Table 8 Steps to planning a CST curriculum

1: Define goals and learning objectives

Often based upon a needs assessment, the support mechanisms, support structures, resources and curriculum, as well as defining the overall goals of the program and the target population to be trained, will help shape the learning objectives of the CST, the codes of conduct, roles and responsibilities of learners and tutors, which will help to align expectations and standardise teaching and assessment methods.

2: Identify target population and ideal characteristics

Understanding the range of individual goals and competencies amongst participants, where they are in their learning journeys, their roles in their particular speciality, the specific kinds of cases that they will face, and the level of competency that should be expected of them will also inform the design of the program and curation of topics to be taught.

3: Determine the curriculum structure

Realising a longitudinal, structured [5, 32, 116, 117, 124, 137, 139, 142, 146, 150,151,152, 160, 175, 179, 184, 200] and spiralled [22, 36, 92, 117, 127] curriculum within whilst taking into account practical considerations and training contexts requires careful thought.

Due consideration to horizontal and vertical integration will determine the contents to be taught and the timing of these sessions. Establishment of protected time will also shape curriculum design.

4: Ensure adequate resources and mitigate the barriers

There must be effective and sustainable human and financial resources. This includes trained faculty [105, 116, 124, 153, 199, 200], communication and feedback platforms [92, 104, 131, 140, 141, 199, 200] and simulated patients [16, 36, 103, 124, 142, 145, 151, 219]. Particularly important is effective oversight and support of the program [37, 117, 170, 174].

5: Determine the curriculum content

The CST will comprise of basic communication knowledge and skills revision, followed by the inclusion of more advanced competencies.

Basic communication knowledge and skills to be built on

• include verbal and non-verbal behaviour, empathy, understanding the patient holistically as a person and providing patient-centred care.

• need to be part of a longitudinal [137] and spiralled program that will be reviewed consistently [143]

With longitudinal support and assessment learners will also develop deeper skills, reflective learning and scaffolding for advanced skills [92].

6.Assess the learner and adopt quality improvement processes

Learner assessments should be accompanied by evaluation of the program and feedback from all the participants. The impact of the sessions should be evaluated longitudinally, and lessons learnt should be used to improve the program.