But in the last few years, medical schools including those at N.Y.U. and Harvard University have been doing some soul-searching about whether this lock-step curriculum creates doctors who lack humanity, who see patients as diseases rather than as whole people and who have what the medical literature calls "ethical erosion" — a loss of idealism, empathy, morality.
The city teachers' union recognized this problem in 1999 when it began writing step-by-step curriculums with detailed lesson plans.
One of the first steps in curriculum development is a needs assessment of targeted learners [ 1, 2].
Table 1 shows the six steps of curriculum development set out by Kern in relation to the sections of this paper in which they occur.
The programmatic approach of Kern's six steps for curriculum development helped to overcome barriers of design, implementation and assessment of an in-situ team and resuscitation training program.
The Stepping Stones curriculum comprises a participatory approach that includes critical reflection to encourage safer sexual practices through building more gender-equitable relationships (54).
As a first step, medical curriculum should incorporate modules specifically targeted at increasing factual knowledge and addressing issues that hinder organ donation.
This was in line with Kern's first step in curriculum development, which entails identifying the problem and doing a general needs assessment by establishing the difference between the ideal and the current teaching approach.
In addition, monthly group counselling sessions emphasising relationship skills training adapted from a subset of the Stepping Stones curriculum 18 were also made available to all study participants in all villages but were not mandatory.
However, these policies and programs are not infallible and do not reflect the struggle failing students face, their rates of graduation, time spent in the program, number of attempts at USMLE Step 1 and Step 2. Importantly, curriculum track options were not discussed.
We designed and implemented a team and resuscitation training program according to Kern's six steps approach for curriculum development.
