Teaching higher order thinking skills in medical assistant education : An evaluation of curriculum management and development

This case study research aims at giving a description of whether the written curriculum and the  operational curriculum provides scope and opportunity for the development of higher order thinking  skills among students enrolled in Medical Assistant Training Program. The study proceeds with an  evaluation of curriculum coherence between the written and operational curriculum on the infusion  of higher order thinking skills by using Stake Countenance Model. The nature of problem evolves  around the inability of fresh graduates to function in real life situations that leads to  questioning the effectiveness of the training model which presents a gap between the learnt and  written curriculum. The study explores the curriculum's content for the infusion of higher order  thinking skills, whilst lecturers' understanding, planning and delivery of higher order thinking  skills is done through interview, content analysis of the instructional plan and observation of  classroom activities. Students' performance at the level of higher order of thinking is gauged  through content analysis of answer scripts of their summative examination. The study reveals that the written curriculum caters for the development of higher order thinking  skills in Medical Assistant education, but this was not reflected in the operational curriculum.  While, some structural dispositions like compact content, time limitations on content coverage,  hierarchical form of cognitive arrangement from lower order to higher order thinking, and  assessment which places emphasis on lower order thinking skills was noted in the written curriculum  which affects the development of higher order of thinking; this is further compounded by lecturers'  belief system, pedagogical literacy and approach towards teaching of thinking, and utilization of  teacher-centered approach which deters the development of thinking in Medical Assistant education.  There is a need for collaborative effort between curriculum planners and lecturers to realign the  written and operational curriculum in providing learning experiences which will enhance the  development of higher order thinking skills. This involves curriculum mapping and reorganizing of  content, shifting learning focus from teacher-centered approach to learner-centered practice in  promoting active academic engagement and early infusion of higher order thinking skills in the  training program. Together with this, the assessment techniques and tools should facilitate the  development of higher order thinking skills through reorganizing the Assessment Specification  Schedule which need to focus on a range of higher order of taxonomy in ensuring learners are  developed and tested at higher order of thinking. In addition, there is a need for embracing  continuous development of pedagogical literacy in teaching thinking skills with the fusion of  content mastery among teaching personnel which will enhance the development of higher order  thinking skills in the teaching and learning process. Future studies need to further explore the  area of infusing higher order thinking skills in clinical practice and the ability of students to  bridge theory and practice in clinical settings which will ensure that the product delivered meets  the educational goals.