Portfolio Project

EDUC 765: Trends and Issues in Instructional Design

By: Matthew Vincenti

Submitted June 23, 2016

PROJECT PROPOSAL MODULE 2

Project Title
A Medical Education Curriculum For VA Physicians: The Immune System As A Therapeutic
Target In Chronic Diseases.

Sponsoring Organization
Department of Veterans Affairs
White River Junction, VT
The mission of the Department of Veterans Affairs is to deliver the highest quality of medical
care and service to veterans returning from active duty in the military.

Project Description
Physicians at Veterans Affairs (VA) medical facilities must stay current with the latest medical
advancements by participating in graduate medical education (GME) and continuing medical
education (CME). This is challenging at rural VA facilities, which are geographically isolated
from medical subject matter experts at major medical universities. This knowledge gap is
particularly acute in the field of immunology, where recent advances have had dramatic impacts
on the treatment of chronic pathologies, such as autoimmune diseases and cancer. For example,
the immunology courses that physicians took in medical school unlikely covered the topic of
immune checkpoint regulators because this is a relatively new concept. As immune checkpoint
regulators currently represent one of the most promising therapeutic targets in cancer, VA
physicians must be exposed to these latest concepts in immunology to be effective in an everchanging landscape of clinical interventions. Specific opportunities for medical education
include:
An overview of the current concepts of immune regulation
Application of current concepts in immunology to the pathobiology of chronic diseases
Exposure to the latest immune-based therapies for chronic diseases

Aim
The aim of this project is to design and deliver GME and CME that addresses the biological
basis and clinical applications of immune-based therapies for chronic diseases such as
rheumatoid arthritis and cancer. The overall goal of this project is to provide VA physicians with
the conceptual basis to effectively treat these autoimmune and neoplastic diseases in the Veteran
population.

Target Audience
Primary care physicians
Specialty care physicians
Medical residents

Delivery Options
It is anticipated that the majority of the content will be delivered through synchronous and
limited synchronous formats. The primary training content will be presented live due to the
current GME and CME accreditation requirements in the VA and its affiliated medical schools.
Delivery approaches will include, but not be limited to, videoconferences, web conferences,
online discussion groups and email.

FRONT-END ANALYSIS: INSTRUCTIONAL NEED MODULE 3

Instructional Need
Felt and anticipated needs for VA GME and CME: Dramatic advances in the field of
immunology over that past decade have provided significant improvements in the treatment of
chronic diseases. For example, autoimmune diseases such as rheumatoid arthritis are now
commonly treated with targeted therapies that impede the ability of a patients immune system to
attack the connective tissues of the joints. Similarly, an approach known as immunotherapy is
now believed to be the most promising approach to treating deadly malignancies, such as
melanoma and lung cancers. Importantly, the broad application of immunotherapies in cancer is
relatively new, with many therapies still in clinical trials. These recent important theoretical and
applied advances in the field of immunology have created an inherent knowledge gap, where
many practicing physicians are not aware of this latest medical information. This knowledge
gap may be most acute in older physicians who attended medical school many years ago, but
may also exist for recent medical school graduates (i.e. residents), who have not had the clinical
context to apply this information. Moreover, as the clinical applications of immune-based
therapies expand, new concepts in immunology will develop, further extending the knowledge
gap. These felt and anticipated needs in the GME/CME could have dramatic effects on the
quality of patient care within the VA. An inability to apply this latest medical information may
result in Veterans not receiving the most effect treatments for their chronic diseases. In addition,
since these approaches have received significant press of late, patients may inquire about them,
and physicians must be able to explain their risks and benefits. This situation fulfills the third
opportunity for addressing a performance problem identified by Rossett (1999): the need to
develop personnel so that they can continue to contribute to the VA mission (employee growth).
Method of identifying the instructional need: While this knowledge gap appears real, we must
collect data that confirms its existence and defines its scope. To do this, we will conduct face-toface interviews of physicians at the White River Junction VA facility. We will use the primary
audience of physicians from primary care, specialty care and medical residents to assess these
needs. Individuals will be asked the following questions:

Have you ever had a formal course in immunology, and if so, how long ago was that?
Have you ever needed to use immunology in your practice, for example through the
interpretation of clinical tests or the prescription of immune-based therapies?
Do you feel that you need to better understand the general concepts of immunology in
order to effectively treat your patients?
Do you think that reviewing the current concepts in immunology and the latest clinical
applications would be interesting and useful to you as a physician?
Would you participate in a formal course on the immune system as a therapeutic target in
chronic diseases, which included didactic lectures and case-based problem solving
exercises?
Are there other educational approaches to this topic that you would find more useful?

