when i say When I say … whole-task curricula Diana Dolmans
Why should I be able to recognise this structure under the microscope? Why should I be able to understand these statistics? These questions are often raised by students who are trained in traditional part-task curricula. Such curricula specify what students must learn in terms of knowledge, skills and attitudes. Having specified a list of objectives to be achieved, lectures are frequently offered to transmit knowledge, skills training sessions to train skills, and role-plays to train attitudes. Thus, we typically split up what should be taught into small parts, teach these small parts separately and tell students that they will be important later. These part-task curricula have two disadvantages. First of all, students wonder why they should learn all these small components that seem to be meaningless for them. Students often do not see the relationship between what they are learning and later professional practice. Secondly, professionals complain that students are not able to apply and integrate their knowledge, skills and attitudes when dealing with a real and complex task in professional practice. What is the alternative? Instead of teaching parts that are not related to one another, we should start to design our curricula on the basis of whole tasks derived from professional practice. What are whole tasks? There are different types of whole task, but basically a whole task is a meaningful task or problem encountered by professionals in daily practice. For example, in the context of a family doctor who is consulted by a patient with knee pain, the whole task for the student might involve a video in which an Maastricht, the Netherlands
Medical Education 2015: 49: 457–458 doi: 10.1111/medu.12634
experienced family doctor performs a consultation with a patient with knee pain. Students observe the video and analyse the steps undertaken. The whole task might also be a simulated task in which students communicate with a simulated patient, conduct a physical examination and diagnose the problem. Students should of course start with simple tasks and only thereafter be confronted with more complex problems (i.e. the students should first meet a patient with clear and standard complaints and no co-morbidities, and should be enabled to easily communicate with that patient and conduct a physical examination without time constraints). Furthermore, it is important that teachers provide support and guidance at each level of complexity. Thus, within whole-task curricula, students are confronted with whole learning tasks that stimulate them to integrate knowledge, skills and attitudes that are ordered from the simple to the complex from the start.1 Knowledge, skills and attitudes are not taught in a piece-by-piece manner, but are integrated and students are encouraged to apply them. Problem-based learning is one example of a wholetask curriculum, but other approaches, such as project-based learning, can also represent examples of whole-task curricula as long as student learning within these curricula is driven by whole learning tasks derived from professional practice. These are curricula in which students are engaged in whole tasks, rather than curricula in which the components of a task are taught in isolation before the real task is introduced (i.e. procedural skills in a whole-task curriculum are taught in a skills laboratory as the need for them in the whole task occurs).2 Correspondence: Diana Dolmans, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, Maastricht 6200 MD, the Netherlands. Tel: 00 31 43 388 5730; E-mail: [email protected]
ª 2015 John Wiley & Sons Ltd. MEDICAL EDUCATION 2015; 49: 457–458
457
D Dolmans Is this just a new fashion? Should we just sit back and wait until it passes? Do these whole-task curricula avoid the problems students (Why do I need to learn this?) and teachers (Why do students not know how to use their knowledge?) often encounter? Do these whole-task curricula really enhance application and integration or transfer to new tasks? Whole-task curricula have been shown to be effective in teaching complex skills and professional competencies.3 Nevertheless, we need to work continuously towards further improving our curricula and must keep in mind that implementing a whole-task curriculum requires preparation at the level of the student, staff and organisation.4 Finally, much more research is needed to test how and under which conditions whole-task curricula can enhance integration and transfer to practice.
