A Study of the General Surgery Curriculum
2011
Specific Learning (Behavioral) Objectives
After studying the latest General Surgery Curriculum being recommended by the Philippine Society of General Surgeons and Department of Surgery of Ospital ng Maynila, the general surgery resident to be must be able to:
- Answer the following questions:
1.1 What is a curriculum?
Ans: A curriculum is an educational document which contains the general program of studies for the learners or students.
1.2 What are the elements of a curriculum?
Ans:
Learning objectives
Content
Learning activities and resources
Evaluation
1.3 What is a general surgery curriculum?
Ans: A general surgery curriculum is an educational document that contains the general program of studies for general surgeons to be.
1.4 What are the elements of a general surgery curriculum?
Ans:
Learning objectives
Content
Learning activities and resources
Evaluation
1.5 What is an instructional design?
Ans: An instructional design is an educational document which by common usage may mean the same thing as a curriculum. However, to make a difference between a curriculum and an instructional design, if a curriculum spells out the general program of studies, an instructional design lays out the strategies and procedures on how the program of studies is to be achieved. In other words, curriculum is more general and instructional design is more specific. Furthermore, instructional design is cascaded from the curriculum.
1.6 What are the elements of an instructional design?
Ans:
Learning objectives
Content
Learning activities and resources
Evaluation
1.7 What is a lesson plan?
Ans: A lesson plan is an educational document which strictly speaking can be synonymous with curriculum and instructional design in the sense that they are all written educational plans. However, to make a difference among curriculum, instructional design, and lesson plan, lesson plan is the most specific or smallest educational plan, usually on a learning session of an hour or two; curriculum is the most general or most encompassing or biggest educational plan; whereas instructional design is between curriculum and lesson plan in terms of scope. Just as an instructional design is cascaded from the curriculum, a lesson plan is cascaded from an instructional design.
1.8 What are the elements of a lesson plan?
Ans:
Learning objectives
Content
Learning activities and resources
Evaluation
- Make a table illustrating the similarities and differences among curriculum, instructional design, and lesson plan.
- Enumerate the five (5) competencies expected of a wholistic general surgeon to enable him/her to effectively contribute to health development in the community.
Ans: Surgeon-clinician-operator
Surgeon-community problem solver
Surgeon-educator-learner
Surgeon-researcher
Surgeon-administrator
- Enumerate the three (3) conventional domains considered in formulating learning objectives for learners/students/residents.
Ans: Cognitive domains
Psychomotor domains
Attitude domains
- Enumerate at least five (5) general psychomotor skills expected of a wholistic general surgeon.
Ans: Surgeon-clinician-operator
Technical skills in doing physical examination
Technical skills in operating and assisting operations
Technical skills in medical recording
Technical skills in medical presentation
Communication skills
Communication skills (with patients)
Communication skills (with colleagues)
Interpersonal skills
Interpersonal skills (with patients)
Interpersonal skills (with colleagues)
- Enumerate at least five (5) general desirable habits or attitude expected of a wholistic general surgeon.
Ans: Self-directed learning habit
Ethical and moral values
Empathy
Humility (accepts limitations)
Honesty
- Define the scope of the specialty known as general surgery in the Philippines as defined by the Philippine Society of General Surgeons.
7.1 Scope in terms of region/system/organ/tissue as “must possess”
Ans: Head and Neck
Breast
Abdomen and Hernia
Skin and Soft Tissue
7.2 Scope in terms of types of operative skills as “must possess”
Ans: Diagnostic operative skills
Biopsy
Endoscopy
Therapeutic operative skills
For diseases that fall within the scope of the general surgery in terms of region (head and neck; breast; abdomen and hernia; skin and soft tissue)
7.3 Scope in terms of types of diseases as “must possess competencies to manage”
Ans: Trauma
Tumor
Infections
Deformity
7.4 Scope in terms of “nice to possess, to have, or to be exposed to”
Ans: Other surgical subspecialties –
Pediatric Surgery
Orthopedic Surgery
Plastic and Reconstructive Surgery
Urology
Neurosurgery
Thoracic and Cardiovascular Surgery
Gynecologic Surgery
- Make a table illustrating the use of appropriate teaching-learning activities (at least 2 each) for the different conventional domains of learning objectives(cognitive or knowledge domain; psychomotor domain; and attitude domain).
Domain | Teaching-learning activities |
Cognitive or knowledge | Lecture; small-group discussion; independent study; problem-solving and decision-making activities |
Psychomotor | Demo-return demo – simulated and actual practicums |
Attitude | Role playing; stimulus for attitude development |
- Make a table illustrating the appropriate use of teaching-learning activities for the following psychomotor skills:
9.1 Problem-solving and decision-making skills in patient management
9.2 Operative skills
9.3 Preop and postop management skills
9.4 Medical recording skills
9.5 Medical presentation skills
9.6 Interpersonal skills
9.7 Team-work skills
9.8 Communication skills
9.9 Research skills
9.10 Administrative skills
9.11 Surgical educator skills
9.12 Public health educator skills
9.13 Self-directed learning skills
Psychomotor skills | Teaching-learning activities |
Problem-solving and decision-making skills in patient management | Simulated and actual cases for problem-solving and decision-making |
Operative skills | Animal and actual patients being operated by learners |
Preop and postop management skills | Simulated and actual cases for preop and postop management skills |
Medical recording skills | Simulated and actual cases for medical recording skills |
Medical presentation skills | Actual medical presentations |
Interpersonal skills | Simulated and actual scenarios for interpersonal skills development |
Team-work skills | Simulated and actual scenarios for team-work skills |
Communication skills | Actual communication experience |
Research skills | Actual research experience |
Administrative skills | Actual administrative experience |
Surgical educator skills | Actual teaching experience |
Public health educator skills | Actual teaching experience |
Self-directed learning skills | Problem-based learning |
- Enumerate at least five (5) essential resource materials that can be used in learning surgical patient management process.