These interviews will be conducted through a qualitative research approach using the grounded
theory of Anselm Strauss and Barney Glaser (Grounded Theory Online, May 20, 2016).

Briefly, data collected from interviews with VA physicians will be coded and analyzed to
identify themes that address the basic concept that current knowledge in immunology is
applicable and relevant across numerous medical subspecialties. Through an iterative approach,
we will analyze responses as the interviews progress in order to refocus the questions and to
optimize the data collection process. For example, if there is a strong interest in having the
training available, the interviews will focus on the format of presentation, taking advantage of
the medical learners educational experiences and clinical priorities. This approach will also
allow for the development of a goals analysis, in which the ultimate educational goal is
identified. Specifically, is the learning goal to develop a generalizable knowledge of modern
immunology theory, or is the goal to focus the curriculum on specific types of clinical cases that
are commonly experienced in the Veteran population? Based on prior experience with these
types of qualitative research (Pamela Lee, Research Analyst, Veterans Rural Health Resource
Center-Togus, personal communication, March 4, 2016), usually a maximum of thirty interviews
are needed to collect reliable data to address the central concept.

FRONT-END ANALYSIS: LEARNER CHARACTERISTICS MODULE 3

Learner Analysis
Primary Audience
Primary Care Physicians
Specialty Care Physicians: Cardiology, Hematology/Oncology, Nephrology,
Gastroenterology, Neurology, Infectious Disease, Rheumatology, Pulmonology,
Anesthesia/Pain Management, Psychiatry
Medical Residents
Secondary Audience
Physicians Assistants
Registered Nurses
Pharmacists
General Learner Characteristics
The entire audience will consist of adult learners.
The primary audience will consist of learners that have completed medical school.
The secondary audience will consist of health care professionals with some medical
training, however they may not have previously completed a formal course in
immunology.
Demographically, the learners will be a fairly even mix of men and women, with all
racial and ethnic backgrounds potentially represented.
Given that this particular training is not mandatory, learners who choose to participate
are likely to be interested and motivated.
Learners will have high expectations that the content will be provided clearly and
have direct applicability to their patient care mission.
Entry Characteristics
The vast majority of the learners will possess a Bachelors Degree and a graduate
degree in some field of medicine. However, Registered Nurses with an Associates
Degree may participate as members of the secondary audience.
Learners will have a generalized knowledge of medicine as would be obtained
through a medical degree program (primary audience) or from an allied health degree
program (secondary audience).
Learners will have had a basic exposure to the concepts of immunology in medical
school or in an allied health program. Learners in some disciplines, such as
Rheumatology and Hematology/Oncology, will likely have had more detailed
exposure to the concepts of immunology.
Learners will have had experience with both didactic, case-based, and small group
problem set learning environments through ongoing medical education programs at
the VA.

The entire audience will have basic computer skills, as this is a requirement for
working in the VA health care system. Those participating at a distance will require
more advanced technological abilities, such as the ability to utilize teleconferencing
equipment and/or web conferencing applications. This may require additional
training.

Contextual Analysis
Orienting Context
The goals of learners participating in this training are improved conceptual knowledge of
immunology and the ability to apply this knowledge toward improved Veteran care.
GME and CME are mandatory training for physicians. However, this particular content
is not mandatory, so that participation indicates a basic interest in the subject matter.
The perceived utility in this instruction is that it will enhance the learners understanding
of the most current medical approaches and improve their ability to treat their patients.
As with most adult learners, there is a perception/expectation that course material will be
well organized and that the learning process will be efficient. Thus, if these criteria are
not met, the learners will hold the Instructional Designer (ID) and Subject Matter Experts
(SME) accountable.
Immunology is a fairly specialized field that may not be regularly considered in all
medical disciplines. Thus, there is a likely misconception that immunology is only
relevant to specific disciplines that utilize immunological tests, such as rheumatology and
hematology.
Instructional Context
A combination of conventional and virtual classrooms will be available at all
participating VA facilities. The primary venue for formal didactic lectures by SME will
be the White River Junction VA Research and Education Building (Building 44/Room G103). This room will have to be scheduled for this use with the department of Facilities
Management Systems.
The G-103 auditorium has ambient and stage lighting that is optimized for both lecture
and small group educational events.
G-103 is in the proximity of other training rooms and administrative offices. Doors will
need to be closed in order to limit extraneous noise.
The temperature will be maintained 72F by the environmental control systems of the VA
facilities.
Seating will be flexible. The auditorium will be laid out with individual chairs (four
chairs per table in an audience configuration for didactic lectures from SME and in a
round table configuration for small group/problem solving sessions.
All venues will be walking distance to restrooms and access to meals at the VA cafes.
Essential computer, AV and teleconferencing equipment will be provided by the VA.
All VA facilities have conference rooms and auditoriums that are walking distance from
the clinics. Learners that will participate at a distance from the formal lectures will do so
via teleconferencing or web broadcasting so that travel is not required.
6

