World-Class Learning Objectives Framework¶
Design Principles¶
1. Bloom's Taxonomy Distribution (Target)¶
| Level | Verbs | Target % | Purpose |
|---|---|---|---|
| Remember | Define, list, recall, identify, name | 10% | Foundation |
| Understand | Describe, explain, summarize, classify | 20% | Comprehension |
| Apply | Apply, demonstrate, calculate, implement | 35% | Core competency |
| Analyze | Analyze, compare, differentiate, examine | 20% | Clinical reasoning |
| Evaluate | Evaluate, assess, critique, justify, recommend | 10% | Decision-making |
| Create | Design, develop, formulate, construct | 5% | Mastery |
2. ACGME Competency Domains¶
Each topic should address multiple domains:
| Domain | Objective Type | Example |
|---|---|---|
| Medical Knowledge (MK) | Know, understand, apply clinical knowledge | "Apply diagnostic criteria for..." |
| Patient Care (PC) | Clinical decision-making, procedures | "Formulate treatment plan for..." |
| Interpersonal/Communication (ICS) | Counseling, shared decision-making | "Counsel families on prognosis of..." |
| Systems-Based Practice (SBP) | Care coordination, transitions, resources | "Coordinate multidisciplinary care for..." |
| Practice-Based Learning (PBLI) | Evidence appraisal, self-improvement | "Critically appraise literature on..." |
| Professionalism (PROF) | Ethics, boundaries, wellness | "Navigate ethical considerations in..." |
3. Training Level Stratification¶
FOUNDATION (PGY-1/Intern)
├── Recognition of common presentations
├── Basic diagnostic workup
└── When to consult/refer
DEVELOPING (PGY-2/3)
├── Application of guidelines
├── Interpretation of diagnostics
└── Initial management decisions
COMPETENT (Fellow Year 1-2)
├── Complex clinical reasoning
├── Independent management
└── Procedural competency
MASTERY (Fellow Year 3/Faculty)
├── Evaluation of treatment options
├── Teaching others
└── Quality improvement leadership
4. Objective Structure Template¶
## Learning Objectives
### Core Competencies
- [ ] [Apply/Analyze verb] [specific clinical skill] for [patient population]
- [ ] [Evaluate verb] [diagnostic/treatment options] in [clinical context]
### Communication & Counseling
- [ ] Counsel [families/patients] on [prognosis/inheritance/treatment options]
- [ ] Lead shared decision-making discussion regarding [specific topic]
### Systems & Practice
- [ ] Coordinate [multidisciplinary care/transition] for [population]
- [ ] [Apply cost-effective/evidence-based] principles when [clinical action]
### Procedural (where applicable)
- [ ] Perform/interpret [specific procedure/test]
Enhanced Objectives by Topic Category¶
Acquired Heart Disease Topics¶
Communication emphasis: Prognosis counseling, treatment decisions Systems emphasis: Follow-up coordination, specialist referrals
Cardiomyopathy Topics¶
Communication emphasis: Genetic counseling, SCD risk discussion, activity counseling Systems emphasis: Genetic testing coordination, ICD decision-making
Electrophysiology Topics¶
Communication emphasis: Device counseling, emergency action plans Systems emphasis: School/sports coordination, medication safety
Preventive Cardiology Topics¶
Communication emphasis: Lifestyle counseling, risk factor modification Systems emphasis: Primary care coordination, screening programs
CHD Topics¶
Communication emphasis: Surgical counseling, long-term expectations Systems emphasis: Transition planning, multidisciplinary coordination
Imaging Topics¶
Procedural emphasis: Image acquisition, measurement techniques Communication emphasis: Results communication, limitation explanation
Mapping to Pediatric Cardiology EPAs¶
| EPA | Related Topics | Key Objectives |
|---|---|---|
| Evaluate new patient | All | History, exam, initial workup |
| Interpret echo | 17, 33 | Measurement, Z-scores, findings |
| Interpret ECG | 5, 11, 18 | Age-appropriate interpretation |
| Manage acute HF | 2, 16, 23 | Stabilization, escalation |
| Counsel families | All | Diagnosis disclosure, prognosis |
| Coordinate care | 15, 22, 23 | Transitions, multidisciplinary |
| Procedural | 34 | Cath lab competencies |
Quality Metrics for Objectives¶
Measurability Checklist¶
- [ ] Contains action verb (not "understand" or "know")
- [ ] Specifies observable behavior
- [ ] Defines context/conditions
- [ ] Implies assessment method
Coverage Checklist (per topic)¶
- [ ] ≥1 Apply/Analyze level objective
- [ ] ≥1 Communication objective
- [ ] ≥1 Clinical decision-making objective
- [ ] Addresses key board content
- [ ] Links to relevant guidelines
Implementation Plan¶
Phase 1: HIGH-Weight Topics (20 topics)¶
Enhance with full objective suite (6-8 objectives each)
Phase 2: MEDIUM-Weight Topics (14 topics)¶
Enhance with standard suite (5-6 objectives each)
Phase 3: Validation¶
- Run against checklist
- Ensure Bloom's distribution
- Verify ACGME coverage