medical staff that were actually seeing one another. So it's interesting to think back to that time and how you reintroduce and ensure that every medical student is up to date, as it were, with their learning.
Mark:
00:19:55
Yeah. So that's your basic foundations that you want to think about for any sort of curriculum design.
Probably just worth mentioning another tool that can be quite helpful if you're going through that process of curriculum design. And this is more about specific areas of professional knowledge. And that's to think about the way that patients present because often people think about medical knowledge as being all around different diagnoses, and there's an innumerable number of diagnoses, hundreds and thousands and more of different diagnoses. But presentations give you a mapping tool for you to think about your knowledge in that there are only about 160 ways that anyone ever presents.
Cheryl:
00:20:44
Oh, that's interesting.
Mark:
00:20:46
So this is the work of a chap called Henry Mandan from Canada. And he describes, say, something like being short of breath or having pain in your chest or having pain in your joints. They are ways that you present. Now, there may be thousands of diagnoses that could cause that presentation, but there are only 160 presentations. And so one of the things that you can use as a tool once you've defined your learning outcomes to map contents of medical knowledge, is presentations, and that enables you to ensure that when you're thinking about your teaching and learning activities that link with professional knowledge; am I covering all 160? Are there gaps where my students haven't thought about that particular presentation?
A student at the point of graduation needs to be able to navigate their way through from here's the presentation, through what are the common diagnoses, the uncommon diagnoses? How does somebody present? What kind of algorithmic thinking do I have that enables me to navigate my way through them? That's the information that I'm getting. That's the problem through to working diagnosis. And then what investigations, treatments might I use? What kind of outcomes might I look at? So you've got so a student can navigate their way through every one of those problems. And that's another useful tool when you're thinking about curriculum planning. So you've got your intended learning outcomes on the one hand, and then you've got your clinical problems or presentations.
And again, here in the UK, the General Medical Council have been working on developing a national licensing exam, The Medical Licensing Assessment, and their mapping of that again maps to those 160 presentations because it's just a useful way to help both students and teachers to understand what we're doing.
Cheryl:
00:22:37
That is useful and as you say, it's about revisiting those and perhaps having different scenarios each time so that a student can then work through and say, “Ah, on this occasion it was X, but on this occasion it wouldn't be that because…” And being able to use that reason and thinking.
Mark:
00:22:55
And that brings us on to another aspect in terms of curriculum design, which is; what kind of frameworks are you going to use to structure how learning takes place? And one of the tools that's quite commonly used is what's called a spiral curriculum that Ronald Harden from Dundee was one of the original ones to define where you spiral through, say clinical problems presentations with increasing complexity as you go through the course.
So in terms of the way that we all learn as adults, we've got sort of constructs, networks, neural networks, frameworks and when we are in an environment we having an experience, we activate those networks. And at the start of a training program, they may be fairly ill formed, there may be a lot of weak points in them. But part of the learning process is to understand, well, what's working well, what do I need to do differently? And at the start of the spiral, you're just building up those very basic frameworks. But you then want to revisit it, just as you've just described, so you want to come back to it and you gradually put in layers of complexity as you go through; so over the course of a five year or six year period, in Cambridge it's a six year program of study, then students are re-encountering problems with progressively increasing complexity. So you now activate your network and we really stretch here and we really test out, you know, how robust is that with multiple morbidity, with other complexities just to work out, have you got robust frameworks, that are going to stand up when you're in that real messy world of real clinical practice? Are we sure that you've got the frameworks that are there that are going to support that?
So that's the sort of underlying principle of a spiral curriculum. And when you've got that kind of framework, the nice thing that you can do there is you can work out themes that you interweave within the spiral. Again, picking up the importance, it's not just about your knowledge. How are we going to thread the skills acquisition into that to ensure that you've got all the professional skills that you need? How are we going to thread in your understanding of your professional responsibilities, ethics in law, palliative care, public health, primary and secondary care, all of those things, you then thread into the spiral curriculum so that you can then articulate again, coming back to your aims, you can articulate to students, to faculty, to external authorities. This is the process in terms of how learning takes place across the whole programme.
Cheryl:
00:25:27
Which makes sense and there's so much to it. You just now highlighted so many different aspects that are not just knowledge. It's about a much wider curriculum and understanding and to do that; you don't have students who sit in classrooms all day just looking at books and screens and that sort of thing.
So can we talk about maybe some of the practical skills that students learn and what that means and how they go about getting those practical skills?
