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Elements of an Instructional Design

Melflor A. Atienza, MD, MHPEd, FPCP, FPSG, FPSDE


National Teacher Training Center for the Health Professions
University of the Philippines Manila

Learning Outcomes

Brown Universitys Nine LOs


1.
2.
3.
4.
5.
6.

7.
8.
9.

Effective communication
Basic clinical skills
Using basic science in practice of medicine
Diagnosis, management, & prevention
Lifelong learning
Self-awareness, self-care & personal growth
Social & community contexts of health care
Moral reasoning & clinical ethics
Problem solving
(Smith & Dollase, 1999)

Brown Universitys Nine LOs


1.
2.
3.
4.
5.

6.

7.

Clinical competence
Communication skills
Management of research findings
Interprofessionalism
Appreciation of systems approach to health
care
Personal and continuing professional
development
Adherence to professional and ethical
practice
(Smith & Dollase, 1999)

Learning outcomes for a competent and


reflective practitioner
1. Clinical skills
2. Practical procedures
3. Patient investigation
4. Patient management
5. Health promotion and disease prevention
6. Communication
7. Appropriate information handling skills

(Harden, et al., 1999)

Learning outcomes for a competent and


reflective practitioner
6. Understanding of social, basic & clinical
sciences
7. Appropriate attitudes, ethical
understanding, legal responsibilities
8. Appropriate DM skills and clinical
reasoning and judgment
9. Role of the doctor w/in the health service
10.Personal development

(Harden, et al., 1999)

Expectations of professionals
1.

Autonomy

2.

Responsibility and accountability

3.

Complexity

4.

Workplace environment

5.

Contingencies

6.

Discretion and judgment


(ILO, 2006)

Higher Order Thinking Skills


Analysis
Logical

thinking
Critical thinking
Problem solving
Decision making
Scientific inquiry
Creative thinking

Cognitive domain (LOTS)


1.

Remember:
Recalling information, recognizing facts
Example: To enumerate the top 10 causes of
morbidity

2.

Understand
Explaining concepts, interpreting results or
data
Classifying, translating, summarizing
Example: To explain the importance of drug
compliance among patients with tuberculosis

(Anderson & Krathwohl, 2001)

Cognitive domain (LOTS)


3.

Apply:

4.

Using information in new situation


Example: To compute the dose of antibiotics
for given patients presenting with infection

Analyze

Breaking information into parts to explore


relationships; organizing
Example: To identify which information is
relevant
(Anderson & Krathwohl, 2001)

Cognitive domain (HOTS)


5.

Evaluate:

6.

Justifying a decision or course of action


Example: To justify the treatment plan for given
patients

Create:

Generating new ideas


Designing, planning
Constructing, formulating
Example: To formulate a comprehensive plan
of management for given patients
(Anderson & Krathwohl, 2001)

What level?

Name of the virus


Meaning of MERS
Dimensions
Type of virus
Identification
When to suspect
Diagnostic tests
Treatment

Remember
Remember
Remember
Understand
Application
Analyze
Analyze; Evaluate
Evaluate; Create

Psychomotor domain
1.

Perception: awareness of objects, qualities, etc.


by way of the senses

2.

Set: physical, mental or emotional readiness for a


particular kind of action or experience

3.

Guided Response: overt behavioral act of an


individual under guidance of instructor, or
following model or set criteria

4.

Mechanism: learned response has become


habitual and learner can perform with confidence
and proficiency
(Henson, 1995)

Psychomotor domain
5.

Complex overt response: Performance of


a motor act that is considered complex
because of movement pattern required

6.

Adaptation: Ability to adjust performance


in response to different situations, difficult
cases

7.

Origination: creating new acts creatively

(Henson, 1995)

Affective domain
1.

Receiving: willingness to give attention


to an event

2.

Responding: willingness to react to an


event through some form of participation

3.

Valuing: willingness to accept an event


through the expression of a positive
attitude

(Krathwohl, 1960)

Affective domain
4.

Organizing: when encountering


situations to which more than one value
applies, organizing the values and
accepts some as more important

5.

