In response, we created an outcome map to capture both the higher level outcomes that participants were striving to achieve and the processes and actions that had been agreed by participant stakeholders [ 18].
Although there had been some convincing reasons to avoid a more richly layered model, the lack of higher level outcomes has now reinforced by participants' overall focus on the operational level of WREMO activities.
A recent meta-analysis of 55 studies (Carbonneau et al., 2013) showed that instruction that used manipulatives, compared with abstract symbolic instruction, produced a moderate- to large-sized effect when students were measured on retention and small effects when higher level outcomes, such as problem solving, transfer, and justification, were considered.
Higher level outcomes prioritised by young people and parents were emotional well-being and involvement in community and social life.
Findings from the analysis were then categorized into either: (1) actions and processes, or (2) higher level outcomes [ 18].
Whether these immediate effects would necessarily have led to higher level outcomes is another matter since this depends on external factors.
However, the programme would have been better placed to achieve higher level outcomes had it given more consideration to feasibility and sustainability when designing interventions.
Achieving higher level outcomes is not dependent on the achievement (in part or full) of all of the lower level outcomes.
However, achieving higher level outcomes is not necessarily dependent on the achievement (in part or full) of all of the lower level outcomes.
With some outcomes, such as pain control, acting as facilitators that contribute to the achievement of higher level outcomes, such as gaining independence.
As the new draft version of the GMCs Tomorrow's Doctors guidelines includes the high level outcome of 'The doctor as a scholar and scientist' [ 3], this may be one way to cover such areas within the medical curriculum.
