Transcript Application of Bloom’s Taxonomy of Learning Domains to

Application of Bloom’s
Taxonomy of Learning Domains
in Medical Education
Joy-Telu Hamilton-Ekeke (PhD)
Department of Curriculum and
Instruction, Faculty of Education, Niger
Delta University, Bayelsa State
Learning Objectives
• At the end of the workshop/presentation,
participants should be able to:
 Formulate test questions that will measure
mastery of subject matter
 Demonstrate understanding of key verbs for the
various categories (domains) of learning
 Appraise the three domains of Bloom’s Taxonomy
of learning domains
 Explain the different categories in each domain
Approach
• It is going to be an interactive workshop
• Resource person will first expose participants to
the premises underpinning Bloom’s Taxonomy of
learning domain and then explain the three
domains and the various categories of learning
behaviours under each domain.
• At the end of the presentation, participants will
be grouped and asked to formulate test questions
based on Bloom’s Taxonomy in their different
specialties which will then be criticized by all with
the resource person moderating.
Introduction
• Taxonomy enable educational training and
learning objectives to be planned and measured
properly – improving the effectiveness of
developing ‘mastery’ instead of simply
transferring facts for mindless recall.
• Bloom believed that education should focus on
‘mastery’ of subjects and the promotion of higher
forms of thinking, rather than a utilitarian
approach to simply transferring of facts - the
lowest level of training
Bloom’s aim
• Bloom’s aim was to develop a system of
categories of learning behaviour to assist in
the design and assessment of educational
learning.
• Bloom demonstrated decades ago that most
teaching tended to be focused on fact-transfer
and information recall – the lowest level of
training – rather than true meaningful
personal development.
Objectives of the paper
• This has remained a central challenge for
educators and trainers in modern times.
• Bloom’s Taxonomy has therefore provided a
basis for ideas which have been used (and
developed) around the world by academics,
educators, teachers and trainers, for the
preparation of learning evaluation materials,
and also provided the platform for the
complete ‘Bloom’s Taxonomy’ (Cognitive,
Affective and Psychomotor Domains).
Explanation of Bloom’s Taxonomy
• Bloom’s Taxonomy underpins the classical
‘Knowledge, Attitude, Skills’ structure of learning
method and evaluation. This taxonomy of learning
behaviours can be thought of as ‘the goals of the
learning processes. That is, after a learning
episode, the learner should have acquired new
skills knowledge, and/or attitudes.
• The model also serves as a sort of checklist, by
which training is planned to deliver all the
necessary development for students, and a
template for assessing the validity and coverage of
any existing curriculum, or an entire training and
development programme for a large organisation.
• In the first publication, Bloom and his team of
researchers produced an elaborate compilation for the
cognitive and affective domains, but none for the
psychomotor domain.
• Their explanation for this oversight was that they have
little experience in teaching manual skills within the
college level. If they were lecturers of medicine they
would not have had this excuse because the health
science curriculum in general has a lot of psychomotor
skills embedded in it.
• Little wonder why most Colleges of medicine have ‘state
of the art’ simulation workshops/laboratories for the
inculcation of psychomotor skills.
Definition of terms
• Taxonomy means ‘a set of classification principles’
or ‘structure’
• Domain simply means ‘category’
• Bloom’s Taxonomy model is in three parts, or
‘overlapping domains’ and these are:
• Cognitive domain (intellectual capability, i.e.,
knowledge, or ‘think’)
• Affective domain (feelings, emotions and
behaviour, i.e., attitude, or ‘feel’)
• Psychomotor domain (manual and physical skills,
i.e., skills, or ‘do’)
• These three domains as applied to the Health
Sciences curriculum means for each topic in the
curriculum to be taught, the lecturer should first
of all identify the (content to be learnt)
knowledge to be inculcated (cognitive), the
corresponding attitude to be developed
(affective) and the corresponding skills to be
acquire (psychomotor) for that particular topic.
• These could then be stated as ‘Learning
objectives’ to guide and direct the teaching
process and ‘outcome measures’ for the
evaluation of the teaching/learning process.
Application of Bloom’s domain to
medical curriculum
• These three domains as applied to the medical
curriculum means for each topic in the curriculum to
be taught, the lecturer should first of all identify the
(content to be learnt) knowledge to be inculcated
(cognitive), the corresponding attitude to be developed
(affective) and the corresponding skills to be acquire
(psychomotor) for that particular topic.
