Examine the University of Toronto Undergraduate Medical Programs Undergraduate Medical Education (UME) Goals and Objectives. a.

What differentiates the goals from the objectives? The goals are far broader set of standards than the objectives. The goals simply state that graduates will be competent with the necessary skills and individuals who will stand out in their community. The objectives explicitly outline what is expected of graduates as medical professionals, professionals, leaders within the community, scholars, and their role in health advocacy. b. Do the objectives seem to align with the goals? Why or why not? I believe the objectives are in line with the goals set out for the students. In order to successfully meet the CanMEDS competencies, the students will have to demonstrate success with the objectives. Because the goals are far more vague the detail of the objectives provides a guide for students to successfully meet both areas of standards. c. Examine the UME Objectives. To whom are these objectives directed? The objectives are directed at both the students and the professors who will be teaching them. In order for the students to fully understand what is expected to meet each objective, the professor must be able to teach them with words as well as his/her own actions. He/she must be able to set the example and allow students to emulate that degree of skill.

2. Types of Knowledge within the learning objectives: a) Provide an example for each type of knowledge as per Blooms revised taxonomy (e.g., cognitive, affective, psychomotor) Cognitive: the objectives under the first sub-heading are all examples of cognitive knowledge
1. 2. 3. Demonstrate a knowledge of the scientific* and humanistic foundations of medicine and be able to apply that knowledge to the practice of medicine. Demonstrate a thorough knowledge of the etiology, pathogenesis, clinical features, complications, principles of prevention and management of common and life-threatening illnesses presenting throughout the age spectrum, including all of the core clinical presentations outlined by the Medical Council of Canada. Demonstrate: -The ability to obtain and document both a complete and a focused medical history, as the situation requires. -The ability to perform and document both a complete and focused physical and mental status examination, as the situation requires. -The ability to interpret commonly-employed laboratory tests, including tests of blood and other body fluids, various imaging modalities, and other specific tests such as electrocardiography. -The ability to integrate the above history, physical and laboratory test findings into a meaningful diagnostic formulation. -Therapeutic and on-going management skills with respect to health and disease 4. 5. Retrieve, analyze, and synthesize relevant and current data and literature, using information technologies and library resources, in order to help solve a clinical problem. Propose clinical decisions utilizing methods which integrate the best research evidence with clinical expertise and patient values

Affective: The objectives under the second sub-heading are examples of affective knowledge:
1. 2. 3. Communicate effectively with patients, their families and the community through verbal, written and other non-verbal means of communication, respecting the differences in beliefs and backgrounds among patients and students. Establish professional relationships with patients, their families (when appropriate) and community that are characterized by understanding, trust, respect, empathy and confidentiality. Deliver information to the patient and family (as appropriate) in a humane manner, and in such a way that it is easily understood, encourages discussion and promotes the patients participation in decision-making.

4. 5.

Gather information, negotiate a common agenda, and develop and interpret a treatment plan, while considering the influence of factors such as the patients age, gender, ethnicity, cultural and spiritual values, socioeconomic background, medical conditions, and communication challenges. Demonstrate the importance of cooperation and communication among health professionals so as to maximize the benefits to patient care and outcomes, and minimize the risk of errors.

Psychomotor:
1. 2. 3. Gather information, negotiate a common agenda, and develop and interpret a treatment plan, while considering the influence of factors such as the patients age, gender, ethnicity, cultural and spiritual values, socioeconomic background, medical conditions, and communication challenges. Demonstrate the importance of cooperation and communication among health professionals so as to maximize the benefits to patient care and outcomes, and minimize the risk of errors. Be prepared to challenge clinical orthodoxy, or identify threats to population health and advocate for their amelioration.

b) Do you think the types of knowledge are equally represented? I do not think that the three types of knowledge are equally represented in the objectives. I think the objectives are far more heavily weighted with cognitive and affective skills. c) Do you think the types of knowledge should be equally represented? Why or why not? I believe all three types of knowledge should be equally weighted in the objectives. Although the cognitive knowledge may be the most important component in a learning environment with tradition evaluation methods, affective and psychomotor skills may be of more benefit when the students have graduate and have to deal with people on a regular basis. 3.If you were a course instructor, how might you use these overall goals and objectives? If I were to be an instructor in this course I would use the goals and objectives as guidelines for the expected outcomes of graduates. I would attempt to develop exercises that would reflect to content of the goals and objectives but put into use all three areas of knowledge. 4. Go to the Preclerkship Curriculum first year course for The Art and Science of Clinical Medicine I located at http://www.md.utoronto.ca/program/preclerkship/year1/ASC_111Y.htm and examine the courses general objectives. a) Critique the objectives by examining the following areas: 1. The types of knowledge as per Blooms revised taxonomy (e.g., cognitive, affective, psychomotor) The objectives are very basic, with very little emphasis on the development of psychomotor skills. Most of the objectives are only concerned with the cognitive skills to be developed. 2. The manner in which the objectives are stated/written (i.e., refer back to your readings!) Consistent with the characteristics of authentic activity as listed in the article Authentic activities and online learning by Oliver, Herrington, and Reeves, these objectives are ill-defined, provide the opportunity for students to examine the task from different perspectives, allows the opportunity for collaboration, and allow competing solutions and diversity of outcomes. 3. The cognitive levels as per Blooms revised taxonomy These objectives seem to focus almost exclusively on the cognitive level of Bloom's taxonomy.

b) Improve the following objective (taken right from the UME objective list and provide a rationale as to why you made the revisions that you did.

The learner must be able to demonstrate the procedure for and explain the significance of key components of documenting medical history and physical examination of patients. I included that students must be able to perform the physical examination and documentation of medical history because this will help to tie in psychomotor and affective skills in the evaluation of competence. The student will have to demonstrate that they are aware of the physical requirements of patient examination and develop and early appreciation for the level of respect and that should be shown to their patient.