Implementing goals for non-cognitive outcomes within a basic science course.

OBJECTIVE: An essential principle of competency-based education (CBE) is use of observable outcomes with assessments as judgments of competence based on defined criteria. Faculty are accustomed to using learning objectives as the defining criteria for knowledge, assessing students using written exams. Faculty are less familiar with how the principles of CBE are applied to other competencies. We recently adopted school-wide goals and objectives, modeled after the ACGME Outcomes Project. The present objective was to give faculty first-hand experience in CBE within a basic science course, including both cognitive and non-cognitive outcomes.

DESCRIPTION: The format for the learner-centered, first-year Cell and Molecular Biology course was previously described.(1) Course goals were that students: (1) gain an understanding of the principles and concepts of cell and molecular biology, (2) develop an appreciation for how these principles and concepts are important to medicine, (3) demonstrate an ability to think critically using these principles and concepts. Goal 1 was measured by written exams. We assumed goals 2 and 3 were met through small-group problem-solving sessions, and outcomes were not assessed. The revised 2001 course goals were to prepare students for medical knowledge and lifelong learning and communication and professionalism. The goals for medical knowledge and lifelong learning were to: (1) demonstrate ability to use principles and concepts of cell biology, molecular biology, and genetics to analyze medically relevant data, solve problems, make predictions, and determine a course of action; (2) effectively use information technology to search, evaluate, and critically review scientific evidence related to principles and concepts covered in the course; (3) use appropriate techniques to teach peers in a conference setting. The goals for communication and professionalism were to: (1) use appropriate skills and attitudes to collaborate effectively with peers and faculty to accomplish learning goals; (2) maintain a personal learning portfolio to develop habits of reflective learning, broaden understanding of content beyond recall, and enhance communication with faculty; (3) demonstrate personal integrity in meeting course requirements and in interactions with peers and faculty throughout the course. Goals for medical knowledge and lifelong learning were assessed by written exams and by separate tools utilizing four-point Likert scales (novice, advanced beginner, proficient, distinguished) with specific observable criteria for a written research paper and a group PowerPoint presentation. Faculty and student assessments generated a number that was combined with exam grades for a lettered competency grade. A 19-item, five-point Likert scale was used by students to self- and peer-assess goals for communication and professionalism. Small-group faculty facilitators used the tool to give formative feedback midcourse, summative feedback at course conclusion, and competency grades. The tools may be viewed at: .

DISCUSSION: Faculty achieved enhanced understanding of students, assisted by descriptive criteria, while suggesting improvements in forms. Better agreement on criteria definitions and consistency in form use is needed. Students developed understanding and improved communication/professionalism skills, based on repeated exposures to criteria and feedback. It remains to be seen whether the skills are used/developed in other courses. A majority of students did not use the learning portfolio as envisioned. Better design and implementation of school-wide rather than course-specific reflective portfolios may increase use and integrate learning in all courses with all six competencies.