Technology Inventory
The Department of Veterans Affairs has adequate computer equipment and network
capability to deliver this content.
Conventional classrooms are available with computer-interfaced, audio-visual equipment.
Virtual classrooms are available equipped with Cisco Systems SX80 teleconferencing
codecs connected to VA computers.
Smart Technologies interactive whiteboards connected to teleconferencing codecs and
computers are available in select virtual classrooms (including the primary venue, G103). These units will facilitate content delivery for local and distance learners alike.
Socrative Student Application will be used for live, in class assessment of learner
comprehension and opinion: http://www.socrative.com/apps.php
Microsoft Lync and Adobe Connect software will be used for content dissemination to
distance learners that do not have access to VA teleconferencing equipment.
Subscriptions to the UpToDate clinical database as a reference for both SME and
learners: http://www.uptodate.com/home
Transfer Context
Transferability of the educational content will be achieved through the combination of
didactic material and case-based problem solving. The current concepts of immunology
will be provided to the learners by SME through formal lectures and access to online
content such as videos and Power Point presentations. This information will then be
transferred to the clinical setting through analysis of fictitious or real patient cases that
involve immunological questions. These clinical cases will be reviewed in either a large
or small group setting, where the salient concepts in immunology will be applied.
There will be numerous opportunities to use this new information in the real world.
Immune modulation is the basis of a wide range of clinical interventions, from the
suppression of the immune system in inflammatory disorders to the augmentation of the
immune system to treat cancer. While the learners may have used these clinical
approaches in the past to treat their patients, they may not have appreciated the larger
immunological context and potential impacts on other biological systems. Through this
new perspective of the immune system, learners will be able to look beyond the
individual symptoms of disease and apply current therapies with a systems approach.
Medical education is a process requiring collaborative learning among peers. For
example, SME for this course in immunology will often be professional colleagues of the
learners (i.e. other VA physicians). This provides a unique opportunity for ongoing
educational support, where learners can follow up with the SME with additional
questions, either in person, by phone or by email. In addition, the ID for this project has
an appointment with the WRJ VA academic affiliate institution, Geisel School of
Medicine at Dartmouth. The Department of Microbiology and Immunology at Geisel has
world-leading experts in the field of immunology, who could provide additional content
support and serve as SME for content that goes beyond the scope of the class.

INSTRUCTIONAL IMPACT BASED UPON LEARNER CHARACTERISTICS

Application of Learning Theories
Physicians and other health professionals are adult learners and this project will benefit from the
adult learning strategies outlined by the Rochester Institute of Technology Innovative Learning
Institute (Rochester Institute of Technology, May 21, 2016). Particular attention must be paid to
the fact that this group of learners is both highly educated and highly motivated to learn.
Moreover, this group of learners will have very specific expectations about the quality and
relevance of the instruction.
GME and CME learners have a wealth of knowledge and experience that is derived from
training in diverse medical disciplines and this background will significantly enhance the
education process. As has been discussed previously, medical education is a learning
process among peers, where learners contribute to the content by sharing their specific
experiences. Incorporating these perspectives not only broadens the curriculum, but also
engages the learners so that they feel more invested in the process.
The values, beliefs and opinions of medical learners are a particularly important
consideration for this teaching approach. Physicians who have specialized in a particular
area will likely have developed unique perspectives about medical care. For example,
physicians practicing in emergency medicine will have an acute care perspective about
treating their patients, focusing on addressing the most life-threatening symptoms
immediately. In contrast, physicians in oncology often must take a broader perspective
about their patients care, considering not only how treatment will effect the duration of
life, but also how treatment will impact the quality of life that remains. These are
extremely valuable viewpoints that have been developed from difficult decisions made
throughout a medical career, and each must be given a sufficient voice in the discussions.
This also speaks to the point that adults expect to be treated as adults (Rochester
Institute of Technology, May 21, 2016), so that there needs to be mutual respect for
differing views and opinions.
Adults need to feel self-directed in their learning, and this is especially true for medical
learners. Physicians in particular are accustomed to staying current with the medical
literature in order to provide the highest quality of care for their patients. This learner
attribute is an important asset and must be cultivated by providing information about
additional literature and other online resources. A commonly used online clinical
resource for physicians is UpToDate (UpToDate, May 21, 2016), which explores the
latest evidence-based standards of care. Resources such as these that provide
supplemental content for this curriculum should be used extensively.
This curriculums use of case-based problem solving exercises will address the problemcentered approach of adult learners. Didactic lectures will be structured to present
clinical cases that will be reviewed, discussed and solved as a group. In addition, learners
can be divided into small groups, given additional clinical cases that highlight an
immunological concept, and then asked to discuss and solve the clinical problem. This
latter approach will allow for more detailed discussion, opportunities for learners to
contribute their own experiences and perspectives, and provide a venue for those that are
more reticent to participate in class (see below). This two tiered approach will also allow

