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Educational strategies in curriculum development:
the SPICES model
Curricular Strategies or Issues
S student centred vs teacher centred
P problem based vs information gathering
I integrated vs discipline based
C community based vs hospital based
E elective vs uniformed/standard
S systematic vs apprenticeship
Utilization of the SPICES model
• to review an existing curriculum to see where improvements can be made
• to develop a new curriculum from scratch
• to tackle specific questions or issues relating to a curriculum
• to help decide on what sort of teaching methods to use on a course
• decide what format the assessment should take
student centred teacher centred
student centred
• Learners involved in curriculum
design
• Teaching content based on
learners’ agenda
• Leaner centre methods used eg
small group work
• Expert outside speakers/resources
little used
• Encourages self directed learning
• Requires hard work to organise
(and can be expensive)
• Facilitators may need instruction
and training
teacher centred
• Teaches design the curriculum
• Teaching content prescribed by
teachers on basis of what they feel
learners should know
• Largely dictatorial eg lectures
• Expert resources often used (and
often deliver on their own
agenda!)
• Encourages a sit and listen
approach
• Easy to organise (and less costly)
• Most lecturers are used to this
model
Supporting Factors
student centred teacher centred
Most of the
emphasis is
on the
learner
Increases
learner
motivation
Prepares
learners for
lifelong self
directed
education
Most
teachers are
familiar with
this method
Fewer
demands on
teachers
repertoire of
skills to be
acquired
Learners are
used to this
method too
Problem based information
gathering
Problem based
• Rids the irrelevance of the mounds of
knowledge which learners have to
acquire
• involve patient problem scenarios,
health care delivery problems and
ethical issues
• development of an integrated body of
knowledge that is deeper, more
effective, and has greater content
relevance in the appropriate context
• Core messages of a discipline might be
missed with this approach
information gathering
• Superficial knowledge
which soon becomes out of
date
• Enables each discipline to
convey its core messages
Supporting Factors
Problem based information gathering
Helps
develop
problem
solving skills
Active
participation
of the
learner
Helps deal with an
overcrowded
curriculum;
highlights concepts
rather than
knowledge
Understanding
the fundamentals
and vocabulary
of each discipline
The
development
of a logical
progression of
concepts in a
discipline
Learners
feel secure
Year 1 & 2
Anatomy
Physiology
Biochemistry
Year 3
General Pathology
Pharmacology
Forensic Medicine
Year 4
Special Pathology
Community Medicine
ENT & Eye
Year 5
Medicine & Allied
Surgery & Allied
integrated discipline based
integrated
• Integration between the various
disciplines – ie how they relate to
each other
discipline based
• Learners have to figure out the
integration bit themselves
• key concepts of a discipline are
conveyed which may otherwise
be lost in an integrated approach
Supporting Factors
integrated
discipline based
Reduces
fragmentation
of courses
Improves
educational
effectiveness of
the teaching
because what is
taught is relevant
Promotes staff
communication
and collaboration
as departments
are being
integrated
Better teaching as
teachers are teaching
subjects they have a
love for
Teachers may be
used to this method
and therefore more
comfortable
Learners see
departments, and
decide what career
they want to choose
Rationalises
teaching
resources –
experts from
different faculties
but with the same
field interest are
brought together
community based hospital based
community based
• Direct contact with the
community the learners are being
taught to serve
• See a wide variety of conditions
at a wide variety of stages
• Learners learn about the social
and economic aspect of illness
• Learners see patients in their own
homes
hospital based
• See only a small subsection of the
community
• See specialised diseases usually in
extremis
• Social and economic aspects of
illness often ignored
• No consideration of the patients
environment
• Can provide focused instruction
in specialised areas
Supporting Factors
community based hospital based
Makes use
of untapped
resources
Introduces
learners to the
health care system
– patterns of
delivery,
manpower,
economics,
decision making,
quality control,
health resources
Experienced
gained in the
hospital context –
a concentrated
form of
experience of
disease than can
be gained in the
community
Enables
learners to
explore
specialist
medicine as a
career
Much
easier to
organise
Provides
community
orientation
provides
useful learning
experiences
eg continuity
of care, which
cannot be seen
in hospitals
elective uniform
elective
• Allows curricular flexibility
• Enables learners to explore
further interests in more details;
matching to the learner’s needs
• Can see health delivery elsewhere
• Promotes self directed learning
uniform
• Standard programme through
which all must go through
• No such opportunity. But does
provide “core” experience which
is prescribed
Supporting Factors
elective
uniform
good way of
dealing with an
overcrowded
curriculum.
