Curriculum Matching

CAPCE will present two sessions at EMS World Expo, October 16–20 in Las Vegas, NV.

The goal of an instructor is to provide a credible and valid educational experience. Curriculum matching is the hallmark of any sound education program. The three components of such a program that must match are the learning objectives, teaching content/methods and testing mechanism.

If they do not match, the desired outcomes are unclear, the learning process becomes arbitrary, and the test is unfair and invalid. Only by aligning all three components of the curriculum can an instructor provide students with a credible, valid educational experience.

The matching process begins by designing relevant objectives and planning lessons so the course content and final exam match as closely as possible. This article provides guidance for curriculum matching using a one-hour online on-demand tutorial on asthma as an example. This example can be readily adapted for other topics and delivery models. The Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) expects all applications for accreditation to employ curriculum-matching techniques.

A typical curriculum contains three main components: learning objectives (deciding your destination), teaching content and activities (the roadmap to get where you want to go) and a testing mechanism (assessing whether you reached your destination). Each of these components has two basic rules, provided under each component’s subheading. 

Learning Objectives

The use of learning objectives, also known as performance objectives, is crucial because they clearly state the desired outcome of instruction. They are the blueprint from which to design specific teaching strategies. The two basic rules for writing learning objectives are:

1. Identify the subtopics of the lesson and write one objective for each subtopic.

The number of objectives must be practical and achievable. For a one-hour class, 35 subtopics would be appropriate (see Table 1).

2. Learning objectives must clearly state what the participant should be able to do at the end of the session.

Performance terms are easily measurable and include action verbs such as describe, explain, perform, state, demonstrate, perform, apply and list. Avoid vague terms that are difficult to measure, such as know, appreciate, learn, understand and be familiar with. A student must understand what they’ll be asked to do to demonstrate what they’ve learned. Table 2 illustrate this principle.

Properly written learning objectives clearly identify how the student will demonstrate that they’ve achieved each objective and provide a solid foundation for designing the lesson and testing mechanism. There must be enough objectives to match the subtopics; write them using measurable terms.¹

Teaching Content and Activities

Designing teaching content that will effectively bridge the gap between the objectives and the test is more art than science. The two basic rules of selecting teaching methods and activities are:

1. Design all learning activities to inform and engage the student.

Designing learning activities that encourage students to become active participants, rather than passive watchers, is the key.² The Internet gives access to an infinite number of materials, and instructors are limited only by their imaginations in finding just the right resource to help students learn. Using instinct and experience, instructors are encouraged to design learning activities that are dynamic and interactive. Always ensure the content helps students achieve the stated objectives.

2. Design the lesson to present information from simple to complex.

It is important to identify the appropriate sequence for presenting the material so you build an escalating body of information in a way that’s easy for students to understand. Using the asthma course as an example, first build a solid foundation of basic knowledge (e.g., epidemiology, anatomy and physiology of the airways). Then describe the pathophysiology of an asthma attack, with special emphasis on the anatomy and physiology of the normal airway. Follow this with a discussion and demonstration of how students should assess the respiratory system, with a special emphasis on the pathophysiology of asthma. Finally present the proper field management of an acute asthma attack, emphasizing the previously learned information. If the flow of information is logical and repetitive, student success increases.³

Testing

Robert F. Mager is a world-renowned expert on the design and measurement of instructional objectives. In his book Preparing Instructional Objectives, he writes, “You cannot find out if the objective is achieved unless you use items that ask the student to perform whatever the objective is about. If you use items that aren’t right for an objective, not only will you not find out if your objective is achieved, you may fool yourself into thinking that it is. That’s not bad when the objective isn’t very important, but when it matters whether it is achieved, you run a risk by using poorly constructed or inappropriate items.”⁴

The two basic rules for test writing are:

1. Write at least three test items for every learning objective.

The testing mechanism and actual test items you select must match what you said the students would be required to do (learning objectives) and the actual lesson you presented. For a test to be valid, it must contain at least three test items for each objective.⁵ In our example the test must contain at least 12 multiple-choice items. For more information on writing a multiple-choice test item, refer to CAPCE’s Item Writing Standards.

2. Design the questions according to the CAPCE standard.

Test validity also depends on the level of knowledge required by the learner to answer the questions correctly. The CAPCE standard requires that no more than 25% of the questions be at the knowledge level, no more than 25% be at the comprehension level, and at least 50% be at the application level.⁶ For our example that means no more than three knowledge questions, no more than three comprehension questions, and at least six application questions.

The following examples of multiple-choice questions illustrate this principle.

Knowledge level: At this level students are required to recall facts, figures, definitions, rules and basic concepts. For example:

• Asthma is a disease that directly affects which parts of the respiratory system?
• Albuterol is a drug from which class?
• The lung sound most often heard during an asthma attack is ________.

Comprehension level: At this level students are required to demonstrate an understanding of a concept or principle by recognizing a previously unseen example of it. For example:

• What causes wheezing during an asthma attack?  
• What side effect might you see after administering albuterol?
• How does cardiac asthma differ from regular asthma?

Application level: At this level students are required to apply what they have learned to a new situation. For example:

• Your patient is experiencing severe respiratory distress. What position would be the most effective for him?
• Your asthmatic patient is refractory to nebulized bronchodilators. What would be the next prudent action to take?
• Your status asthmaticus patient just stopped breathing. What is your first priority?

Table 3 could serve as a test blueprint for the sample class.

Conclusion

Becoming proficient at curriculum matching is essential for any instructor. This skill allows you to design educational programs that provide clear direction for what’s to be learned, a base from which to design a lesson and a valid mechanism for evaluating student success.

References

1. Cherry RA. EMT Teaching. Upper Saddle River, NJ: Pearson Education, 1998.

2. Bonwell C, Eison J. Active Learning: Creating Excitement in the Classroom. AEHEERIC Higher Education Report No. 1. Washington, DC: Jossey-Bass, 1991.

3. Weibell CJ Principles of Learning, https://principlesoflearning.wordpress.com.

4. Mager RF. Preparing Instructional Objectives. Belmont, CA: David Lake Publishers, 1984.

5. Henkelo RE. Sage University Paper Series. Quantitative Applications in the Social Sciences. Beverly Hills, CA: Sage Publications, 1976.

6. Armstrong P. Bloom’s Taxonomy. Vanderbilt University Center for Teaching, https://cft.vanderbilt.edu/guidessub-pages/blooms-taxonomy/#2001.

The Commission on Accreditation for Pre-Hospital Continuing Education (CAPCE) board of directors and staff include Juan March MD, chair; Andy Gienapp, vice chair; Sean Trask, secretary treasurer; Joe Holley, MD; Justin Fuehrer, MD; Robert Wales; Jeremy Miller; Joe Grafft; Susan Bailey; and Jay M. Scott, executive director.