DR.

ELENGOVAN VARUTHARAJU Workshop

BAHAGIAN PENGURUSAN LATIHAN
19 – 21 August 2015
KEMENTERIAN KESIHATAN
MALAYSIA KSKB SAS, UK
 OUTCOME BASED EDUCATION

What is an Outcome? What is an Objective?

• Consequences • Aim
• Results • Purpose
• Product • Set
• Effect • Plan
• Conclusion • Expected
• Ending • Be going to
• Achieved • Intend
 LEARNING OUTCOMES (LO)

Level of Qualification

o Standard and Quality

Teaching and Learning
o Determination of Credits
Assessment of Students
Field of Programs
Study
 ANATOMY OF LO
Behaviour Concept Context

Demonstrate the application of knowledge and

skills in the provision of patient care.
 ANATOMY OF LO
Utilize knowledge and skills in the provision of
patient care.
Demonstrate the application of knowledge and
skills in the provision of patient care.
Apply knowledge and
skills in the provision
of patient care.
Discuss management of
hypertension in elderly
patient.
 OUTCOME BASED PROCESS AND PRODUCT BASED
CURRICULUM CURRICULUM

Curriculum Review
and Development

Objectives
Input
Intended
performance
3-5 years after Content,
Impact Process sequencing and
graduation
delivery

Expected
performance at
the end of the Outcome Output
Assessment
course of study.
 OUTCOME BASED EDUCATION
A comprehensive • What do you want the Outcome
approach to organizing student to be able to
do?
and operating an
education system that is • How will the student Measurement
focused and defined by demonstrate the
the successful learning?

demonstrations of • How will I know the Standard/

students has done Criteria
learning sought from well?
each student. • What does the student Syllabus
(Spady, 1994) need to know in order
to do well?
OBE is an approach of
curriculum design that focuses • What activity will Pedagogy
on the end product, and defines facilitate the learning?
what the learner is able to do.
 OBE CURRICULUM DESIGN
Identify Desired Wiggins and McTighe (1998)
results Backward Design

Determine
acceptable
evidence

Plan learning
experience and
instruction

Learning
Outcome Measurement
Experience
 Objektif Komplians
Program Kompetensi kepada
Pengiktirafan
(PEO) yang Standard
diperlukan Performa

Keberhasilan
Pembelajaran Pengukuran Pengalaman Penilaian
Program Pembelajaran

Hasil Bersemuka
Standard • Syarahan
Pembelajaran
Performa • Tutoran
Kursus
• Amali
Hasil • Klinikal/
Pembelajaran Penempatan
Unit Industri

Hasil Pembelajaran
Pembelajaran Kendiri
Topik
Student Learning Time
 PEMBANGUNAN KURIKULUM
OBE
AREA 1
AREA 2 AREA 3
Vision, mission,
Curriculum design & Assessment of
educational goals &
delivery students
learning outcomes

AREA 4 AREA 6
AREA 5
Student selection Educational
Academic staff
and support services resources

AREA 8
AREA 7 AREA 9
Leadership,
Programme Continual quality
governance &
monitoring & review improvement (CQI)
administration
 FALSAFAH
PENDIDIKAN SAINS KESIHATAN BERSEKUTU

“Pendidikan Sains Kesihatan Bersekutu di Kementerian

Kesihatan Malaysia, merupakan usaha dinamik untuk
memupuk pembangunan modal insan yang kompeten
dengan ciri-ciri intelektual, sosial, moral, dan kerohanian
dalam merealisasikan inisiatif dan aspirasi kesihatan
kebangsaan. Mengakui dinamik imperatif kesihatan dan
peningkatan ekspektasi awam, adalah menjadi komitmen
kami untuk menghasilkan profesional sains kesihatan
bersekutu yang bercirikan penyayang, kompeten, berdaya
saing dan berdaya maju. Ia akan dicapai melalui proses
penglibatan intelektual yang diperibadikan dan profesional,
menghormati kemuliaan insan, serta semangat
pembelajaran berterusan ke arah penyampaian penjagaan
kesihatan yang cemerlang.”
MODEL KERANGKA PEMBELAJARAN
Society Reflective Stake
Practices Holders

