Biggs' constructive alignment is a theory of curriculum design that advocates for a close alignment between the intended learning outcomes of a course, the teaching and learning activities used to achieve those outcomes, and the assessment tasks used to measure whether students have achieved those outcomes. This alignment helps to ensure that students are clear about what they are expected to learn and that they have the opportunity to learn and demonstrate their learning in meaningful ways.
Biggs' constructive alignment is based on the constructivist theory of learning, which posits that students learn best by constructing their own knowledge through active engagement with their learning environment. When teaching and assessment activities are aligned with the intended learning outcomes, students are more likely to be engaged and motivated to learn.
Constructive alignment is particularly important in medical education, where students need to develop a wide range of skills and knowledge in a relatively short period of time. By aligning the intended learning outcomes, teaching and learning activities, and assessment tasks, medical educators can help students to develop the skills and knowledge they need to be successful practitioners.
Here are some examples of how constructive alignment can be implemented in medical education:
Intended learning outcomes: The intended learning outcomes for a medical course should be clearly defined and communicated to students at the outset of the course. These outcomes should be specific, measurable, achievable, relevant, and time-bound. For example, an intended learning outcome for a medical course might be: "By the end of the course, students will be able to perform a comprehensive physical examination on an adult patient."
Teaching and learning activities: The teaching and learning activities for a medical course should be designed to help students achieve the intended learning outcomes. These activities could include lectures, tutorials, clinical placements, and simulation exercises. For example, to help students achieve the intended learning outcome of performing a comprehensive physical examination, a medical educator might lead a tutorial on the different components of a physical examination, and then provide students with the opportunity to practice performing physical examinations on real patients in a clinical setting.
Assessment tasks: The assessment tasks for a medical course should be designed to assess whether students have achieved the intended learning outcomes. These tasks could include written exams, practical exams, and case studies. For example, to assess whether students have achieved the intended learning outcome of performing a comprehensive physical examination, a medical educator might ask students to perform a physical examination on a simulated patient and then complete a written assessment form documenting their findings.
By aligning the intended learning outcomes, teaching and learning activities, and assessment tasks, medical educators can help students to develop the skills and knowledge they need to be successful practitioners.
Improved student learning: Constructive alignment helps students to focus on the most important aspects of their learning and to develop a deeper understanding of the material.
Increased student engagement: Constructive alignment helps students to see the relevance of their learning to their future careers and motivates them to learn.
More efficient curriculum design: Constructive alignment helps to ensure that the curriculum is well-designed and that all of the components of the curriculum are working together to help students achieve the intended learning outcomes.
More effective assessment: Constructive alignment helps to ensure that the assessment tasks are measuring what students are actually learning and that they are providing students with feedback that can help them to improve their learning.
Some critics also argue that constructive alignment is not well-suited to the complex and unpredictable nature of medical education. For example, it can be difficult to predict exactly what students will learn from a particular clinical placement, or how they will apply their knowledge to a particular patient.
It can be time-consuming and difficult to implement. Constructive alignment requires careful planning and coordination between all of the stakeholders involved in medical education, including curriculum developers, teachers, and assessors. This can be a time-consuming process, and it can be difficult to ensure that all of the components of the curriculum are aligned.
It can be seen as a rigid and mechanistic approach to teaching and learning. Some critics argue that constructive alignment can lead to a "tick-box" approach to teaching and learning, where teachers are more focused on ensuring that students cover the required content than on helping them to develop a deep understanding of the material.
It can stifle creativity and innovation in teaching. Some critics argue that constructive alignment can discourage teachers from trying new and innovative teaching methods, as they may be concerned that these methods will not be aligned with the intended learning outcomes.
It can focus too much on measurable learning outcomes and not enough on other important aspects of medical education, such as professional development and patient care. Some critics argue that constructive alignment can lead to a narrow focus on measurable learning outcomes, such as exam scores and OSCE results. This can neglect other important aspects of medical education, such as the development of professional values and skills, and the ability to provide compassionate and holistic patient care.
It is important to note that these are just some of the arguments against constructive alignment in medical education. There is a growing body of research that supports the use of constructive alignment, and it is still widely considered to be a valuable approach to curriculum design. However, it is important to be aware of the potential drawbacks of constructive alignment and to implement it in a way that is flexible and responsive to the needs of students.
Klapheke, M., Abrams, M., Cubero, M., & Zhu, X. (2022). Aligning medical student workplace-based assessments with entrustable professional activities and the rime model in a psychiatry clerkship. Academic Psychiatry, 46(3), 283-288. https://doi.org/10.1007/s40596-022-01614-3
‘Constructive Alignment’. In Wikipedia, 2 June 2022. https://en.wikipedia.org/w/index.php?title=Constructive_alignment&oldid=1158107105.
Bauer, D., Lahner, F., Schmitz, F., Guttormsen, S., & Huwendiek, S. (2020). An overview of and approach to selecting appropriate patient representations in teaching and summative assessment in medical education. Swiss Medical Weekly, 150(4950), w20382. https://doi.org/10.4414/smw.2020.20382