Curriculum Development in Medical Education – Part III: Laying the Foundation with Kern’s Framework
Federico Puerta Martinez, MD, Dario Winterton, MD
Published July 3, 2025 | Clinics in Medical Education
Issue 7 | Volume 1 | June 2025
In the previous two parts of this series, we explored the foundational elements of curriculum development using Kern’s six-step framework. We began by identifying educational problems and assessing learner needs, and then moved on to crafting goals, objectives, and strategies to meet those needs. In this final installment, we turn to the last two steps: Implementation and Evaluation & Feedback. These steps are essential to ensuring that the carefully designed curriculum becomes a dynamic, sustainable educational experience that can adapt and improve over time.
Step 5: Implementation
Turning a curriculum plan into reality involves more than just following a checklist; it requires a thoughtful and strategic approach. Effective implementation depends on adequate resources, broad-based support, structured administration, and a readiness to anticipate and manage barriers.
The first priority is identifying and securing the necessary resources. This includes assembling the right personnel such as trained faculty, administrative staff, simulation specialists, or standardized patients. Time must be allocated not only for teaching but also for preparation, coordination, and feedback. Physical resources, including clinical spaces, labs, and educational platforms, should be evaluated and prepared in advance. Budget planning is a crucial component and often involves seeking internal institutional support or external funding from professional societies or grants.
Support from stakeholders is a foundational aspect of implementation. Internally, curriculum developers must gain the endorsement of faculty, departmental leaders, and learners. Highlighting the curriculum’s alignment with institutional goals and demonstrating its potential to improve learner outcomes and patient care can be persuasive strategies. Externally, aligning with accreditation standards and leveraging grants can enhance legitimacy and provide vital resources.
An effective administrative structure should clearly define roles and responsibilities. Communication strategies must be robust and include mechanisms for sharing the rationale, goals, implementation plans, and eventual results with all stakeholders. Operational workflows should ensure smooth scheduling, distribution of materials, and collection of evaluation data. If dissemination of results is planned, the curriculum team should engage early with the Institutional Review Board to ensure ethical standards and research approval are met.
Barriers to implementation are common and can arise from limited finances, resistance to change, or logistical challenges such as conflicting schedules. These can be mitigated through effective communication, early pilot testing, and collaboration with stakeholders. Demonstrating feasibility and early successes through a pilot or phased approach often builds momentum and reduces resistance.
Introducing the curriculum ideally begins with piloting critical components with a smaller group of learners. Phasing in the curriculum gradually allows for iterative refinement and promotes stakeholder buy-in. In cases where urgency or scope requires full implementation from the outset, it is advisable to treat the initial cycle as a pilot, using evaluation data to inform ongoing adjustments. Ultimately, implementation should be viewed as an ongoing process, continuously refined through feedback and experience.
Step 6: Evaluation and Feedback
Evaluation and feedback are the final but equally vital steps in Kern’s framework. They close the loop by determining whether the curriculum has met its goals and identifying areas for improvement.
Evaluation involves assessing both learner performance and the overall effectiveness of the curriculum. This can include formative assessments, which are conducted during the implementation to guide real-time improvements, and summative evaluations, which assess the curriculum’s overall success after completion. Both quantitative and qualitative methods should be employed, such as performance tests, surveys, focus groups, and reflective writing.
The process begins by identifying the stakeholders who need the evaluation results—learners, faculty, departmental leadership, or accrediting bodies. Clear evaluation questions should be articulated, such as whether learners are achieving the desired competencies or how effective the teaching strategies have been. Appropriate methods must be selected based on these questions, and the results should be analyzed and reported in a way that is actionable and relevant to each stakeholder group.
Challenges in this step include limited time and resources for faculty to conduct evaluations, potential bias in data collection, and variable stakeholder engagement. These challenges can often be addressed by leveraging existing institutional tools, training faculty in objective assessment methods, and designing concise, meaningful evaluation instruments.
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Conclusion
Implementation and evaluation represent the culminating phases of curriculum development. They ensure that a well-conceived plan translates into an effective learning experience and that continuous improvement remains at the heart of the educational process. By thoughtfully executing these steps, educators can ensure their curricula not only meet their intended goals but also evolve to meet future needs. With these final steps, the cycle of curriculum development becomes not just complete, but dynamic and enduring.
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