When writing objectives, always start with a ‘stem’ phrase, such as:
At the end of this session, learners will be able to…
We write this in the future tense. Then use a verb, that states specifically what the learners will be able to do (e.g. ‘demonstrate’) and which relates to the relevant domain described by Bloom (1956) (in terms of knowledge, skills or attitudes) followed by a clear statement of the topic of interest (e.g. that they can administer an intramuscular injection).
Knowledge objectives (which relate to the cognitive domain)
An example of a knowledge based objective (at the level of ‘comprehension’) might be: ‘at the end of this session, learners will be able to describe the key features of hypertension in adults’.
For this learning objective, typical teaching and learning methods might be a lecture, seminar or tutorial, problem-based learning case or clinical scenario. We are not asking the learners to apply this knowledge at this point, and so any assessment would aim to assess that the learners understood and could recall accurately the key features of hypertension in adults.
Skills objectives (psychomotor domain)
Bloom suggested that these should be written in terms of competence. He called this the psychomotor domain (although this taxonomy was completed by others) and ascribed to it five levels:
- imitation (observes skill and tries to reproduce it)
- manipulation (performs skill from instruction)
- precision (reproduces skill with accuracy and proportion)
- articulation (combines one or more skills in sequence with harmony and consistency)
- naturalisation (completes skilful tasks competently and automatically).
Note how the similarity to Miller’s pyramid.
An example of a skills-based objective at the level of ‘precision’ would be ‘at the end of the training session, learners will be able to insert a cannula into a vein accurately without causing a haematoma’.
Teaching and learning methods for this domain may well include some background knowledge (in this case some anatomy and physiology or running through the range of equipment needed), but for learners to perform this skill accurately, they need to practise. This may be on models or, with supervision and feedback, with patients. Assessment of competence would involve a number of observations, not simply asking the learner to describe what they would do.
Attitudinal objectives (affective domain)
Attitudinal objectives are often seen as the most difficult to write because they describe patterns of observable behaviour. Bloom called this the affective domain and again it has five levels:
- receiving (aware of external stimuli, e.g. listening)
- responding (complies with expectations in response to stimuli)
- valuing (displays behaviour consistent with a single belief without coercion)
- organising (shows commitment to a set of values by behaviour)
- characterising (behaviour consistent with a value system).
An example at this domain (at the level of ‘responding’) might be: ‘at the end of the communications skills course, learners will be able to demonstrate awareness of cultural differences in working with actors as simulated patients in three different clinical scenarios’.
This learning objective focuses on the learners being able to show that they have understood and can respond to different (pre-defined in this case) cultural issues with which patients may present. This objective states clearly that learners are not being expected to demonstrate this awareness outside a simulated context, so not in the ‘real world’ of the ward or clinic.