Standard Curriculum for clinical audit learning and development

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					Clinical Audit Learning
and Development
Curriculum Guidance
Foundation Level
Quintessent Ltd




                   March 2012
  Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
  Foundation level



Next Review March 2013.




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Contents

Foreword ..................................................................................................................................... 4

1. Introduction ............................................................................................................................ 7

2. Aims and Objectives ................................................................................................................ 9

3. Characteristics of the Basic Programme ............................................................................... 11

4. Learning and teaching methods ........................................................................................... 12

5. The Curriculum Guidance ..................................................................................................... 13

6. Curriculum Guidance: Foundation ........................................................................................ 14

   Curriculum area one: Understanding clinical audit and its context..................................... 16

   Key reference documents relating to curriculum area one .................................................. 19

   Curriculum area two: The clinical audit process ................................................................... 20

   Key reference documents relating to curriculum area two .................................................. 23

Appendix 1: Definitions of the Framework for Higher Education Qualifications ..................... 24

Appendix 2: Learning objectives/outcomes framework .......................................................... 26




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Foreword
This document sets out guidance for the development and delivery of a clinical audit training,
education and/or development programme aimed at providing learners at a beginner level
with a basic understanding of what clinical audit is and how to carry out a clinical audit
project.



Quintessent Ltd
Caroline Machray, Director, Quintessent Ltd
Ann Innes Smith, Associate and Organisational Development Programme Director,
Northumbria Healthcare NHS Foundation Trust
Tracey Sparkes, Associate, Quintessent Ltd


Core Advisory Group
Dr Katherine Sanderson, Principal Lecturer in Research Methods,
School of Health and Social Care, Teesside University
Dr Theresa Shaw, Chief Executive, Foundation of Nursing Studies
Victoria Patel, Deputy Clinical Effectiveness Manager, Sheffield Teaching Hospitals
Jan Mathieson, Clinical Audit Manager, Barnsley NHS Foundation Trust




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Acknowledgements
The standards went through a consultation process and responses from Royal Colleges and
Societies, independent quality and clinical audit organisations and clinical audit professionals
have been incorporated. HQIP would like to thank all of those who responded to the
consultation process.

Special thanks go to Nancy Dixon and Mary Pearce for their time and energies in contributing
to the development of this document

British Association of Dermatologists

British Orthodontic Society

British Society for Rheumatology

College of Emergency Medicine

Royal College of Anaesthetists

Royal College of General Practitioners

Royal College of Ophthalmologists

Royal Pharmaceutical Society

Society and College of Radiographers

Clinical Audit Support Centre

Healthcare Quality Quest

Irish Clinical Audit Network

Midlands Effectiveness and Audit, Val Bailey, Chair

National Audit Governance Group (NAGG), Ann Burnett Gen. Secretary,

North East Clinical Audit Network, John Hignett, Chair

Christine Johnson, Governance and Risk Officer

Dr Clive Prince, GP Tutor

Dr Ellie Heidari, Senior Specialist Clinical Teacher, Guy's and St Thomas' Audit Lead for
Dental Directorate



Dr Julie Trenholm, Norfolk and Suffolk NHS FT,

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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level



Elaine Swanson, Clinical Quality & NICE Guidance Manager, Luton & Dunstable Hospital
NHS FT

Elizabeth Gallagher, Assistant Clinical and Social Care Governance Manager


Fiona Kevan Programme Director’ BSc Speech & Language Therapy


Gaynor Smith, Clinical Audit/R&D Training Co-Ordinator, Burton Hospitals NHS FT

Katherine Birch Clinical Audit manager Liverpool Women’s NHS FT

Louise Knowles, Clinical Audit Officer, Northumberland, Tyne & Wear NHS FT

Melanie Hingorani, Consultant Ophthalmologist, Moorfields Eye Hosptial

Michael Spry, Clinical Audit Manager’ Countess of Chester Hospital NHS FT

Patricia Norman, Southampton University

Sunny Deo, Great Western Hospitals NHS Foundation Trust


Christine Johnson, Governance and Risk Officer, Lancashire Care NHS FT
Louise Knowles, Clinical Audit Officer, Northumberland, Tyne & Wear NHS FT