Clinical
Practice Knowledge
Based
Learning
Learner Patient
Communication Care /
and Caring
Interpersonal
Skills Professionalism

Inquiry Synthesis

Administrative Academia
Governance

Fig. 1 : Learning Framework of Allied Health Science Education

(Reference: Accreditation Council for Graduate Medical Education, USA, School of Nursing,
Queensland University of Technology, Australia,) 12
MODEL KERANGKA PEMBELAJARAN
Reflective
Practices

Professional
Practice

Developing
Competence

Introduction
to clinical knowledge
and practice

Inquiry Synthesis

Fig 2: Scaffolding of Learning Experience

(Reference: School of Nursing, Queensland University of Technology)
13
 Mapping of AHP’s Philosophy and
Educational Model
LO Clinical Patient Care Professionalism Communication Practice Based
Knowledge Learning

Apply
knowledge of
basic
biomedical,
clinical and
social-
behavioral
sciences in the
provision of
patient /
client care.
 Mapping of AHP’s Philosophy and
Educational Model
LO Clinical Patient Care Professionalism Communication Practice Based
Knowledge Learning

Demonstrate
the use of
professional
knowledge and
clinical
competence
grounded in
evidence
based practice
to support
patient care
decisions.
 Mapping of AHP’s Philosophy and
Educational Model
LO Clinical Knowledge Patient Care Professionalism Communication Practice Based
Learning

Promote
professional
collegiality
and social
skills in in the
provision of
patient
centered care.
Communicate
effectively
with
clinicians,
stake holders,
peers, patient
and relative
about care
plan.
Malaysian Qualification Framework
Malaysian Qualification Framework (MQF) is an
instrument that develops and classifies
qualification based on a set of criteria that is
agreed nationally and benchmarked with
international practices, and which clarifies the
academic levels learning outcomes and credit
system based on student’s academic load.
These criteria are accepted and used for all
qualifications awarded by higher education
providers. Hence, MQF integrates with and links
all national qualifications.
Levels of Qualification & Development of
Learning Outcome
• The depth, complexity and comprehension
of knowledge
• The application of knowledge and skills
• The degree of autonomy and creativity in
decision making.
• The communication skills
• The breadth and sophistication of practice.

TAXONOMIES OF LEARNING
LEARNING DOMAINS
 Levels of Qualifications &
Minimum Graduating Credits
20 Level MGC* Sectors
Skills Vocational & Academic
Technical
8 - Doctoral
40 Masters

Accredited Prior Experiential Learning

7 30 Postgraduate Dip
Note: * MGC = Minimum Graduating Credits

20 Postgraduate Cert
120 Bachelor
6 60 Graduate Dip
30 Graduate Cert
5 40 Advanced Diploma Advanced Diploma Advanced Diploma
4 90 Diploma Diploma Diploma
3 60 Certificate 3 Certificate
2 - Certificate 2 Certificate
1 - Certificate 1

Accredited Prior Experiential Learning

 MQF: Descriptors of Qualification Levels
Certificate Level Diploma level Advance Diploma
 Interpret and use technical o Use knowledge, o Use knowledge,
information comprehension and practical comprehension and practical
 Assist and use the scientific
skills at work. skills at work
work process
 Identify the impact of o Assess and decide, taking into o Assess and decide, taking
regulations, laws and contracts account social, scientific, and into account social, scientific,
upon work process ethical issues with moderate and ethical issues with
 prepare the work process and its autonomy. autonomy
operation o Be confident and o Possess study skills in
 Utilize technique and capabilities
entrepreneurial in pursuing adapting to ideas, processes
to search for and use data in
decision making, having their own career. and new procedures for
considered social, scientific, and o Be responsible member of career development
relevant ethical issues society. o Acquire team and
 Communicate effectively and o Possess study skills in interpersonal skills that are
convey information, ideas, adapting to ideas, processes appropriate to employment
problems and resolutions to the
and new procedures for career o Communicate effectively and
experts and non experts.
 Attain team and interpersonal development to transmit information, ideas,
skills that are appropriate to o Acquire team and problems and resolutions
employment interpersonal skills that are clearly to experts and non
 be responsible member of appropriate to employment experts
society o Communicate effectively and o Identify problems in their
 use independent learning skills
to transmit information, ideas, field of study.
in further education
problems and resolutions
clearly to experts and non
experts (MQA, 2008)
 PROGRAM EDUCATIONAL
OBJECTIVES
Defined as a broad statements that describes
what the graduates are expected to attain
within a 3-5 years after graduation.