these adult learners to directly apply theories and concepts to real world situations that
impact and relate to their professional experiences
This group of medical learners will be at varying stages of their careers. Some will be
fresh out of medical school while others will have been practicing for many years. As a
consequence, the way that individual learn may be quite diverse. For example, younger
learners may be more accustomed to obtaining content online, while older learners may
be more accustomed to reading conventional journal articles and books. Therefore,
special provisions may need to be made to ensure that online content is accessible to all,
either through physical handouts or easily accessible pdf files. Additionally, medical
education has evolved over that past few years with reduced focus on didactic lectures
and increased focus on small group problem solving exercises. In addition, basic
concepts in health care delivery are now being included along with the traditional
medical education curriculum (Geisel School of Medicine, May 21, 2016). Thus, these
approaches and perspectives may be foreign to older medical learners, and this
generational difference must be considered when implementing this curriculum.

Application of Motivational Theories

For this project, the Experiential Learning theories espoused by Carl Rogers (Experiential
Learning; Carl Rogers, Instructional Design.org, June 11, 2016) will be applied to optimize
learner motivation. Specifically, the medical learner has to be personally invested in the material
and will not participate in training irrelevant to their patient care. This is particularly important
for CME, where physicians can choose from a variety of training opportunities. Additionally, an
emphasis on self-assessment of progress and success is essential in this environment.
Historically, requiring external assessment through competency tests is a disincentive to
participation because it is not commonly part of the CME process. Usually, CME is accredited
by the learner filling out a post event survey, which examines if the learners perspective on
whether the learning objectives were met. This approach enables the learner to reflect on the
educational experience and provides valuable feedback to the Instructional Designer and SME.
Finally, an emphasis on meaning to the individual learner is key because the way that the
information is integrated is strongly affected by personal experiences and professional
perspectives.
A formal motivational model that would be most applicable in this educational environment is
the Model of Intrinsic Motivation proposed by James Middleton, Joan Littlefield, and Rich
Lehrer (Vanderbilt University Center for Teaching, June 11, 2016). According to this model, the
learners might be engaged because they know the training topic is interesting. Alternatively, they
may be motivated because the activity provides stimulation (appeals to their curiosity) and/or
provides some degree of personal control. The condition of personal control speaks to the
need of medical learners to feel that they are involved in directing the educational process and
that the motivations for and metrics of success are internal (intrinsic) versus external (extrinsic).

Impact of a Diverse Audience on Instruction

The primary audience will consist of a diverse ethnic and racial background, consistent with the
modern medical community. Due to the high academic requirements in this audience, it is not
expected that language will be a barrier to instruction. However, certain cultural differences
9

could impact participation and therefore, learning effectiveness. This may be particularly true
among medical residents, who often come from countries outside of the United States. Public
speaking may be less natural for these learners so that they may be less likely to participate in
group case discussions or to ask questions of the SME. To address this potential issue, SME will
be instructed to engage reticent learners in a friendly and non-threatening format. If this
approach does not effectively address the issue, separate time will be provided with the SME
one-on-one in order to allow for participating in a more comfortable format.