Patricia Norman, Clinical Effectiveness Manager, University Hospital Southampton NHS FT

Gaynor Smith, Clinical Audit/R&D Training Coordinator, Burton Hospitals NHS FT

Michael Spry, Clinical Audit Manager, Countess of Chester Hospital NHS FT

Elaine Swanson, Clinical Quality & NICE Guidance Manager, Luton & Dunstable Hospital
NHS FT




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




1. Introduction

1.1 This foundation level of training, education and development can be used and adapted
    as an introduction to clinical audit, for example for clinical practitioner/students at
    undergraduate level1, in-service training (whether delivered in house or by external
    providers) and refresher programmes.
1.2 The purpose of the guidance is to establish the corpus of learning for an introduction to
    clinical audit and to start the process of developing clinical audit practitioners,
    regardless of where they are in their career.
1.3 The guidance provides a set of curricula against which providers of learning, training
    and education can self assess against or be benchmarked and awarded a mark of
    excellence, if appropriate. It is intended for use by both public and private providers of
    learning, education, and training.
1.4 The document also sets out guidance on learning and teaching methods.
1.5 Commissioners and providers of training and education and development in clinical
    audit can adapt the guidance to suit the needs of the learners and needs of the
    organisation.
1.6 It is expected that delivery of a clinical audit training, education and development
    programme will take place within a quality and service improvement context and /or
    programme
1.7 The guidance highlights two areas in which learners should demonstrate competence,
    depending on their level and identified needs (see 1.2 above). These competency areas
    are mapped against defined learning outcomes encompassing understanding,
    competencies and skills, attitudes/behaviours and knowledge.
1.8 The curricula have been matched against the key competency documents below as
    appropriate. It should be noted however, that this is not a comprehensive list of all the
    competencies that may be relevant or of interest.
1.9 This document also makes reference to the Advanced Curriculum Guidance, developed
    by HQIP.




1
    Clinical practitioner encompasses medical, nursing and PAMS

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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




1.10 The guidance curriculum has taken into account the following:

            a. Selected outcomes contained in Tomorrow’s Doctors (2009)2

            b. Knowledge and skills required for clinical audit for clinicians and clinical audit
               facilitators as set out in HQIP’s Education, Training and Development Strategy
               for Clinical Audit3

            c. Selected competencies within the Common Competencies Framework for
               Doctors4 August 2009

            d. NHS Knowledge and Skills Framework (KSF) requirements.5

1.11 HQIP has developed a set of quality assurance standards which can be used to self
     assess the level of compliance with this guidance.6
1.12 The guidance in this document was developed in consultation with clinical audit
     practitioners and those currently delivering training, development and education in
     clinical audit.




2
  Tomorrows Doctors. GMC. 2009
3                                                                3
  Education, Training and Development Strategy for Clinical Audit . HQIP/KPA. 2009
4
  Common Competencies Framework for Doctors. Academy of Medical Royal Colleges. August 2009
5
  The NHS Knowledge and Skills Framework (NHS KSF) (October 2004)
6
  Quality Assuring Clinical Audit Learning and Development. HQIP Draft March 2011
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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




2. Aims and Objectives
   A. Aims:

      To raise the national standard of clinical audit training in health and social
       care

      To demonstrate clinical audit as a quality improvement process

      To develop competent and confident practitioners in clinical audit.




   B. Objectives

   To enable clinical audit practitioners:

      To use clinical audit and quality improvement methods in an experiential
       hands –on approach within a learning framework
      To measure the quality of clinical practice and act effectively on the findings



2.1 There are many entry points for practitioners to access clinical audit training and
    development. This curriculum encompasses fundamental information on the whole
    clinical audit process. Once this has been undertaken it is recommended that learners
    undertake more in depth training at an intermediate level on specific aspects of the
    process, such as: data quality; action planning and change management. The subject
    matter would depend on the individual’s role and remit for clinical audit.