Example:
Utilize knowledge and clinical skills to
function competently in the delivery of
patient centred services.

Attain, Perform, Inculcate, Integrate,

Demonstrate, Promote
 LEARNING OUTCOMES

Statements on what a • Program

learner should know,
understand and can do upon
the completion of a period of • Course
study.

Apply knowledge and skills • Unit

in the provision of
professional care.
• Topic
Behavior Concept Context

COGNITIVE PSYCHOMOTOR AFFECTIVE

 PROGRAM LEARNING
OUTCOMES
Apply knowledge of biomedical,
clinical, socio-behavioural sciences in • Program
the provision of professional care.
Apply knowledge of biomedical,
sciences in the provision of • Course
professional care.
Apply knowledge of pharmacological
sciences in managing clinical • Unit
condition.
Discuss the role of antibiotics in • Topic
patient treatment plan.

Behavior Concept Context

COGNITIVE PSYCHOMOTOR AFFECTIVE

 PROGRAM LEARNING
OUTCOMES
Demonstrate clinical competency
incorporating biomedical, clinical, • Program
socio-behavioural sciences in the
provision of professional care.
Demonstrate competency in managed • Course
care grounded within socio-cultural
and ethical practice.
Demonstrate competency of managed • Unit
care within the scope of professional
practical
Perform managed care based on • Topic
ethical principles.

Behavior Concept Context

COGNITIVE PSYCHOMOTOR AFFECTIVE

 PROGRAM LEARNING
OUTCOMES
Promote Professional collegiality and
ethical practice in the provision of • Program
professional care.
Integrate Professional collegiality and
ethical practice in the provision of • Course
professional care
Demonstrate team skills in the
provision of professional care • Unit
Communicate effectively with teams
members in the provision of • Topic
professional care.

Behavior Concept Context

COGNITIVE PSYCHOMOTOR AFFECTIVE

MAPPING AIMS, PEO, PLO WITH LEARNING DOMAINS

i. Knowledge.
PLOs ii. Practical skills.
iii. Social skills and
Responsibilities.
PEOs iv. Values, Attitude and
Professionalism
v. Communication,
Leadership and Team
Skills.
vi. Problem Solving and
Thinking Skills
vii. Information management
and lifelong learning
skills
viii. Managerial and
entrepreneurial skills
 EXERCISE

Task:

You are required to:

• Develop 1 PEO and related PLO for an identified

Program.
• Map your PEO with the Learning Model
• Map your PEO with PLO
• Map your PLO with MQF Learning Domain

Time: 30 mins
 EXERCISE
• PEO are linked to the Vision, Mission and Philosophy
• Map your PEO with the Learning Model

PEO Clinical Patient Prof. Com. Practice

Knowledge Care Based
learning
Utilize knowledge of x
biomedical, clinical,
socio-behavioural
sciences in the
provision of
professional care.

Provide managed care x x

incorporating moral,
ethical and
professional practice
 EXERCISE
• Map your PEO with PLO,.
• Each PLO developed must be linked to at least one PEO.

PEO PLO
Utilize knowledge of Apply knowledge of biomedical, clinical, socio-
biomedical, clinical, socio- behavioural sciences in the provision of
behavioural sciences in the professional care.
provision of professional care.

Provide managed care Demonstrate competence in managed care

incorporating moral, ethical incorporating moral, ethical and professional
and professional practice values grounded in evidence based practice.
 MAPPING PEO, PLO WITH LEARNING
DOMAINS
o PEOs and PLOs are linked to the vision, mission and
philosophy.
o Each PLO developed must be linked to at least one PEO.
o Each PLO must address the learning domains at least once.

