Competency-based curricular design to encourage significant learning.

Most significant learning (SL) experiences produce long-lasting learning experiences that meaningfully change the learner's thinking, feeling, and/or behavior. Most significant teaching experiences involve strong connections with the learner and recognition that the learner felt changed by the teaching effort. L. Dee Fink in Creating Significant Learning Experiences: An Integrated Approach to Designing College Course defines six kinds of learning goals: Foundational Knowledge, Application, Integration, Human Dimension, Caring, and Learning to Learn. SL occurs when learning experiences promote interaction between the different kinds of goals, for example, acquiring knowledge alone is not enough, but when paired with a learning experience, such as an effective patient experience as in Caring, then significant (and lasting) learning occurs. To promote SL, backward design principles that start with clearly defined learning goals and the context of the situation of the learner are particularly effective. Emphasis on defining assessment methods prior to developing teaching/learning activities is the key: this ensures that assessment (where the learner should be at the end of the educational activity/process) drives instruction and that assessment and learning/instruction are tightly linked so that assessment measures a defined outcome (competency) of the learner. Employing backward design and the AAMC's MedBiquitous standard vocabulary for medical education can help to ensure that curricular design and redesign efforts effectively enhance educational program quality and efficacy, leading to improved patient care. Such methods can promote successful careers in health care for learners through development of self-directed learning skills and active learning, in ways that help learners become fully committed to lifelong learning and continuous professional development.