• These could then be stated as ‘Learning objectives’ to
guide and direct the teaching process and ‘outcome
measures’ for the evaluation of the teaching/learning
process.
• The learner should benefit from the development
of knowledge and intellect (Cognitive Domain);
attitude and beliefs (Affective Domain); and the
ability to put physical and bodily skills into effect
– to act (Psychomotor Domain).
• Collectively these concepts which make up the
whole Bloom Taxonomy continue to be useful
and very relevant to the planning and design of:
school, college and university education, adult
and corporate training courses, teaching and
lesson plans, and learning materials; they also
serve as a template for the evaluation of:
training, teaching, learning and development,
within every aspect of education and industry.
Premise of Bloom’s Taxonomy
• Each of the three learning domains (Cognitive,
Affective and Psychomotor) has different
categories under them. In each of the three
domains Bloom’s Taxonomy is based on the
premise that the categories are ordered in degree
of difficulty.
• An important premise of Bloom’s Taxonomy is
that each category (or ‘level’) must be mastered
before progressing to the next. As such the
categories within each domain are levels of
learning development, and these levels increase
in difficulty.
Cognitive Domain
The cognitive domain involves knowledge and
the development of intellectual skills. This
includes the recall or recognition of specific
facts, procedural patterns, and concepts that
serve in the development of intellectual
abilities and skills.
• For instance in the Health Science Curriculum, a course
like ‘Gross Anatomy’ which is one of the beginning
courses for medical students would involve the
possession of knowledge of anatomy sufficient for
medical education and will be evaluated with a
demonstration of theoretical and practical knowledge of
gross and microscopic structures in human anatomy.
• The course ‘Gross Anatomy’ could also involve the
introduction of students to simple clinical applications of
basic anatomy which could be evaluated by the
understanding of the anatomical basis of various clinical
conditions and specific aberrations of human anatomic
structures.
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Cognitive Domain
The cognitive domain involves knowledge
and the development of intellectual skills
Knowledge
Comprehension
Application
Analysis
Synthesis
Evaluation
• Knowledge which involves recall of data or information
and is the least difficult and must be mastered before
the next one can take place, e.g. state the differences in
anatomical structures.
• Comprehension involves demonstration of
understanding of meaning, translation, interpolation,
and interpretation of instructions and problems. It also
includes stating a problem in one’s own words, e.g.
summarise the structures and viscera of the head and
neck.
• Application is the use of a concept in a new situation or
unprompted use of an abstraction. It involves applying
what was learned in the classroom into novel situations
outside the classroom (in the work place), e.g. apply
the knowledge of anatomy in clinical setting.
• Analysis involves separating materials or concepts into
component parts so that its organisational structure
may be understood. It includes distinguishing between
facts and inferences, e.g. distinguish between
anatomical variants that occur (both normal and
abnormal.
• Synthesis involves building a structure or pattern from
diverse elements. Putting parts together to form a
whole, with emphasis on creating a new meaning or
structure, e. g. compose up to date anatomical
nomenclature.
• Evaluation involves making judgements about the value
of ideas or materials e.g. evaluate clinical syndromes
produced by disturbances in the developmental
process.
Matrix detailing the Cognitive Domain
Level
1
2
3
4
5
6
Category
Examples of activity to be trained or demonstration
and evidence to be measured
Knowledge
Recite a policy, recall a process, definition, quote law or
procedure, and know the safety rules.
Comprehension Explain in one’s own words the steps for performing a
complex task. Translate an equation into a computer
spreadsheet.
Application
Put a theory into practical effect, solve a problem,
manage an activity, and apply laws of statistics to
evaluate the reliability of a written test.
Analysis
Troubleshoot a piece of equipment by using logical
deduction. Recognise logical fallacies in reasoning gather
information from department and select the required tasks
for training.
Synthesis
Write a practical laboratory manual, design a machine to
perform specific task. Integrate training from several
sources to solve a problem. Revise a process to improve
the outcome. Develop plans or procedures.
Evaluation
Assess effectiveness of whole concepts in relation to
values, outputs, efficacy, viability; critical thinking,
strategic comparison and review. Selecting the most
Key words - verbs which
describe the activity to
be trained or measured
at each level
Defines, describe, identify,
recognise, select, state etc.
