Conceptual guidelines for developing and maintaining curriculum and examination objectives: The experience of the Medical Council of Canada

In an era of increasing professional accountability, there is a need for bo th medical educators and licensing bodies to identify attributes expected o f medical graduates. Once these attributes are identified, educators must t ranslate them into meaningful learning objectives. Because educators in man y countries are in the process of defining (or have defined) attributes and competencies expected of their graduates, a review of the conceptual basis for writing curricular and examination objectives is relevant and construc tive. The authors compare the principles of a conceptual model for identifying ed ucational objectives and those used in the creation of the second (and most current) edition of the Objectives for the Qualifying Examination of the M edical Council of Canada (MCC). In developing these objectives, extensive a nd careful collaboration between licensing bodies, medical schools, the pra cticing profession, learners, and the MCC was critical. The process illustr ates that the goals for the education of medical students can be consistent whether they are elaborated by medical schools or licensing bodies. The au thors present the method and principles used by the MCC, including the clin ical presentation model. The basic steps in the process are described: iden tifying the attributes, identifying the basic educational philosophy, assig ning priority to problem-solving principles, and deducing learning objectiv es from desirable practice-related behaviors. The authors conclude with a c onsideration of the need and feasibility of defining the scientific underpi nnings of competency-based learning objectives.