Characterizing by a value complex:


consistently acting in accordance with
accepted values as a part of his or her
personality, and total philosophy or world
view
(Krathwohl, 1960)

Instructional design
Specifications

for a unit of instruction

Objectives

Content

Teaching-learning activities

Evaluation

Objectives

Formulating Objectives
What to write?
How to write?

Structure of an objective
Terminal

behavior

Conditions

Criteria

of demonstration

for performance

Given an actual patient,


the student should be able to
take the accurate vital signs.

Qualities of a good objective

S pecific
M easurable
A ttainable

R elevant
T ime bound

Guide in writing objectives


Begin with a verb.
State objective in terms of student

performance.
State the objective as a learning product.
Indicate terminal behavior.
Include only one general learning outcome.
State at the proper level of generality

Whats wrong?

To gain an insight into the role of the surgical

team, concerning pre and post op care

To regularly attend classes

To prepare students for community rotation

To state and compute for the caloric


requirement of given clients

Terminal behavior
AVOID

Acquire the skill


Be exposed
Gain knowledge
Have the ability
Develop the attitude
Think clearly

USE

Assess
Critique
Design
Demonstrate
Display
Perform

Teaching HOTS
LOTS

Bridge

Knowledge of
terms and facts

Challenges
Dilemmas

Comprehension
Simple application

Discrepancies
Paradoxes
Problems
Puzzles
Questions

HOTS

Outcome
Outcomes

Analysis
Logical thinking

Explanations
Insights

Critical thinking
Conclusions
Problem solving Recommendations
Decision making
Decisions
Scientific inquiry
Creative thinking

Products
Compositions

Content

Content

Standards of the profession


Updates in the field
Needs and demands of patients
Health systems
Evidence-based practice
Interprofessional education
Cultural competence
New professionalism
Information technology

Criteria in selecting content

Validity: authenticity & accuracy of topics

Utility: usefulness to present & future roles

Learnability & interest: topics could be learned

Feasibility: within resources, expertise, time

Significance: contributing to aims


(Ornstein and Hunkins, 1998)

Content organization
Scope breadth & depth of content
Range of content areas represented

Depth of treatment of each area

Sequence order in which content is

presented
Criteria to determine order of succession of materials

Order of topics
(Zais, 1976)

Content organization
Sequence order in which content is

presented
Simple-to-complex
Prerequisite learning

Whole-to-part
Chronological sequence

(Zais, 1976)

Sequence
Anatomy

of HN
Physiology of swallowing
Dysphagia
Fluency
Motor speech conditions
Clinical management

Content organization through integration


Horizontal integration unification of

disciplines learned in one year level


Vertical integration interweaving of basic

& clinical sciences from 1st year

(Zais, 1976)

Learning activities

Expectations of Professionals in the


Workplace (ILO, 2006)
Expectations

Autonomy
Responsibility
accountability

Complexity

Implications
Able to make
decisions and carry
out tasks

Provision for
practice in actual
setting

Show responsibility &


accountability to
ensure quality of
service or product

Development of
professionalism,
interprofessional
education

Able to carry out


tasks in complex
situations

Opportunity to
practice and
master abilities in
complex
situations

Expectations of Professionals in the


Workplace (ILO, 2006)
Expectations

Workplace
environment

Contingencies

Discretion,

judgment

Implications
Ability to adjust in
natural
environment

Practice in actual
setting in teaching,
devt. of cultural
competence

Choice and range of


resources to make
logical decisions

Development of
HOTS & exposure
to situations and
resources & tech.

Able to make
sound judgment in
the absence of
supervision

Opportunity to
practice and master
abilities and gain
confidence in DM,
teaching HOTS

Selection of teaching-learning
strategies
Large group teaching strategies
LGL

Interactive lecturing, reflective panel discussion, symposium, debate

Small group learning strategies: SGD, buzz group, brainstorming


SGL

Clinical teaching strategies: conferences, bedside teaching, modeling

Individual learning strategies


Individualized

Module, blended learning, mentoring, learning contract

Workshop 1

Select a learning outcome


Identify a course or module addressing this
Formulate course objectives
Select a session or topic discussed under
this course
Formulate learning objectives for this topic
Outline the content for the session

Workshop 1 output
Learning outcome/s:
Course:
Course objectives
Topic
Learning objectives:
Learning objectives
1.

2.

Content