The problem with outcomes-based curricula in medical education: insights from educational theory

• Published in: Medical education Vol. 38; no. 6; pp. 593 - 598
• Main Author: Rees, Charlotte E
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.06.2004; Blackwell; Wiley Subscription Services, Inc
• Subjects: clinical competence/standards; Curriculum - standards; Curriculum subjects: programmes and methods; education; Education, Medical, Undergraduate - methods; Education, Medical, Undergraduate - standards; Educational sciences; Faculty - organization & administration; health care/standards; Humans; Licensure - standards; Medical and paramedical education; medical undergraduate/standards; Models, Educational; Professional Competence - standards; quality assurance; Students, Medical - psychology; Teaching methods; United Kingdom; Medicine; Curriculum; Skill; Higher Education; Public Health; Standard
• ISSN: 0308-0110; 1365-2923
• DOI: 10.1046/j.1365-2923.2004.01793.x

Background  Educators across the world are charged with the responsibility of producing core learning outcomes for medical curricula. However, much educational theory exists which deliberates the value of learning outcomes in education. Aims  This paper aims to discuss the problems surrounding outcomes‐based curricula in medical education, using insights from educational theory. Discussion  The paper begins with a discussion of the traditions, values and ideologies of medical curricula. It continues by analysing the issue of control within the curriculum and argues that curriculum designers and teachers control product‐orientated curricula, leading to student disempowerment. The paper debates outcomes‐based curricula from an ideological perspective and argues that learning outcomes cannot specify exactly what is to be achieved as a result of learning. Conclusions  The paper argues that medical schools should adopt a model for co‐operative control of the curriculum, thus empowering learners. The paper also suggests that medical educators should determine the value of precise learning outcomes before blindly adopting an outcomes‐based model.