Tensions in curriculum development
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Tensions in Curriculum Development. Prof Della Freeth. Clarifying curriculum. Not simply a syllabus with assessments - Whole learning experience, planned and unanticipated Curriculum as: written delivered Received Formal and hidden curricula. Tensions - not so much . More like .

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Clarifying curriculum
Clarifying curriculum

  • Not simply a syllabus with assessments - Whole learning experience, planned and unanticipated

  • Curriculum as:

    • written

    • delivered

    • Received

  • Formal and hidden curricula

Tension triangles knud illeris
Tension Triangles – KnudIlleris

  • How we learn: learning and non-learning in school and beyond

  • 2007, Routledge

  • Published in Danish in 1999

Individual learning triangle
Individual learning triangle






Interaction triangle
Interaction triangle



Social situation

(e.g. classroom,

simulation, workplace)

Societal situation


Illeris learning model
Illeris’ learning model





Social situation

Societal situation


Who patient safety curriculum for medical schools www who int patientsafety education curriculum en
WHO Patient Safety Curriculum for Medical Schools development ...www.who.int/patientsafety/education/curriculum/en/

  • Introduced 2009, being piloted in 10 countries, ‘multiprofessional’ guide under development

  • 258 pages “... a comprehensive, ready-to-teach, topic-based patient safety programme” p4

Approach development ...

  • Detailed teachers’ notes and presentation slides provided. Also some case studies.

Eleven topics
Eleven topics: development ...

  • What is patient safety?

  • What is human factors and why is it important to patient safety?

  • Understanding systems and the impact of complexity on patient care

  • Being an effective team player.

  • Understanding and learning from errors.

  • Understanding and managing clinical risk.

Topics continued
Topics continued development ...

  • Introduction to quality improvement methods.

  • Engaging with patients and carers.

  • Minimizing infection through improved infection control.

  • Patient safety and invasive procedures.

  • Improving medication safety.

Patient safety curriculum and illeris model
Patient safety curriculum and development ...Illeris’ model

  • Is content dominating at present?

  • Will the suggested activities provide emotions/incentives that support positive and enduring learning?

  • How can we focus on productive tensions and balance points between content, emotion and social environments?

Some thoughts
Some thoughts ... development ...

  • Importance of variety (e.g. stimulus material, structure of learning opportunity; perhaps also which corner of the individual triangle leads)

  • Strategic choice of learning environments, playing to the strengths of each: workplaces, classrooms, residential and leisure settings, physical simulations, virtual worlds, drama, archives of patient experiences, media archives, ...

Some other tensions
Some other tensions development ...

Thread or block
Thread or block? development ...

I favour
I favour development ...

Exotic or mundane
Exotic or mundane? development ...

Error reduction or error recovery
Error reduction or error recovery? development ...

  • See Dror, I. (2011) A novel approach to minimize error in the medical domain: Cognitive neuroscientific insights into training. Medical Teacher, 33(1):34-38

Tensions in curriculum development

  • Daily realities in workplaces, patients’ homes, public spaces

Challenges ...

  • How might you use the Illeris model to:

    • plan and enliven patient safety education?

    • Attend to tensions that you encounter?

Thank you
Thank you ...

  • d.freeth@qmul.ac.uk