Easy Guide to Program Development in Six Steps
The COVID-19 pandemic has caused a myriad of disruptions, but some things never change: Implementing a program for health care professionals under time constraints.
Program developers must identify, appraise, and effectively use resources, objectives, and educational methodologies while keeping the motivation of learners high.
Patricia A. Thomas, David E. Kern, Mark T. Hughes, and Belinda Yim Chen’s groundbreaking program development text, Curriculum Development for Medical Education (2016), offers a six-step method relevant to any development context—from individual lessons to programs involving several departments and sessions. Following this approach, designing or revising a program or course in any learning environment boils down to asking the right questions at each step. The resulting framework will accommodate different learners as well as assess the learners and evaluate the program in general.
Kern’s Six Steps contain:
(1) Problem Identification and General Needs Assessment
(2) Targeted Needs Assessment
(3) Goals and Objectives
(4) Educational Strategies
(6) Evaluation and Feedback
In the following, straightforward questions that represent each of the six steps for establishing effective programs are offered. The six-step approach adds important considerations of the larger picture and the needs of students.
Question 1: What healthcare or healthcare education problems need solving? Why does it matter?
The first step in program and curriculum development is problem identification and general needs assessment: you need to know what stakeholders—such as leadership, learners, and the community—need. This might also be the time to think about collaborators, such as a faculty colleague for team-teaching or to facilitate student break-out groups.
Question 2: Who are your learners?
This question aims to determine students’ learning needs, including consideration of their learning environment. For example, students aiming to be accepted into medical school will need to be exposed to different content and methods of teaching and learning than adult learners such as healthcare professionals seeking to deepen their understanding of the field. This is also the time to come up with ideas about how to engage your students and make them responsible for their own learning. I recommend developing a draft inventory of teaching methods.
Question 3: What are your overarching course goals and learning objectives?
After conversing with colleagues and learners and, if necessary, obtaining leadership approval, your ideas and understanding of needs are probably consolidated, and you can create a schedule of topics and sessions. This is the stage to develop broad overarching course goals and specific, measurable objectives. Learners need to clearly understand (1) cognitive (knowledge), (2) affective (attitudinal), and (3) psychomotor (skill and behavior) objectives to prepare for exams. Goals and objectives are also a great means to communicate the essence of the curriculum to others, such as stakeholders. This is also when to draft the course syllabus. Determining resources such as classrooms, online space, educational IT, and key personnel is prudent. This will provide a reality check about how to accomplish the objectives and which to prioritize.
Question 4: What educational means and methods are you going to choose? What setting works best for the learners and the content?
To answer this question, think about (1) what works best for your learners, (2) using the resources you have access to, and (3) the methodologies with which you are familiar or can engage an expert’s help. For example, if the course will involve teaching large groups of learners, alternating lecture with interactive problem-solving exercises might provide a great solution either face-to-face or online. If the class size is small, however, you can promote active learning through group activities in, e.g., break-out sessions. Learners have different learning styles and preferences, so aim to be inclusive by presenting the content in different formats.
Question 5: What resources do I need to launch the program on the target date?
Need versus availability of resources become more explicit as planning continues. A checklist inventory listing all resources as well as institutional support and administrative structures for future viability helps components such as teaching space, educational technology, topic-specific equipment and many more to be in place to have a coherent program by the target date. Develop a schedule of resources, and consider that even a course taught by the faculty who developed it requires resources in personnel, time, facilities, and either funding or time. Social media and professional websites can be populated ahead of time and perhaps combined with the learning management system. In addition, a backup plan, such as supporting online modules, increases viability and permanence. If several faculty are required, faculty development will need to be included. But innovative types of resources add value and contribute to student and faculty satisfaction.
Lastly, ensure that applicable accreditation standards support the course or curriculum and allow earning CME credits (if applicable). Prior to the launch, send announcements and promotional material (flyers) to stakeholders and community.
Question 6: Did your students learn what you intended? How can you determine program quality?
Assessment and evaluation are often used interchangeably. Briefly, there are two major aspects: assessing learners’ performance on one hand and evaluating the program’s overall effectiveness on the other. In both applications, students or academic leaders or both, as well as other stakeholders (e.g., donors of funds or equipment), receive the results. Evaluation can be formative or summative when final grades are given. Performance assessment (exams) of the learners depend on the nature of the learning objectives assessed (knowledge–attitude–skill) and is also institution specific. For example, faculty can assess skill objectives using simulations, but not every institution has access to a simulation lab, and demonstration of the skill and rating via checklist may be used instead. Most exams will assess mastering knowledge objectives and will need to be tailored to the institutional exam modalities. Program evaluation seeks to deliver a judgment about the entire curriculum’s effectiveness and may involve several components, such as student satisfaction and learning and teacher evaluations. Methods of program evaluation are more holistic in nature and can include learner interviews, surveys, or focus groups. All outcomes and results are collected, analyzed, and reported to reveal a baseline about the program, and how it compares to similar programs in the institution. Successful programs deserve dissemination as great examples for similar developments.
Final thoughts: Your program is successfully implemented—Now what?
A curriculum or program can be likened to a garden: It needs constant work and attention. New plants must be introduced and weeds eliminated to make room for them. Every iteration of the program will necessitate change depending on learner assessment and program evaluation. Change might be drastic or subtle, but it should never be undocumented and random. Every iteration is a new beginning and necessitates considering unanswered questions, values, and the needs from question 1 (needs assessment). For balance, adding new content will require eliminating existing content. The program evaluation is most likely eye-opening in terms of unexpected strengths and weaknesses. One word of advice: listen to your learners. They see the program with the eyes of tomorrow.
Here are some guiding prompts for planning and reflection. I am looking forward to your thoughts!
1) What step outlined by the questions seems most feasible to implement, which one seems most difficult?
2) Who could you team up with for implementing a program?
1) Davis, B. G. (2009). Tools for teaching (2nd ed.). San Francisco, CA: Jossey-Bass. Thomas, P. A., Kern, D. E., Hughes, M. T., & Chen, B. Y. (Eds.). (2016). Curriculum development for medical education: A six-step approach (3rd ed.). Baltimore, MD: Johns Hopkins University Press.