Curriculum development of 6for6

Curriculum design, development, and implementation

Kern and colleagues’ 6-step curriculum development approach for medical education (Figure 1) was used to ground the design and development of the 6for6 framework and identify program goals, learning objectives, curriculum content, and instructional strategies.¹¹ Information from phase 1 was integrated to build an engaging, feasible, and sustainable curriculum framework that met the needs of RRFPs. A curriculum blueprint was developed to define learner outcomes and expected competencies at the end of 6for6, then this information was mapped onto the most effective instructional and assessment strategies. Throughout this process, principles and theories of adult learning were integrated to emphasize the value in the learning process, such as fostering self-directed learning, internal motivation, and relevant, practical experiences given participants’ goals after 6for6.¹²

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Figure 1.

Curriculum development plan

Reprinted from Kern DE, Thomas PA, Hughes MT, editors. Curriculum development for medical education: a six-step approach. ©1998, 2009 The Johns Hopkins University Press. Reprinted with permission from The Johns Hopkins University Press.

Curriculum

The 6for6 curriculum comprises 6 structured, face-to-face sessions at the main campus in St John’s and e-learning activities at a distance. Session content (Table 1) focuses on the priority research topics identified in phase 1.

Experts and presenters are invited by the research team to teach the topics and develop teaching materials that are reviewed and approved by the core planning committee and the Health Research Ethics Authority. To prepare participants for each upcoming session, consolidate participant learning after each face-to-face session, and maintain participants’ skills, presession and postsession curriculum and activities are provided. Individual work is required between the face-to-face sessions and includes e-learning modules, readings, online discussion questions, e-learning assignments (case-based or problem-based activities), and audio- or video-based activities. Participants also fill out evaluation forms electronically before and after completion of any presession or postsession work.

Each session follows a similar agenda (Box 1) with minor edits based on participant feedback. Mealtimes double as social time, allowing participants to form relationships that could extend academically into a research network. Overall, participants appreciate this format, particularly the highly interactive curriculum delivery, the balance between formal curriculum delivery and time to “learn by doing” through dedicated time to work on research proposals, and meeting with the research assistant (RA), librarians, and mentors. The agenda also provides substantial time for participants to work on their proposals and projects, helping to address the self-reported lack of research skills and challenges associated with limited time to do research.

Educational strategies

The 6for6 program is designed around learner-centred principles including active, social, and contextual learning. Participants conduct their own independent research projects on real-world issues in their practices or communities, are taught to conceptualize the project in the context of a framework, and are connected with MUN faculty with similar research interests. Given the personal relevance of these projects, participants are also intrinsically motivated and take ownership of their learning. Further, the curriculum and scheduling are founded on a needs assessment, and a participatory action approach is used for “reflection in action.”¹³ Participants occasionally request agenda changes during sessions, which are accommodated if possible. Changes are also made based on postsession and postprogram feedback. Adjustments are also made to accommodate participants’ “life issues” that challenge full participation (eg, becoming a new parent, children’s illnesses) using flexible program delivery (eg, connecting participants to face-to-face sessions via teleconference), making 6for6 inclusive and respectful of participants’ personal situations.

The 6for6 program uses a blended learning model with synchronous (instructor-led) and asynchronous (self-paced) learning approaches, and didactic and e-learning instructional strategies including podcasts, mobile learning, case- and problem-based learning, group discussion, and in-class activities to consolidate and confirm learning. An Internet portal (www.6for6.ca) was created to house curriculum content, resources (eg, evaluation tools, handouts, and schedules), discussion boards (for group and individual discussion with mentors), and personal reflection or note-taking journals. Each participant has access to their own portal, and committee members have administrative access to discussion boards and to upload resources. Curriculum content in the portal is organized chronologically according to the timing of the face-to-face sessions. All curriculum content from before and after the face-to-face sessions is expected to be completed 1 week before and 3 to 4 weeks following the face-to-face sessions, respectively.

Program infrastructure

The infrastructure of 6for6 is based on findings from phase 1. Participants are provided dedicated time and space to work on research activities and to collaborate with their peers. Partnerships with on-site departments and services (including library services, professional development conferencing services, and ethics) help participants build and formalize research networks and research communities of practice⁴ both within and outside of their respective communities. Librarians and ethics officers not only provide support to our participants, but also teach relevant topics during our face-to-face sessions and develop online learning modules as part of the presession and postsession curriculum, making them critical to the success of 6for6.

Research assistant

The RA assists with activities relevant to participants’ research projects, helps participants between face-to-face sessions, reminds participants of presession and postsession curricular work, and connects participants with on-site research services (eg, librarians, ethics officers, and mentors). The RA also aids with research activities (eg, literature searches, annotated bibliographies, proposal writing, and data collection and analysis), coordinates face-to-face sessions and uploading curricular content to the portal, and tracks participant progress. The RA’s role will also be vital to the ongoing research success of 6for6 alumni.

Recruitment of participants

Over 3 years, 6for6 will accept 18 RRFPs (6 per year) to complete 12 months of a research curriculum. These physicians live and work in small communities throughout Newfoundland and Labrador (NL), New Brunswick, and Nunavut and have part-time appointments as clinical teachers with the Faculty of Medicine at MUN. Although participants vary in practice experience, none has previous advanced research training or experience. We have developed a 2-phase application process whereby individuals submit a letter of intent describing their interest in 6for6 and their ideas for a research project. The committee reviews their applications and ranks the top 10 applicants based on the scientific merits of the letter of intent, the geographic representation, and 6for6 objectives. The top 10 ranked applicants are then invited to submit a formal application, which includes sign-off by their medical directors regarding time away from work to both participate in the face-to-face sessions and complete other program requirements. These applications are then ranked by the core planning committee until consensus is reached.

Program evaluation

Program evaluation is in progress and performed at all levels to include 6for6 participants, the core planning committee, and mentors using focus groups and surveys. Feedback is also sought informally from participants throughout the program, particularly during face-to-face sessions, and is integrated into future sessions. Quantitative and qualitative findings from the evaluation of the first 3 sessions have been extremely positive and suggest a high degree of participant satisfaction and self-perceived growth in research knowledge, skills, and application abilities. Evaluation data will be reported following the first iteration of the program and as a complete 3-year pilot.