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Table 1 The 6Cs of teaching-learning-assessment at the program level

From: Designing health professional education curricula using systems thinking perspectives

C1: Commands

Agencies such as university rules, policies, and procedures; accrediting body’s standards and outcomes; and internship/residency frameworks that command and control the high-level vision, mission, outcomes and practices of the curricular design.

C2: Contextualisation

Curricular themes, learning outcomes, objectives, content, learning and teaching methodologies, depth and breadth of clinical exposure directed by various contextual factors such as educators, staff, students, and teaching-learning settings.

C3: Coordination

Harmonisation of curricular themes, competencies, and outcomes within activities and assessments enabled by coordination between key agents (educators and staff) and structure (e.g. technological support, curricular policies, rules etc.).

C4: Collections

Gathering evidence on students’ developmental progression within a particular year and across all years of a program using a program of assessments.

C5: Collations

Capturing students' progression in various competencies using collated data from various assessment points in a way that facilitates triangulation, coherence, consistency, improved educational effect, and holistic judgement of students’ progression into the next level.

C6: Connections

Connections occur at multiple levels: connecting students with reflections on their performance, and empowering them to be better prepared for the next training level; connecting the network of stakeholders by using their expertise in making judgements about student’s progressions, and connecting the ‘commands’ of standards for a medical program with those of residency/training outcomes by ensuring students are prepared for practice.