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TASK/GOAL/PERFORMANCE ANALYSIS MODULE 5

[If you choose to conduct a task analysis, you will select and conduct a method or methods of
content/task analysis as described in Chapter 4 of the textbook (Topic Analysis, Procedural
Analysis, or Critical Incident. An example of one kind of Task Analysis can be found starting on
page 418.] ONLY complete ONE method of analysis.

Task Analysis Method

[Expectation: This section requires you to choose a method for conducting a Task Analysis.
Describe which method you chose and why.]
[Text Here]

Task Analysis
[Expectation: Based on your method selection, use the structure for that method to detail your
task analysis here.]
[Text Here]

Goal Analysis
Module Five: Writing Goals and Objectives
Goal Analysis Tool and Template
Instructional Need/Aim
Need: Recent important theoretical and applied advances in the field of immunology have
created a knowledge gap, where many practicing physicians are not aware of this latest medical
information.
Aim: The aim of this project is to design and deliver graduate medical education (GME) and
continuing medical education (CME) that addresses the biological basis and clinical applications
of immune-based therapies for chronic diseases such as rheumatoid arthritis and cancer.
Goal Analysis
Step 1 - Write down the goals.
Original goals:
The overall goals of this project are for VA physicians to learn the concepts and principles of
immune regulation and to apply these concepts and principles toward the treatment of chronic
diseases in the Veteran population.
Step 2 - Write down everything a learner would have to say or do for you to agree that the
learner has achieved the goal. This is not a list of what you will need to do as the
instructional designer or teacher.
I can recognize the currently available immune modulating therapies and identify their
clinical applications.
I can critically review clinical trials using immune based therapies.
I can evaluate the risks and benefits of using immune modulating therapies in my clinical
cases.

11

I can comprehend the immunological content when I read the current medical literature.
I can discuss current concepts and principles in immunology with my medical colleagues.
I can apply current concepts and principles in immunology to my clinical cases.

Step 3 - Sort the items Listed in step 2.

I can comprehend the immunological content when I read the current medical literature.
I can discuss current concepts and principles in immunology with my medical colleagues.
I can apply current concepts and principles in immunology to my clinical cases.
I can recognize the currently available immune modulating therapies and identify their
clinical applications.
I can critically review clinical trials using immune based therapies.
I can evaluate the risks and benefits of using immune modulating therapies in my clinical
cases.
Step 4 - Write a complete sentence to describe each of the items on your final list.
Learners from diverse medical subspecialties will be able to comprehend the
immunological content when they read the current medical literature.
Using this skill, learners will be able to apply the current concepts and principles in
immunology to their clinical cases during discussions with their medical colleagues.

In the context of their own medical subspecialties, learners will be able to recognize the
currently available immune modulating therapies and identify their clinical applications.
Using their new knowledge of immunology, learners will be able to critically review
clinical trials using immune based therapies and evaluate the risks and benefits of novel
uses of these therapies in their clinical cases.

Goal
The overall goals of this project are for VA physicians to learn the concepts and principles of
immune regulation and to apply these concepts and principles toward the treatment of chronic
diseases in the Veteran population. As a result of this training, learners will be able to
comprehend the immunological content present in the current medical literature, apply the
current concepts and principles in immunology during clinical consults, identify the clinical
applications of immune modulating therapies and critically review clinical trials using immunebased therapies to evaluate the risks and benefits of these therapies to their patients.
Objectives
1. Terminal Objective:
When reviewing the current medical literature, learners will be able to correctly define the
immunological terminology and fully comprehend the immunological concepts and principles,
with 80% accuracy.
Domain: Cognitive/Categories: Knowledge, Comprehension and
Application
Enabling Objectives:
When reading the medical literature, learners will be able to correctly name and define
the various cells and tissues that constitute the immune system and recall their
developmental origins. Domain: Cognitive/Category: Knowledge
12

When reading the medical literature, learners will be able to fully comprehend the
principles of innate and adaptive immunity and correctly identify the cells and tissues
involved. Domain: Cognitive/Category: Comprehension
When reading the medical literature, learners will be able to correctly identify the four
types of hypersensitivity and apply these to specific diseases. Domain:
Cognitive/Categories: Knowledge, Comprehension and Application
When reading the medical literature, learners will be able to fully understand the immune
response to antigen and how this generates T and B lymphocyte receptor diversity.
Domain: Cognitive/Category: Comprehension
When reading the medical literature, learners will be able to fully understand the
mechanisms of transplantation and tumor immunology. Domain: Cognitive/Category:
Comprehension
When reading the medical literature, learners will be able to correctly apply the concept
of immune checkpoint regulation and explain how disequilibrium leads to autoimmunity,
immune deficiency and cancer.
Domain: Cognitive/Categories: Knowledge,
Comprehension and Application

