AMEE Guide No.14 : Part 1 - An introduction to outcome-based education

AMEE Guide No. 14: Outcome-based education: Part 1 - An introduction to outcome-based education

R. M. HARDEN*, J. R. CROSBY & M. H. DAVIS

Centre for Medical Education, Tay Park House, Dundee, UK

Outcomes and curriculum planning

l  A good archer is not known by his ar rows but by his aim. - Thomas Fuller

l  A windmill is eternally at work to accomplish one end, although it shifts with every var iation of the weathercock, and assumes ten different positions in a day. - Charles C. Colton

 

l  건물을 지을 때 건축가가 명확한 계획을 서술해야 하듯, 의학교육에 있어서도 그 outcome이 무엇인지에 대한 분명하고, 공적인 서술이 있어야 한다. (이 프로그램으로 어떤 종류의 의사가 양성될 것인가? 그들이 갖춘 역량은 무엇이 될 것인가? 등등)

l  모든 의과대학은 설계에 의한 것이든, 그렇지 않든 성과(outcome)을 가지게 되어있다. 즉, 의사를 키워내긴 하지만, 그 결과물은 특정되어 있지 않다.

l  교육과정의 개념은 전통적으로 두 가지(Content and Examinations)를 포함하나, 이 개념은 학습방법, 교수전략, 프로그램의 목적 등으로 넓어졌다. 그 중 “learning outcome”이 핵심 개념으로 등장하고 있다.

l  결과물에 대한 고려가 프로그램 개발과 평가의 바탕이 되어야 한다.

 

What is outcome-based education?

l  OBE의 개념을 잡기(conceptualize)는 쉬우나, 정의를 내리기는 어렵다.

l  OBE에서는 성과가 과정을 정의한다.

l  교육 성과는 명확하게 특정되어야 하며, content와 그 구성, 교육 전략, 교수법, 평가법 등은 기술된 학습 성과의 바탕에서 결정되어야 한다.

l  두 가지 requirement

n  학습 성과(learning outcome)를 정의해야 한다.

n  교육 성과(educational outcome)는 교육과정에 대한 결정에 있어 가장 중요한 이슈가 되어야 한다.

Spady (1988) “OBE is a way of designing, developing, delivering and documenting instruction in terms of its intended goals and outcomes. “Exit outcomes are a critical factor, in designing the curriculum” “Develop the curriculum from the outcomes you want students to demonstrate, rather than writing objectives for the curriculum you already have.”

 

Characteristics of a `fully operational outcomes-based school’, Spady (1993) (1) A collectively endorsed mission statement that reflects commitment to success for all students and provides the means for translating that commitment into action. (2) Clearly defined publicly derived `exit outcomes’ that students must demonstrate before they leave school. (3) A tightly articulated curriculum framework of program, course and unit outcomes that derive from the exit outcomes. (4) A system of instructional decision making and delivery that employs a variety of methods, assures successful demonstration of all outcomes and provides more than one chance for students to be successful. (5) A criterion-referenced system of assessment. (6) An ongoing system of programme improvement that includes staff accountability, effective leadership and staff collaboration. (7) A data base of signi® cant, visionary outcomes for all students, plus key indicators of school effectiveness, that is used and updated regularly to improve conditions and practices that affect student and staff success.

 

Development of outcome-based education

l  OBE는 강한 반대에 부딪혔는데, 우려 중 하나는 ‘교육은 open-ended여야 한다’라는 것이고, 또 다른 우려는 명시된 성과에 태도나 가치관이 들어가는 것은 부적절하다는 것이다.

l  하지만 Glatthorn(1993)은 광범위한 성과를 모두 다루는 OBE가 가능하다고 주장했으며, 성과가 명시된 핵심 교육과정의 필요성과 적절한 행동과 태도를 개발할 필요성은 의학교육 과정의 필수 요소이다.

“To define education as a set of outcomes decided in advance of teaching and learning conflicts with the wonderful, unpredictable voyages of exploration that characterise learning through discovery and inquiry.”

