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Dasar-dasarPengembangan KurikulumPendidikan 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
Proses BelajarMengajar
Penilaian
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. Identifying the need 2. Establishing the learning outcome 3. Agreeing the content 4. Organizing the content 5. 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. Menyusun bahan ujicoba
2. Melakukan ujicoba kurikulum
3. Revisi dan konsolidasi
4. Review kurikulum yang telah disusun
5. 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 Competence embraces the structure of knowledge and abilities” knowledge and abilities” (Messick, 1984)(Messick, 1984)
““Competence rests on an integrated deep Competence rests on an integrated deep structure (understanding) and on the structure (understanding) and on the general ability to coordinate appropriate general ability to coordinate appropriate internal cognitive, affective and other internal cognitive, affective and other resources necessary for successful resources necessary for successful adaptation” adaptation” (Wood & Powers, 1987)(Wood & Powers, 1987)
There are enabling factors for competenceThere are enabling factors for competence
Competencies(a cognitive perspective)
Competence derives from possession of a Competence derives from possession of a set of relevant attributes such as knowledge, set of relevant attributes such as knowledge, skills and attitudes, called skills and attitudes, called competenciescompetencies
a a competencycompetency is a combination of attributes is a combination of attributes underlying some aspect of successful underlying some aspect of successful professional performanceprofessional performance
(Gonczi et al, 1993)(Gonczi et al, 1993)Competence in an area therefore requires a Competence in an area therefore requires a specific set of prerequisite competenciesspecific 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
Structure/Content-based
Competency-based
Driving factorCurriculum
Content-knowledge acquisition
Outcome-knowledge application
Driving force for process
Teacher Learner
Path of learning Hierarchical Non-hierarchical
Differences between Content-based/Structure/Process-based and Competency-based
Educational Programme
Structure/Content-based
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/Content-based
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/Content-based
Competency-based
Timing of assessment Emphasis on summative Emphasis on formative
Program completion Fixed time Variable time
Curricular Design for CBE1. Competency identification
2. Determination of competency components and performance levels
3. Competency evaluation
4. Overall assessment of the process
Examples of performance levels1. Novice
2. Beginner
3. Competent
4. Proficiency
5. Expert
1. Beginning level
2. Intermediate level
3. Advanced level
1. Melihat/tahu
2. Melakukan di bawah supervisi
3. Melakukan mandiri
OutcomesOutcomes(areas of competence)(areas of competence)
CompetenciesCompetencies
Knowledge, Skills, AttitudesKnowledge, Skills, Attitudes
CurriculumDevelopment
EducatingDoctor
Roles and Functions of Health ProfessionalRoles and Functions of Health Professional
Competencies required for performance of roles/functionsCompetencies required for performance of roles/functions
Knowledge, skills, attitudes for acquisition of competenciesKnowledge, skills, attitudes for acquisition of competencies
Competencies required for performance of roles/functionsCompetencies required for performance of roles/functions
Roles and Functions of Health ProfessionalRoles and Functions of Health Professional
Knowledge, skills, attitudes for acquisition of competenciesKnowledge, skills, attitudes for acquisition of competencies
AssessAssess
AssessAssess
AssessAssess
Elements of CBME (1)1. Competencies to be achieved are carefully
identified, verified and made public in advance
2. 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. Competencies are carefully selected2. 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 (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 performance-based 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