2. Terminal Objective:
During diagnostic discussions with their medical colleagues, learners will be able to correctly
discuss the current concepts and principles of immunology and correctly apply these to specific
clinical cases. Domain: Cognitive/Categories: comprehension, application
3. Terminal Objective:
During prescribing discussions with their medical colleagues, learners will be able to correctly
discuss the clinical applications of currently available immune modulating therapies and apply
these to specific clinical cases. Domain: Cognitive/Categories: comprehension, application
4. Terminal Objective:
While reviewing published clinical trials using immune based therapies, learners will be able to
critically analyze the data in order to to confidently evaluate the risks and benefits of using these
therapies in their clinical cases. Domain: Cognitive/Category: Analysis, Synthesis and
Evaluation; Domain: Affective
Enabling Objectives:
When reading publications on clinical trials of immune-based therapies, learners will be
able to effectively analyze the data and assess the indications and contraindications of
these therapies. Domains: Cognitive/ Category: Analysis and Synthesis; Domain:
Affective
When considering prescription of immune-based therapies for their patients, learners will
be able to effectively and confidently evaluate the risks and benefits of these therapies.
Domain: Cognitive/ Category: Analysis, Synthesis and Evaluation; Domain: Affective
When considering off-label uses of immune-based therapies, learners will be able to
effectively and confidently evaluate the risks and benefits of these therapies for their
patients. Domains: Cognitive/ Category: Analysis, Synthesis and Evaluation; Domain:
Affective

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INSTRUCTIONAL OBJECTIVES MODULE 5

[Goals, Terminal Objectives, and Enabling Objectives Check Rubric & Dont forget to map the
domains and level of Blooms Taxonomy with the objectives]

Project (Instructional) Goal

[What is the overall statement you want learners to accomplish at the end of your project no
more than 2 sentences.]
The overall goals of this project are for VA physicians to learn the concepts and principles of
immune regulation and to apply these concepts and principles toward the treatment of chronic
diseases in the Veteran population. As a result of this training, learners will be able to
comprehend the immunological content present in the current medical literature, apply the
current concepts and principles in immunology during clinical consults, identify the clinical
applications of immune modulating therapies and critically review clinical trials using immunebased therapies to evaluate the risks and benefits of these therapies to their patients.

Terminal Objectives and Enabling Objectives

1. Terminal Objective:
When reviewing the current medical literature, learners will be able to correctly define the
immunological terminology and fully comprehend the immunological concepts and principles,
with 80% accuracy. Domain: Cognitive/Categories: Knowledge, Comprehension and
Application
Enabling Objectives:
When reading the medical literature, learners will be able to correctly name and define
the various cells and tissues that constitute the immune system and recall their
developmental origins. Domain: Cognitive/Category: Knowledge
When reading the medical literature, learners will be able to fully comprehend the
principles of innate and adaptive immunity and correctly identify the cells and tissues
involved. Domain: Cognitive/Category: Comprehension
When reading the medical literature, learners will be able to correctly identify the four
types of hypersensitivity and apply these to specific diseases. Domain:
Cognitive/Categories: Knowledge, Comprehension and Application
When reading the medical literature, learners will be able to fully understand the immune
response to antigen and how this generates T and B lymphocyte receptor diversity.
Domain: Cognitive/Category: Comprehension
When reading the medical literature, learners will be able to fully understand the
mechanisms of transplantation and tumor immunology. Domain: Cognitive/Category:
Comprehension
When reading the medical literature, learners will be able to correctly apply the concept
of immune checkpoint regulation and explain how disequilibrium leads to autoimmunity,
immune deficiency and cancer. Domain: Cognitive/Categories: Knowledge,
Comprehension and Application

