Volume 80 - Winter 2002	Download

Improve Program Quality by Developing Instructional Objectives by Charles W. Ford, PhD APRC Committee Member

Program officials should always be concerned with meeting the goals of an instructional program. Some of these goals are quite broad in scope, such as those that pertain to the interests and desires of the profession. Others are more restrictive, such as the ones that are a reflection of the learning institution where the program is housed. Still other goals are quite specific to the content of the courses that comprise the curriculum. These are more often identified as learning objectives.

Several Standards in the NAACLS accreditation process focus on learning objectives. It is these objectives that make up the instructional roadmap to intended outcomes of the teaching/learning process. They can be divided into the three taxonomic areas, cognitive, affective and psychomotor. These areas more precisely describe the intended behaviors the student should exhibit as part of the instructional sequence.

For the health education professional who has been schooled in curriculum development, the process of developing instructional objectives is a combination of professional experience mixed with trial and error. In many ways, the development of a valued set of instructional objectives is a result of the application of cognitive knowledge, affective experiences in dealing with students and other instructors, and the psychomotor skills required to create meaningful patterns of application.

One of the major factors assisting many health education professionals in creating these meaningful patterns is the understanding of the principle that all objectives, in all domains, have a base in the cognitive domain. Both affective and psychomotor domains require a knowledge base. This principle is in opposition to the myth held by many new instructors or program officials that everything is indeed cognitive.

An example of this point is how some students react when they first enter a human anatomy laboratory. The students may be prepared cognitively from detailed descriptions and warnings about potential responses, but it still will not preclude some from fainting or exhibiting some other affective behavior. The cognitive knowledge for some is not sufficient to overcome the affective response.

In accreditation, the spirit and intent of Standards is to ask the program to examine expected learning outcomes in the three domains. This helps the educational process be more precise in defining expectations and outcomes. What does the instructor want to happen (or not happen) at the time of the introduction to the first human anatomy laboratory session? What could the instructor do prior to the session that would modify behavior?

For most of the program and, therefore, the curriculum, the program official will have supervisory control over the course content as listed in the curriculum sections of the Standards. Given this, the program official can guide the program development through hiring practices, faculty development, employer and student follow-up, and the use of consultants. Although the program may not be solely self-contained and administered, the major elements are part of a centralized system.

However, some programs, particularly small ones and/or new ones, are usually part of a larger entity such as a college of medicine or allied health. In these cases, program officials must rely on the cooperation of colleagues who may have a very different perspective about the importance of the program. These colleagues may, in fact, be responsible for delivery of a significant portion of the curriculum through department assignments.

Furthermore, some of these colleagues may be basic scientists or physicians who have had little experience in the accreditation process and little or no formal training or experience in course or curriculum design. To discuss writing instructional objectives with them may produce some results; for others it may fall on deaf ears; for others the response may actually be hostile.

What is a program official to do in cases such as these? The Standards specify areas of curriculum that should be included in the instructional program; they do not, however, specify how the curriculum should be organized or delivered. A typical question from a program official in this situation is: WHAT CAN/SHOULD I DO?

The response that follows is suggested and not prescriptive. There are some responses that are more common than others:

• Faculty Development - providing faculty workshops are always possibilities
• Individual Development - working with faculty members on an individual basis with a specific course
• Curriculum/Course Development - adding some objectives to the course syllabus based on the content and the expectations for the course

These are common choices and most programs choose one of the above or a combination. But program officials should think of the curriculum as a work in progress, particularly the instructional components. Just as there are opportunities for administrative program improvement, there will be regular, ongoing opportunities to improve the teaching/learning process and sequence.

One Standard requires the program to address Educational Methods in some form or another. This is often questioned by health professionals whose emphasis is on delivery of health services and the preparation of students who will do likewise.

One reason for the inclusion of this Standard is based on a strong belief held by the many volunteers and stakeholders who support accreditation. It is the belief that health professionals have a responsibility to begin the process of preparing the next generation of leaders. The understanding of Educational Methods and their application in the teaching/learning process helps create the framework for this development. Furthermore, most health professionals are also educators in the clinical practice setting, teaching patients, colleagues, and future colleagues. An understanding of this aspect of the profession should not wait until it is accomplished by trial and error. An important component can be accomplished by means of the educational program itself.

As in the Standard addressing the systematic development of educational objectives, meeting this particular Standard is not as simple as it sounds. However, it is possible to bring the two Standards together by developing an internal assignment to solve the dilemma of students who need to understand learning principles and program faculty who themselves have not addressed learning outcomes.

The student assignment can be to develop learning outcomes for a course or set of courses. This assignment can be for each individual student or, better yet, for an entire group of students. Since the development of an educational program is usually the result of group effort, a group of students taking a course can develop a set of objectives based upon their own observation and experience.

One may ask how the accreditation agency views innovative program development. NAACLS Standards are based on the applied wisdom of members of a profession. They are not intended to create obstacles to be overcome but rather to serve as aids in assessing program quality. It is entirely within the purview and authority of a program to determine the methods to arrive at those goals. T

The message here should be clear: work within your program limitations and your program mission to improve the quality of your program. Apply your creative abilities to issues at hand and seek help in areas that present difficulties. The NAACLS Board of Directors, the Committee members, and the NAACLS staff are all part of your team. Program improvement is everyone's goal.

Note: In the Spring/Summer 2001 NAACLS News (Volume 78), available online at www.naacls.org, Kathy Waller provided explanation that may be beneficial to program directors as they try to make distinctions between objectives and competencies. The front page article is: "Competencies Versus Objectives: Clarification of Intent." Dr. Waller has also provided specific examples of well-written objectives in an article found at the NAACLS website, "Writing Instructional Objectives."

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