| Abstract/Notes |
Objective: Academicians and administrators must continually revise programmatic curricula to meet the expectations and needs of internal and external stakeholders by reshaping outcome performance goals and supporting course content to better meet external marketplace demands. Many health care curriculum revisers have recently incorporated active learning pedagogies, such as problem-based learning (PBL), to support development of practitioners’ abilities to integrate huge amounts of continually changing and disparate course contents. PBL curricula, both in terms of costs and yields, have not clearly demonstrated significantly improved learning outcomes, and this has led others to create hybrid versions of integrative curriculum. This case study reviews one institution’s current effort to move toward such a hybrid curriculum, detailing the processes of identifying key change agents, pre-planning, timeline development, committee formation, and organizational change strategies. Methods: Key change agents, administrators with excellent facilitation and communication skills along with diverse training across multiple academic and teaching positions, emerged on each of the two campuses to (1) evaluate external practice requirements and realities to inform curriculum revision content changes, (2) evaluate current curriculum assessment instruments, both quantitative and qualitative and make recommendations for changes, and (3) develop a plan to champion the process towards institutional change, cooperation and implementation. Results: Initial subcommittees were created to explore and evaluate optimal programmatic length and structure as well as specific new focus areas such as functional assessment, outcomes measures, health promotion and disease prevention. Additional assessment of current course content was performed. Student, faculty, focus groups and administrative assessments were reviewed. Initial exploratory committees, under the direction of the steering committee, were now reassigned to new areas of target development that included methods to foster improved vertical and horizontal integration, development of curricular pillars, the development of capstone courses, and evaluation of National Board timing, optimal course sequencing, programmatic length and transition planning issues. A new curricular model featuring a ‘balanced’ approach to chiropractic education and practice, and the development of an integrative approach to functional, chiropractic and systemic assessment, was developed that incorporates and integrates chiropractic wellness/preventive care, care aimed at focused neuromusculoskeletal complaints, standard preventive testing, screening and health promotion counseling. A timeline for implementation in all the focused areas was developed. A website was created to facilitate multicampus communication and exchange of information.Discussion: Curricular content was organized and prioritized by its relationship to a set of curricular pillars identified and agreed upon by all campus constituencies. These pillars include chiropractic and ancillary techniques, philosophy, patient-centered approach, health promotion, clinical decision-making, and homeostasis. As one team evaluated current technique offerings and moved forward with a new approach to teaching chiropractic adjustive and rehabilitative techniques, another team focused on opportunities for integration of basic and clinical science material. This process has not been without challenge. Initial discussions about the technique sequence were tense, and resulted in the development of factions within the faculty. Most of the tension was driven by dogmatic adherence of various faculty members to one or another “chiropractic philosophy.” The Steering Committee leadership attempted to address this tension by encouraging the use of evidence to guide discussions – but this only seemed to inflame the controversy. Other challenges centered around heavy teaching and administrative loads of those participating in the revision process – making it difficult to find meeting times to flesh out the new curriculum. Developing a workable transition plan and preparing to launch by the target date has resulted in some difficulty. This abstract is reproduced with the permission of the publisher. |