Convert, comprehend,
summarise, translate
Apply, produce, predict,
change, prepare, operate,
demonstrate, use etc.
Analyse, contrast, relate,
select, infer, separate,
outline, distinguish,
breakdown, compare
Categorise, plan,
rearrange, compose,
reconstruct, design, revise,
tell, rewrite, explain,
combine etc.
Appraise, support,
evaluate, critique,
concludes, investigate,
Affective Domain
• Affective Domain comprises of the manner in
which things are dealt with emotionally, such as
feelings, values, appreciation, enthusiasms,
motivations and attitudes.
• One of the behavioural objectives of surgery
M.B.B.S curriculum is to produce medical
graduates with sound ethical behaviours and an
adequate demonstration of professionalism; to
diagnose and manage patients as products of
his/her socio-economic milieu and attend to
them in a socially-responsive manner.
• Know the various means of communication
including how to obtain an informed consent and
break bad news. These are then measured in
terms of attitudes which are accord with global
standards.
• For instance in a course like ‘Surgery-in-General’
which involves organisation of patients’ care and
ward procedures, history taking and physical
examination could be measured in terms of
effective communication skills (verbal and nonverbal) and efficient clinical practice, respect for
patients values, feelings and decisions.
Categories of Affective Domain
• Receiving phenomena
• Responding to phenomena
• Valuing
• Organisation
• Internalising values
• Receiving phenomena: this includes awareness,
willingness to hear, selected attention, e.g.
listening to bedside clinical teaching, attending
tutorials and taking part in clinical
demonstrations.
• Responding to phenomena involves active
participation on the part of the learners. Attends
and reacts to a particular phenomenon. Learning
outcomes may emphasise compliance in
responding, willingness to respond, or
satisfaction in responding (motivation) e.g.
perform socially responsive surgery.
• Valuing: this is the worth or value a person attaches to a
particular object, phenomenon, or behaviour. This range
from simple acceptance to the more complex state of
commitment, valuing is based on the internalisation of a
set of specified values, while clues to these values are
expressed in the learner’s overt behaviour and is often
identifiable e.g. demonstrate history taking, physical
examination (respecting social, religious and ethnic
differences).
• Organisation includes organising values into priorities by
contrasting different values, resolving conflicts between
them, and creating a unique value system. The emphasis is
on comparing, relating, and synthesising values, e.g.
formulate, diagnose and management of patients.
• Internalising values also referred to as
characterisation involves having a value system
that controls behaviour. The behaviour is
pervasive, consistent, predictable, and most
importantly, characteristic of the learner.
Instructional objectives are concerned with the
student’s general patterns of adjustment
(personal, social, emotional), e.g. demonstration
of ethical behaviour and professionalism in terms
of strengthening skills in recognising and
interpreting symptoms and signs of general
surgery diseases.
Matrix detailing Affective Domain
Level
Category
Examples of experience or demonstration and evidence to be
measured
Key words - verbs which
describe the activity to be
trained or measured at each
level
1
Receiving
phenomena
Listen to others with respect. Listen for and remember the name of
newly introduced people, take interest in session or learning experience.
Ask, listen, attend,
acknowledge, concentrate, do,
feel, take part etc.
2
Responding to
phenomena
Participate in class discussion, give presentation. Question new ideas,
concepts, models etc, in order to fully understand them. Know the safety
rules and practise them.
Answer, assist, aid, perform,
report, present, discuss,
contribute, question, clarify
etc.
3
Valuing
Demonstrates belief in the democratic process. Sensitivity towards
individual and cultural differences (value diversity). Propose a plan to
social improvement and follow through with commitment. Inform
management on matters that one feels strongly about.
Demonstrates, initiates,
forms, proposes, argue,
challenge, justify, criticise,
persuade, confront, refute,
debate etc.
4
Organisation
Recognise the need to balance between freedom and responsible
behaviour. Accepts responsibility for one’s behaviour. Explains the role
of systematic planning in solving problems. Accept professional ethical
standards. Prioritise time effectively to meet the needs of the
organisation, family and self.
Adheres, alter, arrange,
combine, generalise, identify,
organise, prepare, relate,
synthesise, complete, defend
etc.
5
Internalise values
Show self-reliance when working independently. Cooperate in group
activities (display teamwork). Use an objective approach in problemsolving. Display a professional commitment to ethical practice on a daily
basis. Revise judgement and change behaviour in light of new evidence.
