Implementation evaluation as a dimension of the quality assurance of a new programme for medical education and training

[摘要] ENGLISH ABSTRACT: In this thesis, an 'alignment approach' to the quality assurance of medical curricula is developedand practically illustrated in the evaluation of a section of a new curriculum in undergraduatemedical education and training instituted at the Faculty of Health Sciences of the University ofStellenbosch in 1999.The background of curriculum innovation at this institution during the 1990s is described, and theliterature on the concepts of quality assurance is explored in higher education in general and inmedical education and training in particular. The current focus on socially responsive curriculumrenewal and accountability illustrates the need for this study.The empirical part of the study was conducted in two phases. The first phase consisted of a'clarification evaluation'. The planning of the new curriculum introduced in 1999 was analysedretrospectively through a study of the planning documents and interviews with leaders of theplanning process. The results of this clarification evaluation are presented in the form of a 'LogicModel'. The implicit theory of the curriculum, as represented by the Logic Model, was thenevaluated regarding its consistency with trends in medical education. These trends weredetermined through a study of the literature on the subject published during the time of theplanning of the curriculum. It was found that the planning of the curriculum was in line with mostof the identified trends, but that it lacked detailed information on how the basic sciences andclinical skills training were to be addressed. This compromised the evaluability of phase I of thecurriculum and of the clinical rotations1 by the method use in this study. Because of this, and alsoconsidering the time frame of this evaluation, phase I of the curriculum and the late clinicalrotations were excluded from the second phase of the study.The aims identified for the curriculum during the process of clarification evaluation were alsoaligned with the document, The Profile of the Stellenbosch Doctor 2 . This indicates that theplanning process of the curriculum was in line with its intended outcome.The second phase of the study consisted of an 'implementation evaluation' of phases II and III ofthe theoretical components and of the early and middle clinical rotations of the curriculum. Datafor this implementation evaluation were collected from April 2002 to June 2003. Modulechairpersons3, lecturers and students were used as sources of data for the evaluation of thetheoretical phases. The perceptions of these groups regarding the implementation of phases IIand III of the theoretical part of the curriculum were collected by means of questionnairesdesigned specifically for this study. For the evaluation of the clinical rotations, the results of thestandard student feedback obtained by the Faculty of Health Sciences were used as a source ofdata for a secondary analysis. The study guides provided for each of the theoretical modules andthe clinical rotations were also used as a secondary source for the analysis of data.The data obtained were then analysed by using the framework provided by the Logic Model.Following this, a judgment of the quality of the implementation of the curriculum was made. Theplanned curriculum was aligned with the practised curriculum by drawing up a 'curriculumscoreboard'. It was found that alignment was adequately achieved for six of the identified aims,while the implementation of four of the aims was not aligned to the planning according to thecriteria used in this study.The study illustrates that the methods of programme evaluation can be validly applied in theevaluation of a curriculum in medical education and training. The Logic Model enables analignment between the planned and the practised curriculum, which can be used as a measure ofthe quality of a curriculum in terms of 'fitness of purpose'.1 See Addendum A for a diagrammatic overview of the curriculum. The curriculum was structured into three theoreticalphases (phases I, II and III) and three clinical rotations (early, middle and late).2 This document was drawn up during the initial phases of the planning process of the curriculum and regarded by theFaculty as a blueprint for the intended outcomes of the curriculum.3 A module chairperson in the context of the Faculty of Health Sciences of the University of Stellenbosch is a seniorfaculty member responsible for the organisation and management of the modules presented as part of the curriculum inmedical education and training.

[发布机构] Stellenbosch University