Mark:
00:25:59
If you just park practical skills in isolation for a moment. When you're planning a curriculum, you want to think about all sorts of teaching and learning activities. And so there might be some practical things, there will be some experiential things, there will be some probably some large group things, there'll be some online resources, there'll be some small group activities, some 1 to 1 tutorial. So there may be a whole variety of different learning activities and that brings us into you know, how do you plan those learning activities, practically? Useful exercises that that work well is, you know, you can give people a series of, say, different coloured cards and get people to write the small group activities that they want to do on one set of cards and the large group activities that they want to do.
Cheryl:
00:26:49
So this is the teaching staff?
Mark:
00:26:50
Teaching staff. Ideally, you'd like to get again, have some students and laypeople involved in those discussions. So work out, you know, what are you e-learning resources that you're going to utilise large group, small group, practical experiences and then lay them out in terms of on a table, literally on a table so you have an idea in your mind that you can see the student journey through your area as you say. So, you know, if you find you've got this huge block of just large group teaching, then you might want to shuffle them around a bit and put the cards in a slightly different order and so when it comes to looking at your learning activities, that's quite a useful, practical way of getting a teaching team within a particular theme to start thinking about how do we deliver on our theme?
Cheryl:
00:27:36
I can see that being really useful. And also it's about thinking about students learn differently. And so by having this exercise where you're looking at different ways of teaching will help different students.
Mark:
00:27:51
And again, that sort of brings us back to that whole concept of the curriculum is everything that happens in an educational program. So one way of thinking about that is imagining so we're here to produce high quality, effective professional doctors. That's our end product. And it's a bit like having a flatpack wardrobe. So you start off with your sort of entry students, be that from school or with a graduate program that we run here. And the goal is to is to produce the wardrobe at the end of day. But when you have a flatpack wardrobe, there's a couple of ways that you can put it together. You can tip all the bits out and just have a go at screwing, all the bits together and it all falls apart and then you read the manual or you can sit down with a cup of tea and read the manual and then start putting your wardrobe together.
And in many ways simplistic model of curriculum design is to think, well, which of those models are you going to go for? How are you going to get from your incoming student to your wardrobe at the end of your five or six year course? And you can use that sort of to chuck it all out of the box, which we call activist learning kind of model, which is very much the sort of problem based learning kind of approach where you structure your curriculum really around those 160 problems and you just give people a problem on day one and they have a go at trying to sort it out, have a go at building the wardrobe, and then you sit down in your problem based learning group, PBL Group, and you look at, well, what should we have them, you know, let's learn from this.
And over the course of that of the program, then you gradually build up experiences of that with all 160 different problems but you're learning from that sort of action and really learning from being involved with stuff. Whereas the other approaches say, well, let's look at the theory first and structure our curriculum more in a sort of theorist model where, well, we understand the theoretical frameworks and we've got a great understanding of how the body works and normality, and then we build on that. Which is much more of the sort of theorist model, which is how the curriculum here in Cambridge might be structured. Then you can have something in between, which might be called an integrated curriculum. But again, that comes back to, well, what are you looking to do? What are your aims in terms of your program? Because you might be thinking do we want to have a more problem based course, do we want to have a more integrated course, a more theorist, kind of what's often just called a traditional approach to the curriculum. How do we want our spiral to work? How are we going to address the different clinical presentations?
Cheryl:
00:30:32
So we've got to think about that about yes, that's useful for you to have broken it down in those different methods as well, because it really depends; as a university, how do you want to approach this? What about the staff? What's their way of thinking in terms of how best to develop it? And that's really important to get those values out there.
Mark:
00:30:56
It's important as well to be able to articulate that with incoming students. So a student who starting your course understands the rationale for why your curriculum looks the way that it does.
Cheryl:
00:31:08
And it could be a choice of, you know, students saying, actually, I would value being taught this way. Or actually, I really like the idea of just being thrown in and the problem base is working for me, so it's really important for both sides.
Mark:
00:31:24
Yeah. And at the end of the day, you both approaches, you end up building a wardrobe.
Cheryl:
00:31:29
Yes.
Mark:
00:31:29
So and then again that comes back to the in the UK, the GMC outcomes are a way that our curricula are quality assured. So we need to be able to demonstrate that it doesn't matter what approach you've taken, you've got to meet the 152 outcomes that are defined by the outcomes for graduates. And so that doesn't matter where you do your training, but you'll pick up slightly different skills, slightly different approaches. Hopefully, you'll find a course that maps to your particular way of learning more effectively. If we're transparent about the curriculum approach that we're taking.
