Using consumer stories to inform curriculum renewal prioritisation: how can we examine if an entry-to-practice curriculum prepares students to work in healthcare?
What is curriculum renewal?
Each year, thousands of students enrol in, and graduate from, university degrees. Each degree consists of a certain number of units of study. Successfully completing units within a course in a particular sequence is required to earn the degree. Each course has learning outcomes that are achieved by successfully completing its units. A well-designed course will be made up of unit teaching and learning activities that allow learners to pass the unit, and a sequence of units that, when all are successfully achieved, allow the learner to successfully complete the course. After a course curriculum is established, the work of reviewing and revising it to ensure that learning outcomes and teaching and learning activities are consistent with current practice is known as curriculum renewal.
Why is consumer-informed curriculum renewal a priority?
Universities must demonstrate that their degree programs equip graduates with the knowledge, skills and attributes appropriate to the award level. This accountability extends to students, accrediting and regulatory bodies, and, in the case of healthcare degrees, to the public, who may interact with students during work-integrated learning or receive care from graduates.
Developing a curriculum requires significant effort, and although programs are launched with current, well-designed content, keeping curricula up to date becomes part of ongoing operations. Because programs continue to enrol students, curriculum renewal must occur within a ‘live’ environment, typically during the brief periods between teaching periods, often by academic staff who work across multiple courses or units. As a result, renewal efforts risk becoming piecemeal, inefficient, or focused on the easiest issues rather than on the most important ones.
Engaging with people who have encountered students during work-integrated learning may offer a resource-efficient way to identify renewal priorities that align with the related professional entry-to-practice attributes universities are responsible for assuring. Increasingly, universities and accrediting bodies expect explicit engagement with consumers in curricular development. Yet involving consumers meaningfully is challenging when curricula are vast, complex, and difficult to navigate behind the scenes across multiple media and delivery platforms. The use of consumer stories, supported by restorying methods, may help busy educators integrate authentic experiences into the curriculum in a manageable, meaningful way.
What was the purpose of this fellowship?
The purpose of this fellowship was to develop a scalable, consumer‑informed curriculum‑renewal method that draws on stakeholder experiences with students, uses storytelling and structured re‑storying methods to identify priority areas for improvement, and provides clear procedural steps for integrating these insights into sustainable, live curriculum‑renewal processes across any discipline. A healthcare‑focused case study, "Preparing Students to Work with Older Adults," was used to test and refine the methodology.
Specific aims for the project included:
- Exploring the experiences and perspectives of older adult consumers who encounter healthcare students during work‑integrated learning, including their perceptions of student readiness and the qualities most important for safe, person‑centred care.
- Examining how storytelling and structured re‑storying methods can be applied to consumer narratives to identify curriculum renewal priorities and key questions that matter most to consumers, educators, and students.
- Developing and describing a practical methodology for using consumer‑informed stories within a curriculum‑renewal priority‑setting process, including the procedural steps, roles, and conditions needed for effective and sustainable application to live curricula.
What were the fellowship outcomes?
This fellowship has adapted a methodology originally developed for hospital‑based continuous quality improvement, another environment where ongoing renewal is essential but must occur without pausing core operations (Hsu et al., 2012; Rand et al., 2019), and applied it to the similarly “always on” context of live university curricula. Using a design-based implementation research approach (Penuel et al., 2011), an interdisciplinary project team collaborated to recruit 12 older adults, 16 students, 14 academics, and 2 work-integrated learning supervisors to collect stories, which were then used to design and test 5 key questions related to preparing healthcare students to work with older adults.
Stories of healthcare student encounters collected from 9 older adults were restoried into 12 encounters across a variety of contexts: hospitals, rehabilitation centres, private practice, and university health services. The students encountered in these stories were studying medicine, nursing, and allied health courses across Australia. This project demonstrated how short interviews can be ‘re-storied’ into authentic vignettes that protect the storyteller's identity while maintaining a genuine connection to their experiences, values, and motivations for sharing their story. These ‘authentic vignettes’ are now available as a teaching resource for academics.
Several methods have been trialled and tested. Some did not work - like trying to get all stakeholders in the same space to review the consumer stories, even by hybrid methods. Older adults, academics, students and clinical educators work on different schedules and cycles with little crossover. Finding ways to engage each stakeholder group in ways that suited them led to the successful identification of 5 key questions, facilitating a targeted curriculum review that took all stakeholders’ perspectives into account.
Methods trialled in this project demonstrated that consultation strategies prioritising conversations (hard to schedule and coordinate, but highly meaningful) over documentation review (easy to look at, but hard to find meaning in) offer the most sustainable way forward. The final outcome of this project will be delivered in journal publication(s) and conference presentation(s), and will be tabled at Departmental and Faculty Education meetings to discuss the scalability of this methodology for identifying curriculum renewal priorities.
What resources were developed?
The Consumer Voice in Curriculum Renewal
This site presents a consumer‑informed approach to curriculum review and renewal, using stories of student care encounters as a catalyst for identifying practice‑relevant priorities. It includes co‑created stories from older adults for use as teaching resources, along with a step‑by‑step methodology for creating stories, identifying guiding questions, and practical process guidance and templates to support curriculum review in other programs.
How does the work from this fellowship inform future practice?
Ongoing work will focus on the scalability of the storytelling and restorying methods tested in this project to increase the use of authentic consumer stories in curricula. This use may be teaching and learning resources, or as the stimulus for identifying consumer-driven curriculum renewal priorities.
References
Hsu, M. Y., & McCormack, B. (2012). Using narrative inquiry with older people to inform practice and service developments. Journal of Clinical Nursing, 21(5-6), 841-849. https://doi.org/10.1111/j.1365-2702.2011.03851.x
Penuel, W. R., Fishman, B. J., Haugan Cheng, B., & Sabelli, N. (2011). Organizing Research and Development at the Intersection of Learning, Implementation, and Design. Educational Researcher, 40(7), 331-337. https://doi.org/10.3102/0013189x11421826
Rand, L., Dunn, M., Slade, I., Upadhyaya, S., & Sheehan, M. (2019). Understanding and using patient experiences as evidence in healthcare priority setting. Cost Effectiveness and Resource Allocation, 17(1). https://doi.org/10.1186/s12962-019-0188-1