SUSTAINING CURRICULAR CHANGE AT SHERBROOKE THROUGH EXTERNAL, FORMATIVE PROGRAM EVALUATIONS

In this case study, the authors discuss external, formative program ev aluation as a means to monitor and sustain ongoing curricular change a nd to prepare for periodic accreditation reviews. The Faculty of Medic ine at Sherbrooke (in Quebec, Canada), following a major curricular re form begun in the mid-1980s, held three external, formative program ev aluations in 1988, 1991, and 1994, using expert judgment and ''connois seur'' models of evaluation. The authors present the goals of the eval uations (e.g., to evaluate the implementation of intended curricular c hanges) and the 17-step process used (e.g., ''involve as many faculty and students as possible before and during the visit''), and describe the preparation for the evaluations, the selection of the external eva luators (e.g., a chief medical officer from the World Health Organizat ion a high-profile basic sciences teacher, the chairman of the previou s accreditation team, and others), and on-site activities and reportin g. Recommendations from the evaluators and the subsequent actions take n (and in a few cases, not taken) by the school are presented and disc ussed in terms of program planning, curricular content, basic sciences , problem-based learning and tutors' training, assessment of students, resource constraints, clerkships, community orientation, students' se lf-directedness, and medical humanism. The three evaluations helped gu ide and support the major curricular undertakings and encouraged conti nued change and refinements. They also had a significant effect on the curriculum itself, on the faculty, and on the socio-educational clima te of the school.