MQF 1 MQF 2 MQF 3 MQF 4 MQF 5 MQF 6 MQF 7 MQF 8

Apply X X X
knowledge of Know Prof TS
biomedical,
clinical, socio-
behavioural
sciences in
the provision
of
professional
care.
 WRITING LEARNING OUTCOMES

Clinical Knowledge
Demonstrate knowledge 1. Apply knowledge of basic
and skills on basic biomedical, clinical and
biomedical, clinical and social-behavioral sciences in
social-behavioral sciences the provision of patient /
in the provision of patient client care.
care. 2. Demonstrate the use of
professional knowledge and
clinical competence
grounded in evidence based
practice to support patient
care decisions.
 WRITING LEARNING OUTCOMES
Patient/Client Care
Provide patient care 1. Communicate effectively and demonstrate caring and
that is compassionate, respectful behaviors when interacting with patients and their
families
appropriate, and 2. Gather essential and accurate information about their patients
effective for the in the management of care
management of 3. Develop and implement patient management plans
4. Advice and educate patients and their families on health
health problems and matters
the promotion of 5. Use information technology and evidences to support patient
health. care decisions and patient education
6. Perform competently procedures considered essential for the
area of practice
7. Provide health care services aimed at preventing health
problems or maintaining health
8. Work with health care professionals, including those from
other disciplines, to provide patient-focused care
 WRITING LEARNING OUTCOMES

Professionalism

Demonstrate 1. Demonstrate respect,

commitment to carrying
out professional compassion and integrity in the
responsibilities, provision of healthcare services.
adherence to ethical 2. Demonstrate commitment to
principles, and sensitivity ethical principles, sensitivity, and
to a diverse patient responsiveness to a diverse
population. patient population.
 WRITING LEARNING OUTCOMES
Interpersonal and Communication Skills
Promote professional 1. Communicate effectively in
collegiality with patients promoting a therapeutic and
and their family, ethical relationship with
agencies, professionals patients/clients.
and community in the
promotion , prevention, 2. Demonstrate interpersonal and
treatment, rehabilitation communication skills that result
and palliation services. in effective information
exchange and teaming with
patients, patient’s families, and
other professional
 WRITING LEARNING OUTCOMES

Practice Based Learning and Improvement

Perform competently to 1. Use information technology

investigate and evaluate and evidence based practices
patient care practices, to support decisions in
appraise and assimilate managing patient care.
scientific evidence, and 2. Participate in life long learning
improve their patient initiatives grounded in
care practices. scientific evidence to improve
patient care practices.
LEARNING OUTCOMES
Breaking learning outcome into
cognitive, psychomotor, and
affective domain is primarily an
analytical exercise.

In reality, neither teaching nor

learning neatly separates these
domains. The domain structures are
fluid.

Establish a balance of Learning

Outcome.
LEARNING OUTCOMES ESTABLISHING A BALANCE:

Balancing range and mixtures of

outcomes that meets learner,
societal and knowledge needs.

Balancing Levels; Lower levels

with higher levels outcomes.
 LEARNING
TAXONOMY
BALANCING LEARNING
TAXONOMIES

• Krathwohl Higher
Affective 1964
Order
Thinking
Skills

• Simpson
Psychomotor 1972
Lower
Order
• Revised Thinking
Cognitive Bloom 2001 Skills
 Remember Understand Apply Analyze Evaluate Create

Factual List Summarize Classify Order Rank Combine

Knowledge

Conceptual Describe Interpret Experiment Explain Assess Plan

Knowledge
Procedural Tabulate Predict Calculate Differentiate Conclude Compose
Knowledge

Meta- Appropriate Execute Construct Achieve Action Actualize

cognitive Use
Knowledge
 Simpson’s Model of
Psychomotor Domain (1972)
Origination Creates new patterns of
movements
Adaptation Responds to unanticipated Higher
experience
levels
Complex Overt Shows skilled performance
response
Mechanism Develops habitual responses

