Outcome-Based Education & CDU-CM MD Program – Comprehensive Study Notes

Goal of Professional Education

• Foundational dictum cited: Charles Gragg, Harvard Business School ( $1940$ )

  • “Education in the professions should prepare students for action.”

  • Sets philosophical bedrock: learning is judged by graduate performance in authentic settings.

Overview of the CDU-CM Curriculum

• Core design: Problem-Based Learning (PBL) + Outcome-Based Education (OBE)

  • PBL supplies the student-centred, inquiry-driven pedagogy.

  • OBE supplies the results-oriented, competency-anchored frame for curriculum, teaching, and assessment.

Definition of Outcome-Based Education (OBE)

• William Spady’s twin definitions ( $1994$ ):

  • “Clearly focusing and organizing everything in the education system around what is essential for all students to be able to do successfully at the end of their learning experiences.”

  • “A comprehensive approach to organizing and operating an education system that is focused on and defined by the successful demonstrations of learning outcomes sought from each student.”

• Key construct: Outcomes = clear, demonstrable learning results expected at the conclusion of significant learning experiences.

Rationale for Shifting to OBE

Emerging Problems of the $21^{st}$ Century

• $1.$ Wide inequalities in health within & between nations ⇒ collective failure to share advances equitably.

• $2.$ Fresh health threats:

  • New infections, environmental hazards, behavioural risks.

  • Pressures on global health security.

  • Health-care systems confronted with increasingly complex & costly demands.

• $3.$ Health-professional education lagging behind because of:

  • Fragmented, outdated, static curricula → ill-equipped graduates.

Systemic Deficiencies in Traditional Medical Education

• a. Competency mismatch vis-à-vis patient & population needs.

• b. Poor teamwork culture.

• c. Gender stratification in professional status.

• d. Over-narrow technical focus, lacking contextual breadth.

• e. Episodic encounters, not continuous care.

• f. Hospital-dominant orientation → neglect of primary care.

• g. Quantitative & qualitative labour-market imbalances.

• h. Weak leadership to uplift health-system performance.

Additional Macro-level Pressures (Emerging Challenges)

• Epidemiological & demographic transitions.

• Technological innovation outpacing curricula.

• Growing professional differentiation.

• Heightened population expectations & demands.

Key Questions Addressed by OBE (Backward-Design Logic)

• WHAT should the student learn? → Outcomes.

• WHY is each learning outcome important? → Purpose/relevance.

• HOW will we best help students learn? → Teaching/learning strategies.

• HOW will we know they have learned? → Assessments aligned to outcomes.

Basic Principles of OBE

• Clarity of Focus

  • Students & faculty share transparent targets.

• Designing Backwards

  • Outcomes first → curriculum → instruction → assessment.

• High Expectations for All

  • Not remedial tracks, but universal emphasis on higher-order thinking skills (HOTS) & authentic performance in real workplaces (not just simulation).

• Expanded Opportunity & Support

  • Multiple, varied learning chances; flexible pacing; feedback-rich environment.

Policy & Regulatory Context in the Philippines

Governance Bodies

• Technical Panel for Health Professions Education (TPHPE) under CHED.

• Technical Committee for Medical Education (TCME) – successor of the Board of Medical Education.

CHED Memorandum Order (CMO) No. $46$ s$2012$

• “Policy-Standards to Enhance Quality Assurance in Philippine Higher Education through an Outcomes-Based and Typology-Based QA.” ( $December\;11,\;2012$ )

• Mandates all higher-education programs to adopt OBE + competency-based QA.

Contextual Data Prompting Reform

• National PLE (Physicians’ Licensure Examination) passing averages: $67.52\%$ ( $2011$ ) & $70.5\%$ ( $2012$ ).

• ≈$\tfrac{1}{2}$ of $38$ medical schools scored below national average & exhibited major deficiencies in CHED/PRC monitoring.

• NMAT takers & first-year enrolment doubled in $2012$ vs $2007$.

• TCME vision: transform all medical schools to ≥$90\%$ institutional PLE passing average by $2020$ (“Rationalizing Medical Education”).

• WHO & global calls: transformative, inter-professional, socially accountable education → “More doctors, but not of the same kind.”

CHED-Specified Ten MD Program Outcomes (OBE)

1. Demonstrate Clinical Competence

   • Competently manage clinical conditions across settings.

2. Communicate Effectively

   • Convey information orally & in writing, to all audiences/media, in an understandable manner.

3. Lead & Manage Health-Care Teams

   • Plan, organize, implement & evaluate programs/facilities; inspire & motivate.

4. Engage in Research Activities

   • Use current evidence in decisions; participate & disseminate research.

5. Collaborate within Inter-Professional Teams

   • Work effectively with diverse professionals in patient & institutional management.

6. Utilize Systems-Based Approach to Health Care

   • Apply systems thinking; network with partners to solve health problems.

7. Pursue Continuing Personal & Professional Development

   • Engage in life-long learning to ensure quality & safety.

8. Adhere to Ethical, Professional & Legal Standards

   • Comply with national/international codes & laws.

9. Demonstrate Nationalism, Internationalism & Dedication to Service

   • Value heritage, respect other cultures, commit to service.

10. Practice Principles of Social Accountability

    • Uphold relevance, equity, quality, cost-effectiveness in delivering care.

