Backward course design: making the end the beginning.

Pharmacy education is in a state of flux as we deal with teaching more students with a shortage of faculty members. We, as pharmacy educators, also have to deal with our lack of formal training in the area of course and lecture design. Backward course design is one method that can guide individual instructors as they struggle with designing their own courses or even an individual lecture. The steps in backward course design include: (1) identify the desired results, (2) determine the acceptable evidence, and (3) plan learning experiences and instruction. By focusing on the end results first, we can help students to see the importance of what they are learning and make our activities more meaningful and based less on what we have seen others do or how we were taught. This type of course design can also help us teach students to become lifelong learners. Consider these 2 classroom vignettes from a traditional classroom setting. The first focuses on a common problem seen among our students and the second on a problem faced by many teachers. A National Assessment of Educational Progress mathematics assessment asked the following question: “How many buses does the army need to transport 1,128 soldiers if each bus holds 36 soldiers?” Many of the eighth grade students answering this question gave the answer “31 with a remainder of 12.”1 In other words, the students were able to construct the mathematical equation to determine the answer, but they failed to apply their results to the context of the question, ie, a 32nd bus would be required to transport all of the soldiers. An example of a common problem teachers face can be seen in the following scenario. A world history teacher realizes late in the year that he is not going to finish presenting the information in the textbook to his class unless he covers 40 pages a day in a lecture-based format. Because of this he eliminates all of his active-learning activities and instead covers the leftover textbook material in a fast-forward lecture mode.1 In this example, the teacher forgoes the activities that may help the students remember and relate the material being presented to the world around them in favor of covering all of the facts necessary to pass the examination. Many pharmacy educators can identify with one or both of these vignettes. Many of us have been given answers to examination questions like that in the first example when we asked for the number of tablets or particular doses. We have all been faced as well with the dilemma of realizing that we have more lecture material to cover than time in the class period or semester allows. Why is this? It is because we are caught in the “twin sins”1 of typical instructional design. These sins are activity-focused teaching and coverage-focused teaching where we either teach to “cover” the material required for an examination or we give students activities to complete without making sure they understand the concepts we want them to learn (eg, for a problem such as “calculate the dose of warfarin needed to bring the patient's INR to the therapeutic range,” we get answers like 5.65 mg daily).1 Educators should keep the following question in mind: “How do we make it more likely by our design that more students really understand what they are asked to learn?”1 To do this, we need to train teachers to be able to demonstrate knowledge of their course content and different methods of pedagogy, knowledge of their students, knowledge of selecting suitable instructional goals, knowledge of the resources available to help in their teaching, the ability to design coherent instruction, and the ability to assess student learning.2 Traditional models of curriculum, course, and lecture construction have the following steps: (1) define the goals, purposes, and objectives of your lecture/module; (2) define experiences or activities related to the goals; (3) organize the experiences and activities, and (4) evaluate the goals. This method of teaching leads to “coverage-oriented” teaching where topics are checked off as they are covered. It also leads to conducting assessments at the end of a lesson or module because it has to be done, not because the teacher wants to see if the students understood the material.2 Backward course design changes the order of the steps: (1) identify the desired results, (2) determine the acceptable evidence, and (3) plan learning experiences and instruction. This model of design is standard-oriented instead of activity- or coverage-oriented because the teacher starts with what he/she wants the students to be able to do when the lesson has been completed rather than what material needs to be covered. This design also makes assessment part of the learning process and not just something to do at the end of a chapter or section because the student needs a grade.1,2 The purpose of this paper is to define backward course design, outline the steps for this process, provide an example of this process, and explain where this type of course design can be used in pharmacy education.