14

2. Terminal Objective:
During diagnostic discussions with their medical colleagues, learners will be able to correctly
discuss the current concepts and principles of immunology and correctly apply these to specific
clinical cases. Domain: Cognitive/Categories: comprehension, application
3. Terminal Objective:
During prescribing discussions with their medical colleagues, learners will be able to correctly
discuss the clinical applications of currently available immune modulating therapies and apply
these to specific clinical cases. Domain: Cognitive/Categories: comprehension, application
4. Terminal Objective:
While reviewing published clinical trials using immune based therapies, learners will be able to
critically analyze the data in order to confidently evaluate the risks and benefits of using these
therapies in their clinical cases. Domain: Cognitive/Category: Analysis, Synthesis and
Evaluation; Domain: Affective
Enabling Objectives:
When reading publications on clinical trials of immune-based therapies, learners will be
able to effectively analyze the data and assess the indications and contraindications of
these therapies. Domains: Cognitive/ Category: Analysis and Synthesis; Domain:
Affective
When considering prescription of immune-based therapies for their patients, learners will
be able to effectively and confidently evaluate the risks and benefits of these therapies.
Domain: Cognitive/ Category: Analysis, Synthesis and Evaluation; Domain: Affective
When considering off-label uses of immune-based therapies, learners will be able to
effectively and confidently evaluate the risks and benefits of these therapies for their
patients. Domains: Cognitive/ Category: Analysis, Synthesis and Evaluation; Domain:
Affective

ENABLING OBJECTIVES MATRIX & SUPPORTING CONTENT

MODULE 6
Title of the unit/module:
Overview Of The Current Concepts And Principles Of Immunology
Brief description of target audience:
Primary Audience
Primary Care Physicians
Specialty Care Physicians: Cardiology, Hematology/Oncology, Nephrology,
Gastroenterology, Neurology, Infectious Disease, Rheumatology, Pulmonology,
Anesthesia/Pain Management, Psychiatry
Medical Residents
Secondary Audience

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Physicians Assistants
Registered Nurses
Pharmacists

List Terminal Objective Here:

When reviewing the current medical literature, learners will be able
to correctly define the immunological terminology and fully
comprehend the immunological concepts and principles, with 80%
accuracy. Domain: Cognitive/Categories: Knowledge,
Comprehension and Application
List Pre-instructional Strategy:
Pretests
Questions:
1. How are immune cells defined based on their developmental
lineages, phenotypes and functions?
2. How do innate and adaptive immunity differ and how do these
differences impact immune responses to foreign and infectious
agents?
3. Which immune cells participate in the various forms of
hypersensitivity and how do these responses lead to disease?
4. How are T and B lymphocytes able to respond to an infinite
number of foreign antigens and how are these responses
controlled?
5. How are the immune responses to tumors and transplants
similar, how are they different and what does this indicate
about the mechanisms of cancer and organ transplantation
rejection?
6. What are the mechanisms of immune checkpoint regulation
and how can these mechanisms be targeted to treat chronic
diseases?

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Enabling
Objective

Level on Blooms
Taxonomy

Learner
Activity (What
would learners do
to master this
objective?)

When
reading
the
medical
literature, facts
learners will be able to
correctly name and
define the various cells
and
tissues
that
constitute the immune
system and recall their
developmental origins.
Domain: Cognitive

Knowledge of

Consider
pretest
question #1.

Read
assigned review
articles on
hematopoiesis
and immune
cell maturation
in
development.

Remembe
r
cell/tissue/orga
n names,
functions and
origins during a
lecture and
correctly
complete the
post-lecture
quiz.

Delivery Method
(Group
presentation/lecture, selfpaced, or small group)

Pose pretest
question #1.

Assign review
articles prior to
lecture.

Provide a large
group didactic
lecture reviewing the
components and
development of the
immune system.

Conduct a live,
post-lecture quiz
using the Socrative
Student app to
assess learner
knowledge.

17

When reading the

Comprehensi
medical literature, on of concepts and
learners will be
principles
able to fully
comprehend the
principles of innate
and adaptive
immunity and
correctly identify
the cells and
tissues involved.
Domain: Cognitive

Consider
pretest
question #2.

Read
assigned review
articles
comparing the
innate and
adaptive
immune
responses.

Remembe
r these
principles
during a lecture
and correctly
complete the
post-lecture
quiz.

Pose pretest
question #2.

Assign review
articles prior to
lecture.

Provide a large
group didactic
lecture reviewing the
principles of innate
and adaptive
immunity.

Conduct a live,
post-lecture quiz
using the Socrative
Student app to
assess learner
comprehension.

18

When reading the

medical literature,
learners will be
able to correctly
identify the four
types of
hypersensitivity
and apply these to
specific diseases.
Domain: Cognitive

Knowledge of
facts

Comprehensi
on of concepts and
principles

Application of
rules

Consider
pretest
question #3.