Table 1: Levels of learning/training


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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level



Advanced

                         Suitable for postgraduate students, medical directors, clinicians and
                         clinical audit practitioners with a lead/specialist/training role in clinical
                         audit

Intermediate

                         This may include more specialised training in specific areas of clinical
                         audit depending upon the roles and responsibilities of the learner
                         involved

Foundation

                         Suitable for undergraduate students, vocational training students, in
                         service clinicians (refresher), clinical audit support staff. May also
                         provide template for awareness raising training for trust boards and
                         service managers

Curriculum Guidance is available from HQIP for the Advanced Level

2.2 It is envisaged that clinicians and clinical audit practitioners access the appropriate
    training level depending on their role and current requirement. For example, as part of
    revalidation, clinical doctors will need to demonstrate they have undertaken quality
    improvement activities, such as clinical audit, leading to improved quality of patient care.
    To help support this they may wish to refresh their skills and access an accredited clinical
    audit development programme at foundation level.

2.3 Others may wish to become specialist practitioners in clinical audit or become involved
    in national audit programmes and undertake a programme of learning that will lead to
    accreditation and /or postgraduate credits. The Level 3 Advanced programme will
    provide this level of expertise and engagement.

2.4 The learning outcomes for this curriculum are referenced against Blooms Taxonomy 7 of
    Educational Objectives. A summary of the framework is attached as appendix 2.

2.5 Section 3 below describes the foundation curriculum programme areas against the
    appropriate academic/vocational benchmark, a summary of the learner profile, the
    practical and academic learning objectives and possible assessment criteria against
    which the outcomes of the learning might be evaluated.




7
 'Taxonomy Of Educational Objectives: Handbook 1, The Cognitive Domain' (Bloom, Engelhart, Furst, Hill,
Krathwohl) 1956

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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




3. Characteristics of the Foundation
Programme
Table 2: Characteristics of Foundation Programme

                                                  Foundation

    Depending on provider arrangements the timescale will vary but could be up to 16 hours

Academic or                   Learner profile              Practical and             Suggested
vocational level                                           academic learning         assessment criteria
                                                           objectives
For academic
organization or
those wishing to
seek academic
accreditation

 Up to FHEQ Level             Suitable for          Attendance or                  Test of knowledge
  58                            undergraduate          completion of e-                and understanding:
                                students (as part of   learning
 Note: the                                                                           Multi choice
                                degree courses)
  foundation                                          Completion of                   questionnaires –
  curriculum has               Vocational training    personal action                 (to assess learning).
  been matched to               students               plan
  the                   To meet In-Service                 Actively
  competencies for       training                            participate in a
  clinical audit at
                         requirements for                    clinical audit
  undergraduate          example
  level for clinicians                                     NO to above – It is
                         mandatory training                impossible to
                         as part of NHS                    demonstrate
                         Litigation Authority              ‘understanding’
                               Junior clinical staff      which is a cognitive
                                                           process
                               Administration and
                                clerical staff
                               Managers                   Design and carry
                                                           out a clinical audit?


8
    See Appendix 1: Table 3: Definitions of the framework for Higher Education Qualifications

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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level



                         Ancillary staff
                                                   Critique the design
                                                   and conduct of
                                                   sample clinical
                                                   audits?




4. Learning and teaching methods
4.1 Providers of clinical audit training and development will need to demonstrate a range of
    innovative and interactive methods for enhancing learning and acquisition of practical
    skills. It is expected that the content and delivery of the respective programmes will:

      Be linked to current roles of learners
      Incorporate reflective practice
      Have scientific rigour
      Incorporate a mix of teaching methods
      Incorporate scenarios and case studies
      Provide opportunities for learners to facilitate their own learning
      Provide opportunities for discussions with peers
      Provide opportunities for innovative on-going methods of learning and assessment
      Reflect the content and format of the programme.




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level



5. The Curriculum Guidance
5.1 The aim of this curriculum guidance is to set a benchmark for the development
    and delivery of training for learners new to clinical audit. It is hoped that this
    guidance will be used by commissioners and providers of training to develop
    their programmes which will lead to well trained and competent clinical audit
    practitioners.