Value people for what they are, not how they look.
Acts, discriminate, perform,
solves, verify, question,
modify, display, influence,
revise etc.
Psychomotor Domain
• This domain includes physical movement,
coordination, and use of the motor-skill areas.
Development of these skills requires practice and
is measured in terms of speed, precision,
procedures or techniques in execution which is
basically what the Health Sciences curriculum in
generally is based on specially surgery.
• The psychomotor domain was later developed
and elaborated by three of Bloom’s
scholars/tutees: Simpson (1972), Harrow (1972)
and Dave (1975).
Dave version of psychomotor domain
• The Dave version of the Psychomotor Domain is
featured most prominently here because in my
view it is more opt and succinct in its application
to the health sciences curricula as it is most
relevant and helpful for work- and life-related
development.
• Although the Psychomotor Domains suggested by
Simpson and Harrow are relevant and helpful for
certain types of adult training and development
that take them out of their comfort zone, as well
as the teaching and development of young people
and children.
• Dave’s Psychomotor Domain Taxonomy
consisted of five categories or levels starting
with simplest behaviour to the most complex.
• Imitation
• Manipulation
• Precision
• Articulation
• Naturalisation
• Imitation – This is observing and patterning
behaviour after someone else. Performance
maybe of low quality. Example: trying out an act
after seen it demonstrated - (catitarisation on
manikins).
• Manipulation – This is being able to perform
certain actions by following instructions and
practicing. Example: creating work on one’s own,
after taking lessons, or reading about it e.g. been
able to manipulate a microscope or a sterilising
machine or an ECG machine.
• Precision - This is refining, becoming more exact.
Few errors are apparent. Example: working and
reworking something, so it will be ‘just right’, e.g.
been able to carry out a simple surgical operation
like an appendectomy.
• Articulation – This is coordinating a series of
actions, achieving harmony and internal
consistency. Example: is been able to diagnose
surgical emergencies and been able enable to
institute life saving first aid and basic life support.
• Naturalisation – This is having high level performance
become natural, without needing to think much about it.
This is the level of automaticity that comes with regular
practice and familiarity.
• In case of surgical curriculum it involves the mastery of
clinical features of common surgical diseases and to be able
to synthesise the features into clinical diagnosis. And how
to investigate a patient to refine the differential diagnoses
to a definitive diagnosis and the treatment of common
surgical diagnosis.
• It also includes how to diagnose clinically uncommon
surgical diseases, including syndromes, interpretation of
results of common investigations and recommendation for
further advanced investigations, minimal invasive surgery.
Matrix detailing Dave’s psychomotor domain
Level
Category
Examples of activity or demonstration and evidence to
be measured
Key words - verbs which
describe the activity to be
trained or measured at
each level
1
Imitation
Watch teacher or trainer and repeat action, process or
activity.
Copy, replicate, adhere,
follow, repeat etc.
2
Manipulation
Carry out task from written or verbal instruction
Re-create, build, execute,
implement etc
3
Precision
Perform a task or activity with expertise and to high quality
without assistance; able to demonstrate an activity to other
learners
Demonstrate, show,
complete, calibrate, control
etc
4
Articulation
Relate and combine associated activities to develop methods Construct, adapt, modify,
to meet varying, novel requirements
formulate, coordinate,
solve etc
5
Naturalisation
Automated, unconscious mastery of activity and related
skills at strategic level
Design, project-manage,
specify, invent, etc
Conclusion
• Bloom’s Taxonomy is a wonderful reference model
for all involved in teaching, training, learning,
coaching – in the design, delivery and evaluation of
these development methods
• Bloom’s Taxonomy provides a simple, quick and easy
checklist to start to plan any type of personal
development;
• As with any checklist, it helps to reduce the risks of
overlooking some vital aspects of the development
required. The more detailed elements within each
domain (matrix) provide additional reference points
for learning design and evaluation, whether for a
single lesson, session or activity, or training need, or
for an entire curriculum;
• As with so many of the classical models
involving the development of people and
organisations, you actually have a choice
as to how to use Bloom’s Taxonomy. It’s a
tool – or more aptly – a toolbox. Tools are
most useful when the user controls them;
not vice-versa. Use Bloom’s Taxonomy in
the ways that you find helpful for your
own situation.
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