Guided response Uses trial and error/imitations

Lower
Set Establishes a mental set for levels
readiness
Perception Responds to sensory
stimulation
 Krathwohl’s Taxonomy of
Affective Domain (1964)

Characterization The learner provides evidence of

consistency of belief system
from the learner’s perspective
Higher
Organizing values The learner examines issues levels
from various perspectives after
analyzing each perspective
Valuing The learner supports his or her
belief /values on issues
presented.
Lower
Responding The learner presents argument
supporting one perspective levels
Receiving The learner actively listen to
issues presented
 OBE CURRICULUM DESIGN
Identify Desired Wiggins and McTighe (1998)
results Backward Design

Determine
acceptable
evidence

Plan learning
experience and
instruction

Learning
Outcome Measurement
Experience
 OUTCOME BASED
ASSESSMENT
It is an integrated, valid, reliable, fair, continuous
(rather than continual and judgmental testing) and
aligned approach to collecting evidences of students
learning for the purpose of improvement by focusing
more on formative assessment and provide timely
feedback.
It employs multiple and diverse assessment
methods.

It is criterion-referenced where the learning outcomes

and the benchmark standards become the assessment
criteria when judgment is made at the end of a course
and at the end of a program.
 OUTCOME BASED
ASSESSMENT

Measurement

Measurement is a product of measuring and

quantifying attributes or learning outcomes.

Measuring tools are used to quantify learning

outcomes.
 OUTCOME BASED ASSESSMENT
Assessment
Assessment is a process of finding evidence that the LOs, which are
the minimum performance standard or competence level, that have
been achieved when students have successfully completed a certain
course.

Assessment Tool
The measuring device used for learners to qualitatively and
quantitatively provide direct and indirect evidences of learning that
are aligned to LOs (valid) and highly accurate (reliable).

Assessment Items
The questions constructed in the assessment instruments that will
allow students to directly or indirectly demonstrate how much and
how well they know, understand and able to transfer what they know
to a variety of authentic context.
OUTCOME BASED ASSESSMENT

Evaluation

Evaluation is a process of using the evidences

collected through assessment to make a value
judgment on students’ performance relative
to benchmark standards specified by learning
outcomes.
 Evaluation strategy is to ensure that the
curriculum design components actually
enable learners to meet the outcomes
identified.

MEASUREMENT ASSESSMENT EVALUATION

Device to gather Techniques to Making Judgment
Information Interpret and render verdict
Performance

FORMATIVE SUMMATIVE
Measure Progress Provide the Grade
MEASUREMENT & ASSESSMENT
 OUTCOME BASED
ASSESSMENT
 Determine Learning Outcome
 Develop Evidence of Measurement
 Determine performance indicators
 Use those indicators as criteria for
assessment
 Apply result of assessment for continuous
improvement
 Don’t establish an outcome that cannot be
assessed.
 OUTCOME BASED
ASSESSMENT
LEARNING OUTCOMES: • Define a condition.
• List the manifestation of a
condition.
• Discuss intervention of a
condition.
• Apply knowledge, skills and
professional attributes in the
management of a condition.
• Perform competently
procedures with the scope
of professional practice

LEARNING
EXPERIENCES
 OUTCOME BASED ASSESSMENT
Learning Outcome Learning Measurement Assessment Evaluation
Taxonomy