Learners can
now identify and
tackle areas in
which they feel
they are deficient
provide learners with
increased responsibility for
their own learning
facilitate
career
choices by
learners
Teachers feel
at ease
No disruption
in regular
coursework
Electives can
bring about
an attitude of
change in
learners
systematic apprenticeship
systematic
• Training is more defined and
structured eg a checklist of the
type of conditions that must be
seen and managed (or rotating
through specified specialties)
• Core competencies identified and
labelled
• Teaching is structured and
organised
• Many teachers may be involved;
developing a 1-1
relationship might prove
difficult
• Better for revalidation and
accreditation purposes
apprenticeship
• Learners exposed to a fair
proportion of the patients that
pass through the system over a
fixed period of time
• Over time, learners may see a
fairly representative sample of
problems they are expected to
deal with
• What is taught depends on the
deficiencies identified
• Teaching is largely opportunistic
• Helps build a close 1-1
relationship between learner and
teacher and yields a sense of
belonging to the learner
Supporting Factors
systematic apprenticeship
Learners need
to be exposed
to a variety and
range of health
problems
Enables
competencies
to be defined
and
rationalised –
what is
essential and
what is not
Organisational
advantages –
follows the service
commitments of
those already
involved
Continuity of
teaching and
sense of
belonging on the
part of the learner
is maintained
Rationalises
time – learner
can become
competent and
confident with
the least waste
of time and
resources

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SPICES Medical Education

  • 1. Educational strategies in curriculum development: the SPICES model
  • 2. Curricular Strategies or Issues S student centred vs teacher centred P problem based vs information gathering I integrated vs discipline based C community based vs hospital based E elective vs uniformed/standard S systematic vs apprenticeship
  • 3. Utilization of the SPICES model • to review an existing curriculum to see where improvements can be made • to develop a new curriculum from scratch • to tackle specific questions or issues relating to a curriculum • to help decide on what sort of teaching methods to use on a course • decide what format the assessment should take
  • 5. student centred • Learners involved in curriculum design • Teaching content based on learners’ agenda • Leaner centre methods used eg small group work • Expert outside speakers/resources little used • Encourages self directed learning • Requires hard work to organise (and can be expensive) • Facilitators may need instruction and training teacher centred • Teaches design the curriculum • Teaching content prescribed by teachers on basis of what they feel learners should know • Largely dictatorial eg lectures • Expert resources often used (and often deliver on their own agenda!) • Encourages a sit and listen approach • Easy to organise (and less costly) • Most lecturers are used to this model
  • 6. Supporting Factors student centred teacher centred Most of the emphasis is on the learner Increases learner motivation Prepares learners for lifelong self directed education Most teachers are familiar with this method Fewer demands on teachers repertoire of skills to be acquired Learners are used to this method too
  • 8. Problem based • Rids the irrelevance of the mounds of knowledge which learners have to acquire • involve patient problem scenarios, health care delivery problems and ethical issues • development of an integrated body of knowledge that is deeper, more effective, and has greater content relevance in the appropriate context • Core messages of a discipline might be missed with this approach information gathering • Superficial knowledge which soon becomes out of date • Enables each discipline to convey its core messages
  • 9. Supporting Factors Problem based information gathering Helps develop problem solving skills Active participation of the learner Helps deal with an overcrowded curriculum; highlights concepts rather than knowledge Understanding the fundamentals and vocabulary of each discipline The development of a logical progression of concepts in a discipline Learners feel secure
  • 10. Year 1 & 2 Anatomy Physiology Biochemistry Year 3 General Pathology Pharmacology Forensic Medicine Year 4 Special Pathology Community Medicine ENT & Eye Year 5 Medicine & Allied Surgery & Allied integrated discipline based
  • 11. integrated • Integration between the various disciplines – ie how they relate to each other discipline based • Learners have to figure out the integration bit themselves • key concepts of a discipline are conveyed which may otherwise be lost in an integrated approach
  • 12. Supporting Factors integrated discipline based Reduces fragmentation of courses Improves educational effectiveness of the teaching because what is taught is relevant Promotes staff communication and collaboration as departments are being integrated Better teaching as teachers are teaching subjects they have a love for Teachers may be used to this method and therefore more comfortable Learners see departments, and decide what career they want to choose Rationalises teaching resources – experts from different faculties but with the same field interest are brought together
  • 14. community based • Direct contact with the community the learners are being taught to serve • See a wide variety of conditions at a wide variety of stages • Learners learn about the social and economic aspect of illness • Learners see patients in their own homes hospital based • See only a small subsection of the community • See specialised diseases usually in extremis • Social and economic aspects of illness often ignored • No consideration of the patients environment • Can provide focused instruction in specialised areas
  • 15. Supporting Factors community based hospital based Makes use of untapped resources Introduces learners to the health care system – patterns of delivery, manpower, economics, decision making, quality control, health resources Experienced gained in the hospital context – a concentrated form of experience of disease than can be gained in the community Enables learners to explore specialist medicine as a career Much easier to organise Provides community orientation provides useful learning experiences eg continuity of care, which cannot be seen in hospitals
  • 17. elective • Allows curricular flexibility • Enables learners to explore further interests in more details; matching to the learner’s needs • Can see health delivery elsewhere • Promotes self directed learning uniform • Standard programme through which all must go through • No such opportunity. But does provide “core” experience which is prescribed
  • 18. Supporting Factors elective uniform good way of dealing with an overcrowded curriculum. Learners can now identify and tackle areas in which they feel they are deficient provide learners with increased responsibility for their own learning facilitate career choices by learners Teachers feel at ease No disruption in regular coursework Electives can bring about an attitude of change in learners
  • 20. systematic • Training is more defined and structured eg a checklist of the type of conditions that must be seen and managed (or rotating through specified specialties) • Core competencies identified and labelled • Teaching is structured and organised • Many teachers may be involved; developing a 1-1 relationship might prove difficult • Better for revalidation and accreditation purposes apprenticeship • Learners exposed to a fair proportion of the patients that pass through the system over a fixed period of time • Over time, learners may see a fairly representative sample of problems they are expected to deal with • What is taught depends on the deficiencies identified • Teaching is largely opportunistic • Helps build a close 1-1 relationship between learner and teacher and yields a sense of belonging to the learner
  • 21. Supporting Factors systematic apprenticeship Learners need to be exposed to a variety and range of health problems Enables competencies to be defined and rationalised – what is essential and what is not Organisational advantages – follows the service commitments of those already involved Continuity of teaching and sense of belonging on the part of the learner is maintained Rationalises time – learner can become competent and confident with the least waste of time and resources