Cheryl:
00:32:04
And that's really important, because as a student, you need to pick what's going to be best for you to get through. And also, as a university, you want the students who have picked the right sort of course for them as well, because it's important for both to succeed, so that's helpful. Thank you for explaining that because it's really useful to understand.
Mark:
00:32:25
And you mentioned earlier practical skills.
Cheryl:
00:32:27
I did.
Mark:
00:32:28
So when you're planning a curriculum, there is a variety of ways that you can look at delivering your practical procedures program so you can link that in with different experiences. The number of practical skills that you need to be able to do is again, the core in the UK is defined by the General Medical Council and so there are set skills that every graduating doctor has to be competent to be able to do, at least in a simulated setting in in a skills lab.
But again, very often there's a spiral curriculum that underpins that. So you start off with just the basic techniques, often with a rubber mannequin, a bit of rubber arm that you have a go at so that you get the sort of basic approach that you need, and then you increase the complexity of that as you go through the course and you might do that in a simulated setting, you might then do that closely supervised in a ward situation, and you gradually build up the competence over the course of the programme. And so skills is a great example of how you use a spiral curriculum to gradually improve your skills competency as you go through.
Cheryl:
00:33:44
Yeah. And that makes sense. And we do want them starting on mannequins, not people, please! I think everybody would be grateful for that one. But that makes sense that you would again, thinking about that spiral, it adds on if you keep tacking on the complexity as you go through it, which is really useful for everybody.
Good, we've covered a lot.
Mark:
00:34:07
Yes, absolutely.
Cheryl:
00:34:08
And I'm just trying to think, have we missed anything that you would say, you know what, we really need to think about X.
Mark:
00:34:16
If there were three things that I was defining that you need to your first step is define what your aims are, get groups of people together and having those discussions. And it's often a really productive opportunity because it's not very often you get a chance to really talk about what are we trying to do here, what our aims and it usually produces really thought-provoking discussions, having somebody facilitate that with flip charts or whatever, in order that you're documenting the outcomes of those discussions. But make sure that you've got an agreed aim and that everybody's on the same page with where you are going. So that would be my first thing.
The second thing is now do the hard work of writing your intended learning outcomes. Working out; what does a graduate look like? How am I going to describe this? The key thing in terms of intended learning outcomes is when you're writing the learning outcomes, use active verbs. Again, Bloom's work in terms of the verbs that we use to describe different levels of competency are really helpful for getting you to think, is this a phrase that I can now assess against? Because what you write for your intended learning outcomes doesn't just tell you about what you're going to teach, it's what you're going to assess.
Cheryl:
00:35:28
So that's quite good.
Mark:
00:35:29
Yes. So define your intended learning outcomes.
You know, you're probably looking at somewhere between two and three hundred of them to describe your course in a meaningful way that would then enable you to assess them.
And then the third bit that I'd pick up is now get your teams to work with you to look at their individual programs. How do those modules now link in with that? Doing things like those tabletop exercises to actually start visualising the program, the module, the course that I'm delivering with a group of people, because then everyone's engaged and you've got everybody on board.
Cheryl:
00:36:07
And that's really important I think as you've said, it's about getting those aims, then getting down to those learning outcomes and then pulling it together in a way that's coherent.
Mark:
00:36:15
Yes. So those three things; get your aims, do your learning outcomes, now plan your learning activities.
Cheryl:
00:36:22
Makes sense. Thank you.
It's been really interesting speaking to you today and you've covered a lot. It shows it's not an easy task. It's quite complex.
Mark:
00:36:33
Very satisfying though.
Cheryl:
00:36:36
Yes. And important to get, right? Because then at the end of the day, in this case, we're not just building a wardrobe, we're getting really good doctors that we're going to have treating all patients. And that's really important. So thank you.
Mark:
00:36:51
Thank you.
Cheryl:
00:36:52
So, Dr Mark Lillicrap, thank you once again for such an interesting discussion.
If listeners are interested in learning more, please contact us via the CUMEG website at www.cumeg.cam.ac.uk . We are grateful to you, our listeners. Thank you for taking the time out of your busy schedules to listen to us today. If you'd like to hear more from this and our previous podcast series, please like and subscribe to our podcast.
Until next time. I'm your host, Cheryl France. Thank you again for listening.