So, here we are, you are ready to develop your objectives.   This job-aid provides a high-level step-by-step procedure for developing the right ones in the right way. 

 

STEPS TO DEVELOPING OBJECTIVES 

 

Remember, a great objective has three parts: the first part is the context (the "givens"), the second part is the actual performance that the student will learn (it is a verb), and the third part is the performance criteria which describes how  well the learner will perform the task.  

 

1. First, you must select the right objectives.    For our foundational sciences, the best starting place for this is the NBME Subject Guide.   You can get it here, in the "Instructor References" section of this website, or from the NBME website.    This subject guide describes the content and the percentage of the subject exam devoted to each topic.   This is your best guide.    If  you use NBME Customized Assessments (which use recently-active USMLE test items), pay attention to the topics emphasized in those question banks as you select questions.  The test bank questions serve as a great indicator of the type of content that will be on the STEP exam.    You may also use guidelines published by your academic discipline (but, use some discretion here, the best sources for medical program information are the NBME and USMLE guides.)  

2. Identify the most important objectives (Conduct a "Triage").  If you have done it right, you should have identified far more potential objectives than you will be able to meaningful address.  The best way to narrow down and prioritize which objectives you should address is to coordinate with a physician. We want to address the objectives that affect physician practice and that will show of on the STEP exams.  Dr. Neel Krishna sent clinicians lists of diseases divided into organ system modules and asked them to prioritize the diseases.   From this he was able to develop prioritized lists (using a classification system) by module for module directors to consider.  This reinforces the practice of doing most important things first.   

3. Always focus on how you will test the objective.   An objective's purpose is two-fold: it identifies what must be learned, AND it identifies how you will know it was learned.   As you develop your objectives, think about how you will test for learning.  

4. Select appropriate performance standards.   We all want our students to be geniuses at our subject.   In a real sense, however, that is not our best goal.   Our goal should be to bring the students to a place of extreme competence as it relates to the standards of the gateway exams and resident practice.   We graduate excellent residents, and our performance standards should reflect that level of expertise. 

5. Use The New Bloom's Taxonomy table to help you select appropriate action verbs.   Notice that in our program, we seldom have students "describe," "discuss," or "diagram" things on tests, yet, many of our current objectives use these verbs.   Be creative here:  in most of our tests students are identifying things.   But, if you think about it, you can still describe complex relationships.   For example, an objective could read, "Given a clear case description, students will identify the three most probable diagnoses."     Or, "Given a service learning context, students will identify the key determinants of a prevalent community health challenge."   For affective objectives, refer to the Affective Taxonomy table.

6. Describe the context for the performance in your objective.   For example, "After making a differential diagnosis..."  or, "Given a cadaver..." or, "Given a complete case scenario..."     This context is important for two main reasons.   First, it helps us know the circumstances of the performance, second, the context is often the stimulus for the action.   

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