Purposeful design in health professions' curriculum development.

Background: The content and delivery of a health professions' curriculum is often regarded as 'intuitive' and 'self-defining', based on commonly encountered professional roles, detailed knowledge of human structure, function and pathology, and opportunities to acquire necessary clinical and communication skills.  However, a curriculum tends to develop, sometimes in unexpected ways, due to scientific advances, changes in teaching faculty and variations in clinical placement experience. Trends come and go, often without careful scrutiny and evaluation. A common result is curriculum 'creep', where learning may drift away from the original plan.

Methods: A review of available curriculum models produced several descriptions that appear to be based primarily on professional norms and traditions and not linked strongly to learning theories or expectations of employers and the community. Regulators accept variety in curriculua so long as agreed outcomes are achieved. Unless planned and maintained carefully, a curriculum may not necessarily prepare graduates well for a.

Results and discussion: Health professions curricula are required to produce graduates not only with higher education qualifications but also capable of providing healthcare services needed by regulators, employers and their communities. The design includes curriculum content, curriculum delivery and assessment of learning, topics often listed separately in standards but in fact closely intertwined, ideally demonstrating constructive alignment that sends consistent messages and facilitates achievement of graduate outcomes. Purposeful design is a systematic approach to defining, developing, and assessing learning that produces competent graduates who will maintain currency throughout their careers. Just as with the human body, everything is connected so a change anywhere is likely to have implications for other parts of the curriculum ecosystem. The role of clinical cases, level of integration, balance of assessment tasks, use of technology, on-site or remote delivery, and choice of assessment methods are important considerations in curriculum design. Any changes should be strategic and aligned with vision, mission, and graduate outcomes. This paper provides a framework analogous to the human body that may facilitate purposeful design of health professions curricula.