ADLT 672: Instructional Strategies
Thursday, October 31, 2013
What are Checklists and How are
Used in many disciplines:
Originated in Aviation
Anatomy (Hofer et al, 2001)
Use in Medicine
Guides physician through
Family Medicine (Ferrell et al, 1996)
Anesthesiology (DuBose et al, 2008)
Neonatal Medicine (McCurdy et al,
Various Types of Checklists
(Hales et al, 2007)
Laundry List (no order; e.g.
Sequential (order is relevant;
e.g. procedure checklist)
McCurdy et al (1995) p. 50
Iterative (items require
repeated passes; e.g. CPR)
Diagnostic (flowchart; e.g.
diagnosis of brain death)
Hettinga et al (2010) p. 877
Steps in Development
(Hettinga et al, 2010)
Draft using operational
Revise based on input from
(Hales et al, 2007)
guidelines; add specific customs
and behaviors in accordance with
Present checklist in logical,
List should not be so onerous that
Experimental use in pilot
it interferes with learning activity.
Clearly space and delineate items.
Revise as necessary (or repeat
Items can be “general” so that
individual creativity is still
What Checklists Do:
What Checklists Don’t Do:
Simplify complex tasks
Learners may focus on
Allow learner to focus on one
checklist and not overall
functioning (Norman, 2005).
task at a time
Can inhibit “holisticism” and
“Real Time” self efficacy
Model desired behavior
Some studies show benefit
(Hofer et al, 2011; O’Conner
and McGraw, 1997), while
others do not (McCurdy et
al, 1995; at least student
DuBose JJ, Inaba K, Shiflett A, Trankiem C, Teixeira PG, Salim A, Rhee P, Demetriades D,
Belzberg H (2010). Measurable outcomes of quality improvement in the trauma intensive care
unit: the impact of a daily quality rounding checklist. Journal of Trauma. 64: 22-27.
Ferrell BG (1996). A critical elements approach to developing checklists for a clinical
performance evaluation. Medical Online Education. 1(5).
Hales B, Terblanche M, Fowler R, Sibbald W (2007). Development of medical checklists for
improved quality of patient care. International Journal for Quality in Health Care. 20(1): 22-30.
Hettinga AM, Denessen E, Postma CT (2010). Checking the checklist: a content analysis of
expert- and evidence-based case-specific checklist items. Medical Education. 44: 874-883.
Hofer RE, Nikolaus OB, Pawlina W (2011). Using checklists in a gross anatomy laboratory
improves learning outcomes and dissection quality. Anatomical Sciences Education. 4: 249-255.
Jablonski E (1965). Flying fortress: the illustrated biography of the B-17s and the men who flew
them. 1st Edition. Garden City, NY: Doubleday & Company.
McCurdy FA, Wesiman LE (1995). Teaching newborn medicine to third-year medical students.
Use of a Checklist. Archives of Pediatric and Adolescent Medicine. 149: 49-52.
Norman G (2005). Editorial – checklists vs. ratings, the illusion of objectivity, the demise of
skills and the debasement of evidence. Advances in Health Sciences Education. 10: 1-3.
O’Conner HM, McGraw RC (1997). Clinical skills training: developing objective assessment
instruments. Medical Education. 31: 359-363.