A site dedicated
to supporting case-based learning by offering an educational
interface that uses patient problems as stimulus for learning
appropriate dermatology subjects.
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Dermatology
Integrative Competency Curriculum is case-based learning
that uses a patient problem as a stimulus for learning appropriate
dermatology subjects. Compared to traditional memory-based or
didactic learning, the integrative competency curriculum is
thought to be more effective for creating a usable body of knowledge
in the mind of the learner. In addition, it allows identification
and assessment of competently discussed case objectives categorized
into one or more of the ACGME defined competency areas. In the
integrated competency curriculum, the problem is encountered
first in the learning process and served as a focus or stimulus
for learning. The primary educational goals of the dermatology
integrative competency curriculum are to acquire an integrative
body of knowledge related to the problem and to develop and
apply critical thinking, problem solving and self-directed life-long
learning skills.
Why Integrative Competency Curriculum? Adult Learning Theory.
Dermatology residents have learning style preferences consistent
with adult learners. Many programs may wonder, “If it
isn’t broke, why fix it?” There are two main answers
for that question. First, we have to meaningfully incorporate
core competencies into our curriculum and, second, our learners
are adults, not children. The characteristics of dermatological
knowledge is immense and constantly changing. Decision-making,
reasoning and problem solving are critical cognitive processes
in dermatology practice. Dermatology education extends over
the lifetime of the individual, so we need to create a resourceful,
efficient, life-long learner. This brings us to the theories
of adult learning and brings up a new term to review - andragogy.
Adults have different learning styles than children. Throughout
most of primary, secondary and undergraduate education, and
even in many medical schools, pedagogical learning styles prevail.
The word pedagogy has its roots in the art of teaching children.
Andragogy is a term coined by Dr Malcolm Knowles, one of the
central figures in US adult education in the second half of
the Twentieth Century. Andragogy refers to the art of teaching
adults. The reason for the new term was to stress the fact that
adults learn differently than children.
There are five main qualities of adult learners. The first is
self-direction. Adult learners tend to prefer having a hand
in deciding what they need to know. Adult learners are in general
experience oriented. Many might consider the entire clinical
learning process of dermatology residents to be an excellent
example of experience-oriented adult learning. Adult learners
are internally motivated. Adults will pursue knowledge for knowledge’s
sake, or because of relevance to their chosen area of interest.
They do not do it because of a score or a grade. They seek knowledge
to improve themselves. Adult learners look for immediate application.
Knowledge that has no obvious relevance will often be lost shortly
thereafter in the mind of the adult learner. So many facts fill
the minds of the adult, but only the most relevant and applicable
knowledge will have a tendency for long-lasting resilience.
And, finally, adult learners tend to prefer problem-centered
learning rather than content-oriented learning. Information
concepts and skills are put in the memory in association with
a problem, allowing material to be recalled more easily when
the adult learner is faced with another related problem. Thus,
information obtained in the context of a problem is far better
retained than that information passively obtained out of context.
Integrating the Competencies
With the ACGME Outcomes Project beginning in 2000, just at the
time the curriculum was being developed and piloted, the curriculum
project took on new life and new purpose to have at its core
a complete integration of all six competencies. No longer would
the curriculum focus on patient care and medical knowledge,
but now dissecting the learner’s thought processes with
the other competencies would occur as well. With each learning
session and with each case, faculty, facilitators and dermatology
learners would discuss relevant patient-related applicable information
and scenarios to further develop the resident’s self-directed
competency in a meaningful, applicable, problem-centered fashion.
With each case, competently discussed questions and objectives
are documented and summarized each in one or more of the six
competency areas. Thus, the dermatology integrative competency
curriculum serves as a potent format for identifying, teaching
and assessing the competencies.
Expanding the Curriculum Faculty
“No One Person Owns a Curriculum”
Success of the dermatology integrative curriculum can only occur
with the sharing of the curriculum. This begins at the creator
level with an expansion of the key curriculum development faculty.
Key dermatologists with various backgrounds and specialty areas
of interest have joined the curriculum development faculty.
They include experts in general and medical dermatology, pediatric
dermatology, dermatology surgery, dermatopathology, basic science,
and cosmetic dermatology.
There are many opportunities to participate as a curriculum
faculty member. These are the experts currently working to define
learning objectives and to develop the problem-centered cases.
Plan to Share
“If you have knowledge, let others light their candles
with it.”
-Sir Winston Churchill
We are all members of the same residency education community.
My hope is that this can be a helpful tool made available to
all programs. The intent of this project has always been to
share a vision and what I believe to be a better way of learning
and a better way of creating a body of knowledge usable in the
future in the mind of the learner. For those programs who would
like to try this, I would like to offer free access to our online
site. User identification and passwords will be given only so
that we may help your program keep track of all competently
discussed objectives and questions. We will also look forward
to your comments, suggestions, and case developments of your
own. The feedback from other programs will be very important
for us to maximize resident competency. |
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