Level and Tools Standards and Grading

Types
Apply knowledge Demonstrate  Not able to apply
of basic Cognitive Level: Know, how much knowledge
biomedical, L3 know how, and how well
clinical and social- show they know,  Some level of
behavioral MCQ understand understanding
sciences in the Essay and able to
provision of Case study transfer what  Demonstrate application
patient / client they know to of sound knowledge
care. a variety of
authentic  Demonstrate application
context. of sound knowledge with
rationale and logic
reasoning.
 OUTCOME BASED ASSESSMENT
Learning Outcome Learning Measurement Assessment Evaluation
Taxonomy
Apply knowledge, Cognitive L3 Essay
skills and MCQ
professional Assignments
attributes in the Case
execution of discussions
patient centred
care
Perform Cognitive L3- OSCE
competently 6 OSPE
procedures within Psychomotor Case Based
the scope of L4 Assessment
professional Mechanisms
practice Affective L4 -
Organize
 Performance Criteria and Indicators
Criteria Knowledge/Cognition Level of Performance Professional Attributes
level
Dependent  Lacks knowledge  Lacks accuracy & confidence  Action & behaviour are not modified
Novice  No awareness of alternatives  Needs continuous guidance & to meet the needs of the client and
 Unable to explain or give reasons supervision situation
for action  Poor organization  No meaningful explanation given
 No awareness of priorities  Lacks insight into professional
behaviour
Assisted  Knowledge is usually accurate  Accurate performance but some lack of  Recognizes the need to modify
Advance  Little awareness of alternatives confidence & efficiency actions/behaviour to client and
Beginner  Identifies reasons for action  Requires frequent direction & situation, but unable to do so in non-
Supervision routine situations.
 Some awareness of priorities &  Gives standard explanations/does n
requires prompting ot modify information.
Minimal  Applies accurate knowledge to  Safe and accurate; fairly confident/  Actions/interventions/behaviour
Supervision practice efficient.. generally appropriate for the client
Competent  Some awareness of alternatives  Needs occasional direction or support and situation
 Beginning to make judgments  Beginning to initiate appropriate actions  Explanation is usually appropriate &
based on contemporary evidence  Identifies priorities with minimal confident
prompting  Identifies the need for assistance
Independent  Applies evidence based knowledge  Confident/safe/efficient  Conscious/deliberate planning
Proficient  Demonstrates awareness of  Needs minimal direction/support  Actions/interventions/behaviour are
alternatives  Able to prioritise appropriate to the client & situations
 Sound rationale for actions  Able to adapt the situation  Give coherent/appropriate
 Makes judgments/decisions based information
on contemporary evidence  Identifies & makes appropriate
referral.
 OUTCOME BASED ASSESSMENT

Learning Domains Assessment Performance Indicator

Tools
Outcome
Kno Skill Aff SBST BST SST AST
Mengaplikasikan x x Tugasan Tidak dapat Tidak konsisten Kebolehan Kebolehan
konsep pengurusan
x Pemerhatian mengaplikasik dan cekap menggunakan mengaplikasika
masa dalam an dalam pengurusan n pengurusan
tugasan seharian pengurusan pengurusan masa secara masa secara
masa masa cekap konsisten
Case Study:
• Curriculum Level 5; Advanced Diploma,
12 months duration.
A curriculum was developed with a total of 45 NC.
Credit distribution were as follows:
• 32 credit was given for theory of 12 weeks
didactic input (
• 13 credit was given for 26 weeks of clinical
experience.
• A total of 8 weeks was given for seminar
week and examination.
Q: Calculate the distribution of SLT with
WMAL
Course Course Title Face to Face IL SLT
Code L T P
ADOE Biomedical 40 15 5 60 120
510103
ADOE Behavioral 50 20 0 90 160
510204
ADOE Clinical Science 1 30 10 20 140 200
510305
ADOE Clinical Science 2 40 15 15 130 200
510405
ADOE Pharmacology 40 5 15 100 160
520504
ADOE Management Science 30 10 0 120 160
520604
ADOE Professional development 40 20 0 100 160
520704
ADOE Research 40 10 0 70 120
520703
32 NC 12 weeks 310 105 55 810 1280
 Curriculum Evaluation
Elements Findings Remarks and
Recommendations
Awarded Credit 45 Within accepted range of
MQF
Theoretical 32 NC x 40 hrs = 1280 hrs With 32 NC, learners
Credit 12 weeks x 48 hrs (WMAL) require a total of 26.7
= 576 hours weeks.
Current WMAL: 106.7 .
8 minggu x 48 = 384 hours Daily SLT= 15.4 hours.
Clinical 13 NC = 26 weeks Industrial Placement
Experience 1 NC = 2 weeks

Remarks:
i. Curriculum too heavy to implement and very much teacher
centered.
ii. Implication: Very heavy academic load – learning will be
affected and LO not achieved. Suggestions?????