458
REFERENCES 1 van Merri€ enboer JJG, Kirschner PA. Ten Steps to Complex Learning, 2nd edn. New York, NY: Routledge 2013. 2 Merrill MD. First Principles of Instruction. New York, NY: John Wiley & Sons 2012. 3 van Merri€ enboer JJ, Kester L. Whole-task models in education. In: Spector JM, Merrill MD, Elen J, Bishop MJ, eds. Handbook of Research on Educational Communications and Technology. New York, NY: Springer 2007;441–56. 4 Dolmans DHJM, Wolfhagen IH, van Merri€ enboer JJ. Twelve tips for implementing whole-task curricula: how to make it work. Med Teach 2013;35 (10):801–5. Received 21 July 2014; editorial comments to author 17 September 2014; accepted for publication 29 September 2014
ª 2015 John Wiley & Sons Ltd. MEDICAL EDUCATION 2015; 49: 457–458
Why should I be able to recognise this structure under the microscope? Why should I be able to understand these statistics? These questions are often raised by students who are trained in traditional part-task curricula. Such curricula specify what students must learn in terms of knowledge, skills and attitudes. Having specified a list of objectives to be achieved, lectures are frequently offered to transmit knowledge, skills training sessions to train skills, and role-plays to train attitudes. Thus, we typically split up what should be taught into small parts, teach these small parts separately and tell students that they will be important later. These part-task curricula have two disadvantages. First of all, students wonder why they should learn all these small components that seem to be meaningless for them. Students often do not see the relationship between what they are learning and later professional practice. Secondly, professionals complain that students are not able to apply and integrate their knowledge, skills and attitudes when dealing with a real and complex task in professional practice. What is the alternative? Instead of teaching parts that are not related to one another, we should start to design our curricula on the basis of whole tasks derived from professional practice. What are whole tasks? There are different types of whole task, but basically a whole task is a meaningful task or problem encountered by professionals in daily practice. For example, in the context of a family doctor who is consulted by a patient with knee pain, the whole task for the student might involve a video in which an Maastricht, the Netherlands
Medical Education 2015: 49: 457–458 doi: 10.1111/medu.12634
experienced family doctor performs a consultation with a patient with knee pain. Students observe the video and analyse the steps undertaken. The whole task might also be a simulated task in which students communicate with a simulated patient, conduct a physical examination and diagnose the problem. Students should of course start with simple tasks and only thereafter be confronted with more complex problems (i.e. the students should first meet a patient with clear and standard complaints and no co-morbidities, and should be enabled to easily communicate with that patient and conduct a physical examination without time constraints). Furthermore, it is important that teachers provide support and guidance at each level of complexity. Thus, within whole-task curricula, students are confronted with whole learning tasks that stimulate them to integrate knowledge, skills and attitudes that are ordered from the simple to the complex from the start.1 Knowledge, skills and attitudes are not taught in a piece-by-piece manner, but are integrated and students are encouraged to apply them. Problem-based learning is one example of a wholetask curriculum, but other approaches, such as project-based learning, can also represent examples of whole-task curricula as long as student learning within these curricula is driven by whole learning tasks derived from professional practice. These are curricula in which students are engaged in whole tasks, rather than curricula in which the components of a task are taught in isolation before the real task is introduced (i.e. procedural skills in a whole-task curriculum are taught in a skills laboratory as the need for them in the whole task occurs).2 Correspondence: Diana Dolmans, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, Maastricht 6200 MD, the Netherlands. Tel: 00 31 43 388 5730; E-mail: [email protected]
ª 2015 John Wiley & Sons Ltd. MEDICAL EDUCATION 2015; 49: 457–458
457
D Dolmans Is this just a new fashion? Should we just sit back and wait until it passes? Do these whole-task curricula avoid the problems students (Why do I need to learn this?) and teachers (Why do students not know how to use their knowledge?) often encounter? Do these whole-task curricula really enhance application and integration or transfer to new tasks? Whole-task curricula have been shown to be effective in teaching complex skills and professional competencies.3 Nevertheless, we need to work continuously towards further improving our curricula and must keep in mind that implementing a whole-task curriculum requires preparation at the level of the student, staff and organisation.4 Finally, much more research is needed to test how and under which conditions whole-task curricula can enhance integration and transfer to practice.
458
REFERENCES 1 van Merri€ enboer JJG, Kirschner PA. Ten Steps to Complex Learning, 2nd edn. New York, NY: Routledge 2013. 2 Merrill MD. First Principles of Instruction. New York, NY: John Wiley & Sons 2012. 3 van Merri€ enboer JJ, Kester L. Whole-task models in education. In: Spector JM, Merrill MD, Elen J, Bishop MJ, eds. Handbook of Research on Educational Communications and Technology. New York, NY: Springer 2007;441–56. 4 Dolmans DHJM, Wolfhagen IH, van Merri€ enboer JJ. Twelve tips for implementing whole-task curricula: how to make it work. Med Teach 2013;35 (10):801–5. Received 21 July 2014; editorial comments to author 17 September 2014; accepted for publication 29 September 2014
ª 2015 John Wiley & Sons Ltd. MEDICAL EDUCATION 2015; 49: 457–458