Level I Mapping: Outcomes → Competency Standards → Performance Indicators → Curriculum Goals

(The CDU-CM excerpt details the first execution tier; italics below signal sample evidence.)

1 Clinical Competence (Practiced)

• Competency standards include correlating clinical problems with basic-science foundations.

• Indicators: submission of reflection papers, written exams, lab/practical results.

• Curriculum goal: correlate trigger-case problems with normal morphology & physiology.

2 Communication (Demonstrated)

• Standards: articulate ideas during small-group & plenary sessions.

• Indicators: reflection papers, tutorial grades, assessed presentations, comm-skills OSCEs.

• Goal: deploy varied communication modes in SGDs & plenaries.

3 Leadership & Management (Demonstrated)

• Standards: give direction in SGDs; defend research-based evaluations of health programs.

• Indicators: reflection papers, time-management plan, EF-series tutorial ratings, Gantt chart.

• Goal: assume leadership in health-advocacy initiatives.

4 Research Engagement (Demonstrated)

• Standards: craft descriptive research aligned with College agenda → critique literature; analyze data; apply evidence in SGD.

• Indicators: defended proposals, final papers, bound copies, reflection papers, EF grades.

• Goals: produce & disseminate research; use findings in community service & pathophysiology integration.

5 Teamwork (Demonstrated)

• Standards: collaborate effectively with group members.

• Indicators: CERAE reflections, EF grades, concept-map evaluations, peer assessments (Form $16$).

• Goal: joint analysis of case problems & research tasks.

6 Systems-Based Care (Practiced)

• Standards: develop community health-promotion/education plans via systems lens.

• Indicators: CERAE reflections.

• Goal: integrate systems-based planning for community settings.

7 Life-Long Learning & Personal Growth (Demonstrated)

• Standards: proactive self-development; appropriate professional attitudes.

• Indicators: reflections, time-management plan, EF grades.

• Goal: display integrity, honesty, gender sensitivity in all interactions.

8 Professionalism & Legal-Ethical Compliance (Demonstrated)

• Standards: comply with codes; secure ethical clearance; avoid plagiarism; join professional bodies.

• Indicators: CERAE reflections, EF grades, IERC approval, anti-plagiarism report, memberships.

• Goal: uphold professionalism in every stakeholder encounter.

9 Nationalism & Cultural Competence (Demonstrated)

• Standards: responsible citizenship; cultural sensitivity.

• Indicators: reflections, EF$1$, council approvals, outreach certificates.

• Goal: display cultural sensitivity with patients & peers.

10 Social Accountability (Practiced)

• Standards: apply relevance, equity, quality, cost-effectiveness plus CDU core values: Competence, Dedication, Uprightness, Compassion, Accountability, Respectfulness, Excellence, Service ( mnemonic: “CDU-CARES” ).

• Indicators: reflections on health issues & advocacies, research abstracts, EF grades.

• Goal: appreciate patient words within SA framework.

Student Implementation Prompt

• Orientation-module task: “How will you, as a CDU-CM medical student, achieve/implement the different OBE program outcomes?”

  • Presentation due to SGD facilitator during PBL-tutorial OBE-workshop (Day $2$ of orientation).

Ethical, Philosophical & Practical Implications

• Ethics: explicit alignment with national & international codes; fostering integrity and social justice.

• Philosophy: education judged by outcomes, not seat-time → learner agency & accountability.

• Practice: authentic assessment in real or near-real contexts → gradual replacement of pure simulation.

• Social contract: medicine’s legitimacy lies in meeting society’s evolving health needs; OBE provides the mechanism.

Key Terms & Abbreviations

• OBE – Outcome-Based Education.

• PBL – Problem-Based Learning.

• HOTS – Higher-Order Thinking Skills.

• CHED – Commission on Higher Education (Philippines).

• TPHPE – Technical Panel for Health Professions Education.

• TCME – Technical Committee for Medical Education.

• CMO – CHED Memorandum Order.

• PLE – Physician Licensure Examination.

• NMAT – National Medical Admission Test.

• CERAE – Context, Experience, Reflection, Application, Evaluation (reflection-paper format).

• EF – Evaluation Form (tutorial rubric series).

• IERC – Institutional Ethics Review Committee.

• SGDs – Small Group Discussions.

Numerical & Statistical Highlights (for recall)

• $1940$ – Gragg’s seminal quote.

• $1994$ – Spady’s landmark OBE definitions.

• $38$ medical schools monitored; ≈$50\%$ below national passing average.

• PLE pass rates: $67.52\%$ ( $2011$ ), $70.5\%$ ( $2012$ ).

• TCME vision: ≥$90\%$ institutional PLE pass rate by $2020$.

• CMO $46$ issued $December\;11,\;2012$.

Study Tips

• Map each CHED outcome to specific learning artefacts you must produce (reflection papers, EF ratings, research deliverables).

• Internalise backward-design: first ask, “What performance will show my competence?” then choose study strategies.

• Use CDU-CARES values to evaluate your day-to-day behaviours.

• For exam prep, rehearse explaining how each systemic problem (e.g.
  hospital-centric bias) is addressed by a particular OBE outcome.

• Keep a running evidence portfolio that matches the Level I performance indicators.