Read
assigned review
articles and
clinical case
examples
comparing the
various forms
of
hypersensitivity
.

Remembe
r the four forms
of
hypersensitivity
correctly
discuss and
apply these
principles to
clinical case
examples.

Pose pretest
question #3.

Assign review
articles and clinical
case examples prior
to lecture.

Provide a large
group didactic
lecture reviewing the
four forms of
hypersensitivity.

Facilitate small
group discussions on
the clinical examples
of hypersensitivity.

19

When reading the

medical literature,
learners will be
able to fully
understand the
immune response
to antigen and
how this generates
T and B
lymphocyte
receptor diversity.
Domain: Cognitive

Comprehensi
on of concepts and
principles

Consider
pretest
question #4.

Read
assigned review
articles about
the
mechanisms of
antigen
presentation
and lymphocyte
clonal
expansion.

Remembe
r these
principles
during a lecture
and correctly
complete the
post-lecture
quiz.

Pose pretest
question #4.

Assign review
articles prior to
lecture.

Provide a large
group didactic
lecture reviewing the
mechanisms of
antigen presentation
and lymphocyte
clonal expansion.

Conduct a live,
post-lecture quiz
using the Socrative
Student app to
assess learner
comprehension.

20

When reading the

medical literature,
learners will be
able to fully
understand the
mechanisms of
transplantation
and tumor
immunology.
Domain: Cognitive

Comprehensi
on of concepts and
principles

Consider
pretest
question #5.

Read
assigned review
articles about
the
mechanisms of
transplantation
and tumor
immunology.

Remembe
r these
concepts and
principles
during a lecture
and correctly
complete the
post-lecture
quiz.

Pose pretest
question #5.

Assign review
articles prior to
lecture.

Provide a large
group didactic
lecture reviewing the
mechanisms of
transplantation and
tumor immunology.

Conduct a live,
post-lecture quiz
using the Socrative
Student app to
assess learner
comprehension.

21

When reading the

medical literature,
learners will be
able to correctly
apply the concept
of immune
checkpoint
regulation and
explain how
disequilibrium
leads to
autoimmunity,
immune deficiency
and cancer.
Domain: Cognitive

Knowledge of
facts

Comprehensi
on of concepts and
principles

Application of
rules

Consider
pretest
question #6.

Read
assigned review
articles and
clinical case
examples
illustrating
immune
checkpoint
regulation.

Remembe
r the principles
of immune
checkpoint
regulation and
correctly
discuss and
apply these
principles to
clinical case
examples.

Pose pretest
question #6.

Assign review
articles and clinical
case examples prior
to lecture.

Provide a large
group didactic
lecture illustrating
immune checkpoint
regulation.

Facilitate small
group discussions on
the clinical examples
of immune
checkpoint
regulation.

Feel free to include your instructional content here or attach it as another document in the
dropbox, as appropriate. It could be a PowerPoint, Word doc, video, etc.

22

REFERENCES
Rossett, A. (1999) Analysis of human performance technology. In H.D. Stolovitch & E.J. Keeps
(Eds), Handbook of performance technology: Improving individual and organizational
performance worldwide. (pp. 139-162) San Francisco: Jossey-Bass/Pfeiffer.
Grounded Theory Online (May 20, 2016). What is Grounded Theory? Retrieved from
http://www.groundedtheoryonline.com/what-is-grounded-theory/
Rochester Institute of Technology (May 21, 2016). Adult Learners. Retrieved from
http://www.rit.edu/academicaffairs/tls/course-design/instructional-design/adult-learners
UpToDate (May 21, 2016). Smarter Decisions. Better Care. Retrieved from
http://www.uptodate.com/home
Geisel School of Medicine (May 21, 2016). Curriculum Redesign.
Retrieved from
https://geiselmed.dartmouth.edu/insider/curriculum-redesign-2/
Instructional Design.org (June 11, 2016). Carl Rogers (Experiential Learning). Retrieved from
http://www.instructionaldesign.org/theories/experiental-learning.html
Vanderbilt University Center for Teaching (June 11, 2016). Motivating Students. Retrieved from
https://cft.vanderbilt.edu/guides-sub-pages/motivating-students/#model

23

FINAL PROJECT RUBRIC

Please see the final project rubric at: http://www2.uwstout.edu/content/profdev/idtrends/Portfolio-Rubric.pdf and the
reflection paper rubric at: http://www2.uwstout.edu/content/profdev/idtrends/Portfolio-RubricReflection.doc

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