 

Advantages of outcome-based education

l  1. Relevance  : 교육과정과 의학의 practice에 초점을 맞춤.

l  2. Controversy : 논쟁적인 이슈를 다룰 수 밖에 없도록 한다.

l  3. Acceptability : 모든 교수자들이 받아들일 수 있는 교수자 친화적 모델.

l  4. Clarity : 쉽게 이해 가능하다

l  5. Provision of framework : 교육과정에 대한 강력하고 튼실한 framework 제공

l  6. Accountability : 성과물이 판단될 수 있는 세부사항을 결정함으로써, 책임과 QA를 강조함

l  7. Self-directed learning

l  8. Flexibility

l  9. Guide for assessment

l  10. Participation in curriculum planning : 다수의 개개인이 성과를 구체화 하는 것에 기여할 수 있다.

l  11. Tool for curriculum evaluation

l  12. Continuity of education

 

Presentation of the outcomes

l  학습 성과는 다양한 방법으로 표현될 수 있다.

l  “the key for most schools seems to be developing outcomes that are broad in their vision but specific enough to be taught and measured effectively”

l  기억하기 쉽게 만들면 장점이 많다.

l  Three circle

n  Inner : 의사가 하는 일

n  Middle : 그 일에 대한 접근방법

n  Outer : 하나의 의사로서의 성장

l  의학의 여러 영역을 포괄하여 3차원적으로 볼 수 있음. 

 

Specification of outcomes

l  OBE를 하게 되면 많은 도전에 부딪힐 것이다.

l  한 학교의 교육성과는 그 학교의 교육목표(mission statement)를 반영한다.

l  넓은 범위의 이해관계자가 참여해야 한다.

l  교육 요구를 identification할 때 사용된 접근법이 성과를 identification할 때도 사용될 수 있다.

l  OBE를 도입할 때 주요한 해결과제 중 하나는 학생 평가에 적합한 시스템을 도입하는 것이다. 성과에 대한 기준이 정해져야 한다. 예를 들면 다음과 같다.

n  Level 1. an awareness of the procedure;

n  Level 2. a full theoretical understanding of the procedure;

n  Level 3. observation of the procedure;

n  Level 4. carrying out part of the procedure;

n  Level 5. undertaking the procedure under supervision; and

n  Level 6 undertaking the procedure unsupervised.

 

Implementation of outcome-based education

l  Faculty

n  Was due consideration given to determining the educational outcomes? Were all the stakeholders involved?

n  Have the outcomes been clearly and unambiguously communicated to all concerned?

n  Is the overall educational programme and educational environment consistent with the outcomes as stated?

n  Are the exit outcomes achieved by the students at the time of graduation?

l  Curriculum planning committees and course committees

n  Are teachers familiar with the specified educational outcomes?

n  Are the outcomes, appropriate to each phase of the curriculum, addressed in that phase?

n  Does each course contribute appropriately to the outcomes for the phase?

n  Are the learning experiences offered likely to assist the students to achieve the outcomes?

n  Do students achieve the outcomes specified for the phase of the curriculum by the end of the phase?

l  Individual teacher

n  Have teachers a general awareness of the educational outcomes for the curriculum?

n  Have teachers a detailed understanding of the educational outcomes relating to their own contribution to the curriculum?

n  Does their contribution to the educational programme reflect this understanding?

l  Staff with responsibility for assessment

n  Do the assessment procedures adopted assess the outcomes?

n  Are under-performing students, those who do not reach the standard required, given appropriate feedback and a further opportunity to demonstrate their competence?

l  Students

n  Are students familiar with the outcomes?

n  Have students been involved in discussions relating to the outcomes as specified?

n  Do they find the outcomes helpful as guides to learning?

n  Do students recognise that the learning experience provided and the assessment procedures reflect the outcomes?

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Med Teach. 1999;21(6):546-52. doi: 10.1080/01421599978951.

AMEE Guide No. 14: Outcome-based education: Part 5-From competency to meta-competency: a model for thespecification of learning outcomes.

Harden J R Crosby M H Davis M Friedman RM.

Abstract

Increased attention is being paid to the specification of learning outcomes.This paper provides a framework based on the three-circle model: what the doctor should be able to do ('doing the right thing'), the approaches to doing it ('doing the thing right') and the development of the individual as a professional ('the right person doing it').Twelve learning outcomes are specified, and these are further subdivided.The different outcomes have been defined at an appropriate level of generality to allow adaptability to the phases of the curriculum, to the subject matter, to the instructional methodology and to the students' learning needs. Outcomes in each of the three areas have distinct underlying characteristics.They move from technical competences or intelligences to meta-competences including academic, emotional, analytical, creative and personal intelligences. The Dundee outcome model offers an intuitive, user-friendly and transparent approach to communicating learning outcomes. It encourages a holistic and integrated approach to medical education and helps to avoid tension between vocational and academic perspectives.The framework can be easily adapted to local needs. It emphasizes the relevance and validity of outcomes to medical practice.The model is relevant to all phases of education and can facilitate the continuum between the different phases. It has the potential of facilitating a comparison between different training programmes in medicine and between different professions engaged in health care delivery.