5.2 However, whilst the content areas are described, the detail as to the ‘what and
    how’ is open to individual interpretation and it is envisaged and hoped that
    training and development providers will develop their own innovative approach
    to delivering the curriculum.

5.3 Foundation programme: this guidance is aimed at clinical practitioners and new
    entrants to audit work with no or limited knowledge and skills in clinical audit. It
    is primarily based on training requirements for clinical audit contained in
    Tomorrow’s Doctors (2009)9. However it may also be used to guide the content
    of other undergraduate courses and trust training days for other clinical groups
    and support staff.




9
    Tomorrows Doctors, GMC, 2009


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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




6. Curriculum Guidance:
Foundation Programme




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level



                                                                 Curriculum Guidance: Foundation
This guidance may be used to develop good practice guidelines and should be seen as a minimum content for courses and programmes based
at a foundation level. It is expected that training providers would adapt the indicative content to reflect the different needs and requirements
of the learners.

The statements marked with an asterix10 (*) will enable medical students to work towards the overarching outcomes 1 -3 as set out in
Tomorrow’s Doctors (2009)11: Outcomes 11a, 11c, 19a –d, 22 a – b, and 23 a – e.

The foundation programme for clinical audit is organised into two curriculum areas, with associated learning outcomes:

       1. Understanding clinical audit and its context

       To be able to explain what clinical audit is; what it achieves and how it fits into the context of quality improvement, patient experience, risk
       management and clinical practice.

       2. The clinical audit process

               Preparation and planning a clinical audit
               Measuring performance
               Implementing change
               Sustaining improvement



10
     Dixon N, Pearce M. The knowledge and skills involved in clinical audit in Clinical Audit Manual. Romsey: Healthcare Quality Quest; 2011.

11
     Tomorrow’s Doctors. GMC. 2009




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Curriculum area one: Understanding clinical audit and its context


Learning Outcomes

To be able to explain what clinical audit is; what it achieves in relation patient experience, risk management and clinical practice.

By the end of this curriculum area learners will be able to explain:

      How clinical audit fits into the NHS at a national and local level
      The role of clinical audit in improving quality of patient care and experience
      How clinical audit links to other aspects of good governance
      How evidence based information relates to organisational development and quality improvement in healthcare
      The ethical, legal, governance, data protection and patient confidentially and consent considerations when undertaking clinical audit
      How clinical audit is a process shared with patients and other key people.
Key reference documents relating to curriculum area one are listed at the end of the section




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




     Indicative content                                                                       Notes

1    What is clinical audit (see 4.) and when to apply it *

2    Overview of the differences between clinical audit, service evaluation and research




3    Introduction to where clinical audit fits into the national and local NHS context and
     policy*

     The differences and uses of local and national clinical audit

4    Summary of how the clinical audit process works to drive quality improvement and
     improvement of clinical care*

5    Introduction to different forms of evidence used to inform clinical audit
     e.g. research findings; clinical guidelines; NICE Quality Standards




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




6    How clinical audit relates to the following:*

            Quality improvement*
            Evidence based practice*
            Patient experience and care
            Patient safety*
            Risk assessment
            Clinical risk management*
            Adverse incident reporting*
            Quality assurance process*
            Measuring compliance with standards
            Regulatory Frameworks*
            Clinical governance*
            Data protection requirements*

7           The importance of building in ethical considerations*
            Data protection
            Patient confidentiality and consent
            Regulatory requirements
            Duty of care responsibilities