Ans: Reading materials on the topic
Textbooks
Journals
Self-instructional programs
Observation/analysis of patient management processes of consultants
Observation/analysis of patient management processes of colleagues /
peers
Simulated patient problem-solving and decision-making
Actual patient problem-solving and decision-making
- Make a table illustrating the use of appropriate evaluation tools (at least 2 each) for the different conventional domains of learning objectives (cognitive or knowledge domain; psychomotor domain; and attitude domain).
Domain | Evaluation tools |
Cognitive or knowledge | Written exam; oral exam |
Psychomotor | Practical exam:observation with rating scale; record review (eg medical recording; mortality and morbidity review) |
Attitude | Observation with rating scale; critical incident report |
- Make a table illustrating the appropriate use of evaluation tools for the following psychomotor skills:
12.1 Problem-solving and decision-making skills in patient management
12.2 Operative skills
12.3 Preop and postop management skills
12.4 Medical recording skills
12.5 Medical presentation skills
12.6 Interpersonal skills
12.7 Team-work skills
12.8 Communication skills
12.9 Research skills
12.10 Administrative skills
12.11 Surgical educator skills
12.12 Public health educator skills
12.13 Self-directed learning skills
Psychomotor skills | Evaluation tools |
Problem-solving and decision-making skills in patient management | Practical exam; review of records |
Operative skills | Practical exam; review of records |
Preop and postop management skills | Practical exam; review of records |
Medical recording skills | Practical exam; review of records |
Medical presentation skills | Practical exam; review of records |
Interpersonal skills | Observation with rating scale; critical incident report |
Team-work skills | Observation with rating scale; critical incident report |
Communication skills | Practical exam; review of records |
Research skills | Practical exam; review of records |
Administrative skills | Practical exam; review of records |
Surgical educator skills | Practical exam; review of records |
Public health educator skills | Practical exam; review of records |
Self-directed learning skills | Observation with rating scale; critical incident report |
- Compare the similarities and differences (advantages and disadvantages) between norm- and criterion-referenced standards used in evaluating learners/students/residents for assessing accomplishment or non-accomplishment of competencies / passing or failing a learner / promotion or nonpromotion of a resident.
Ans: Norm-referenced and criterion-referenced systems are standards in interpreting scores of students in an evaluation tool.
Norm-referenced system uses relative standards whereas criterion-referenced system uses absolute standards.
Criterion-referenced system uses objectives as basis of interpretation.
In norm-referenced system, the passing grade is decided after the exam whereas in criterion-referenced system, the passing grade is decided before the exam.
Criterion-referenced system is preferred in evaluating physicians and surgeons because of the sensitivity of the responsibilities and competencies expected by the community.
It is a good indicator of level of mastery attained by students.
- Based on Philippine Society of General Surgeons’ recommendation, make a table illustrating the parameters and criteria or standards to be used in passing or failing (promotion or nonpromotion) of surgical residents.
Evaluation Component | MPL |
Basic Theoretical Knowledge | 50% |
Clinical Competencies | 50% |
Technical Skills | 50% |
Attitudinal Competencies | 50% |
- Based on OMMC Department of Surgery policies, make a table illustrating the parameters and criteria or standards to be used in passing or failing (promotion or nonpromotion) of surgical residents.
General Surgery Residents’ Annual Performance Report
Residents | Governance Team Player Work Ethics | Service | Training | Research | PBS-RITE | ||
Cognitive | Skills | Attitude | |||||
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Legend:
P – Pass F – Fail Inc – Incomplete NA – Not Applicable
Guides:
Governance – Performance as a chief resident and other assigned administrative functions
Service – Number of complaints (external and internal); morbidity and mortality
Training – Knowledge (Written and oral exams)
Training – Skills and Attitude (PCS-prescribed Clinical-Attitude-Technical skills rating scale; oral-practical exams)
Research – Research paper requirements and quality
NOTE: Resident must have a passing grade in all parameters to be eligible for promotion or graduation.
- Construct a table illustrating methods on how to evaluate a general surgery curriculum and its implementation.
Elements to be evaluated | What to evaluate | Methods of evaluation (by external evaluators) |
Input (Structure) | Presence of a structured general surgery curriculum Presence of adequate learning resource facilities | Review of records Site visit and inspection and checking |
Process | Implementation of curriculum being done according to plan | |
Output | Presence of effective and efficient results of implementation of curriculum |
- Enumerate the elements that will be evaluated by external accrediting agencies in a general surgery program.
Ans: The curriculum and its implementation
Learning resources
- Using a table, describe the recommendation of the Philippine Society of General Surgeons as regards organization of rotation of residents vis-à-vis level of training.
For 5-year Program
Year Level | Rotations |
1st | General Surgery |
2nd-3rd | Other Surgical Subspecialties and General Surgery |
4th-5th | General Surgery |
For 4-year Program
Year Level | Rotations |
1st | General Surgery |
2nd | General Surgery and Other Surgical Subspecialties |
3rd | General Surgery and Other Surgical Subspecialties |
4th | General Surgery |