8    The role of patients and other key people in clinical audit




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Key reference documents relating to curriculum area one
New Principles of Best Practice in Clinical Audit. Edited by Robin Burgess. 2011. Radcliffe publishing

http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-009-251111-A-Guide-for-Clinical-Audit-Research-and-Service-
Review.pdf

http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-018-160112-How-to-Implement-Local-Changes-from-National-
Clinical-Audit.pdf

http://www.hqip.org.uk/assets/Downloads/Criteria-and-indicators-of-best-practice-in-clinical-audit.pdf

http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-009-251111-A-Guide-for-Clinical-Audit-Research-and-Service-
Review.pdf

http://www.hqip.org.uk/patient-and-public-engagement-2/

http://www.hqip.org.uk/assets/Guidance/HQIP-Clinical-Audit-Simple-Guide-online1.pdf

http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-026-251111-Guide-to-Involving-Junior-Doctors-in-Clinical-Audit.pdf

http://www.hqip.org.uk/assets/Guidance/Statutory-and-mandatory-requirements-for-Clinical-Audit-07.12.2011.pdf




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Curriculum area two: The clinical audit process


Learning Outcomes

To be able to describe a clinical audit process

By the end of this curriculum area learners will be able to describe:

          How to choose a topic, design and plan a clinical audit
          How to develop appropriate criteria, standards and objectives for clinical audit
          The different methods for collecting and recording data and how to use them
          The need for and strategies to engage and/or involve key and relevant stakeholders in a clinical audit project
          How to analyse data from a clinical audit project
          Different methods of presenting data and the importance of sharing results of clinical audit to improve patient care
          How to use the results of audit to improve practice
          The importance of continual review and repeating data collection and analysis to assess the effectiveness of actions taken to
           achieve improvements.
Key reference documents relating to curriculum area two can be found at the end of the section




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




     Indicative content                                                                       Publications

1    How to design and plan a clinical audit*

2    The different stakeholders and how to work with them and engage them in clinical
     audit*


3    Explanations of the following:*

            Definition of an objective, criteria and standard
            The difference between them
            How to use them in clinical audit

4    How to use standards and objectives correctly as measures*

     The use of verbs when writing achievable objectives
     How to set a quantitative standard (%) for a clinical audit measure

5    How to ensure data are reliable and valis
6    Sampling theory and application in different clinical audits

7    Different forms of data and data collection methods*

8    Different ways of collecting and collating data for clinical audit




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level


     Indicative content                                                                       Publications

9    The importance of inter-rater reliability and how to prevent inconsistencies in data
     collection

10   Principles of piloting

11   How clinical audit data are analysed*


12   How to turn recommendations into actions that lead to improvement
13   How to present key findings from clinical audit to different target audiences

14   How to use the results of audit to improve practice*

15   The different ways to influence people’s attitudes towards improvement in practice*

16   Closing the loop – the importance of checking that improvements have been made
     through re-audit
17   The different methods for publicising the outcomes of clinical audit




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Key reference documents relating to curriculum area two
http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-031-251111-Guide-to-carrying-out-clinical-audits-on-the-
implementation-of-care-pathways.pdf

http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-029-251111-Guide-to-Facilitating-Clinical-Audit-across-Different-
Care-Settings.pdf

http://www.hqip.org.uk/template-policy-strategy/

http://www.hqip.org.uk/template-clinical-audit-report/

http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-028-Guide-to-Ensuring-Data-Quality-in-Clinical-Audits-251111.2.pdf

http://www.hqip.org.uk/information-governance-guide-for-clinical-audit/

http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-018-160112-How-to-Implement-Local-Changes-from-National-
Clinical-Audit.pdf

http://www.hqip.org.uk/assets/Guidance/Guide-to-Using-Quality-Improvement-Tools-to-Drive-Clinical-Audits-HQIP.pdf

http://www.hqip.org.uk/assets/LQIT-uploads/Guidance-0112/HQIP-CA-PD-002-251111-An-Introduction-to-Statistics-for-Clinical-Audit.pdf




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Appendix 1
 Definitions of the Framework for Higher Education Qualifications12
FHEQ Examples of HE             Examples of              Examples of




                                                                                 Advanced

                                                                                            Intermediate

                                                                                                           Basic
level qualifications            National                 Qualifications and
                                Qualifications13         credit framework14




4        Certificates of  NVQs at level 4  BTEC                                          Yes Yes
          higher            BTEC               Professional
          education        Professional       Diplomas
         Higher national   Diplomas          Certificates and
          certificates     Certificates and   Awards
                            Awards            HNCs
                                              NVQs at level 4
5        Diplomas of             HNCs and HNDs          HNDs                             Yes Yes
          higher                  NVQs at level 5        BTEC
          education               BTEC                    Professional
         Foundation               Professional            Diplomas
          Degrees                  Diplomas               Certificates and
         Higher national         Certificates and        Awards
          diplomas                 Awards                 NVQs at level 5
6        Bachelor’s        National           BTEC Advanced Yes
          degrees            Diploma in          Professional
         Bachelor’s         Professional        Diplomas
          degrees with       Production Skills  Certificates and
          honours           BTEC Advanced       Awards
         Graduate           Professional
          certificates and   Diplomas
          diplomas          Certificates and
         Professional       Awards
          Graduate
          Certificate in
          Education




12
   The FHEQ broadly corresponds with levels 4 – 8 of the National Qualifications
13
   Have to be accredited by the three regulators for England, Wales and Northern Ireland
14
   New framework

                                                                                                                   24
Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level



FHEQ Examples of HE          Examples of           Examples of




                                                                         Advanced

                                                                                    Intermediate

                                                                                                   Basic
level qualifications         National              Qualifications and
                             Qualifications13      credit framework14




7       Masters degrees  Diploma in        BTEC Advanced Yes
        Integrated        Translation        Professional
         masters degrees  BTEC Advanced      Diplomas
        Postgraduate      Professional      Certificates and
         certificates      Diplomas           Awards
        Postgraduate     Certificates and
         diplomas          Awards
8       Doctoral             Specialist awards  Award,          ?
         degrees                                   Certificate and
                                                   Diploma in
                                                   strategic
                                                   direction




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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
Foundation level




Appendix 2
Learning objectives/outcomes framework
Context

The type of verb that is used in the task statement, determines the level or of
learning (or degree of difficulty) that must be achieved. For example, being able to
criticize a process shows a much more complex behaviour than simply being able to
identify a process. For the purposes of the guidance we have used Bloom's
Taxonomy15 and its adaptations, as a framework and reference model. Bloom's
Taxonomy was primarily created for academic education, however it is relevant to all
types of learning.

Blooms Taxonomy

Bloom's Taxonomy underpins the classical 'Knowledge, Attitude, Skills' structure of
learning method and evaluation, and aside from the even simpler Kirkpatrick
learning evaluation model, Bloom's Taxonomy of Learning Domains remains the
most widely used system of its kind in education particularly, and also industry and
corporate training. It is a simple, clear and effective model, both for explanation and
application of learning objectives, teaching and training methods, and measurement
of learning outcomes.

Bloom's Taxonomy model is in three parts, or 'overlapping domains'
     1. Cognitive domain (intellectual capability, i.e. knowledge, or 'think'). What do
        we want people to know?
     2. Affective domain (feelings, emotions and behaviour, i.e. attitude, or 'feel').
        What do we want people to think or care about?
     3. Psychomotor domain (manual and physical skills, i.e. skills, or 'do'). What do
        we want people to be able to do?



15
  Bloom B. S. (1956). Taxonomy of Educational Objectives, Handbook 1: The Cognitive Domain. New
York: David McKay Co Inc.


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Clinical Audit Curriculum Guidance for Foundation Level Training, Education and Development
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An important premise of Bloom's Taxonomy is that each category (or 'level') must be
mastered before progressing to the next. As such the categories within each domain
are levels of learning development, and these levels increase in difficulty.

The Cognitive Domain16 is primarily used in determining the learning objectives of
the curriculum guidance.

The simple matrix structure enables a checklist or template to be constructed for the
design of learning programmes, training courses, lesson plans, etc. Effective learning
- especially in organisations, where training is to be converted into organisational
results - should arguably cover all the levels of each of the domains, where relevant
to the situation and the learner.

Fig.1: Categories in the cognitive domain of Bloom's Taxonomy
Anderson & Krathwohl7




16
     Detail of Bloom's Taxonomy Domains can be found in: 'Cognitive Domain' - 'Affective Domain' -
'Psychomotor Domain')



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