Blueprint for an Intentionally Designed Educational System

Part 1: Preparation Phase

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Educational Purpose 

The Preparation phase establishes the foundation for meaningful learning by engaging residents with the assigned content before the in-person learning session. Within this methodology, Preparation is centered on the assigned BCSC reading and is intentionally designed to transform reading from a passive activity into an active learning experience.

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Preparation serves two complementary purposes. First, it develops foundational knowledge that allows residents to participate meaningfully in the Application phase. Second, it teaches residents how to engage more effectively with educational materials through evidence-informed learning strategies. 

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Educational Science 

The Preparation phase is grounded in educational principles demonstrating that learning is enhanced when learners actively engage with material before formal instruction. Strategies such as generation, self-assessment, and active reading promote deeper processing, identify knowledge gaps, and prepare learners to integrate new information more effectively during subsequent instruction.

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Generation is the process of attempting to recall or predict information before it is presented. Learners first activate prior knowledge by answering questions, making predictions, or organizing existing understanding. The effort to generate information improves subsequent learning and retention.

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Self-assessment is the process of evaluating one’s current understanding in order to identify strengths, misconceptions, and areas requiring additional study. It also informs faculty which concepts need focus and clarification. 

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Active reading is the intentional engagement with educational material through questioning, organizing, summarizing, annotating, or connecting new information with existing knowledge.

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Preparation reduces the cognitive burden of encountering unfamiliar concepts for the first time during the in-person session, allowing faculty time to focus on clarification, application, and clinical reasoning rather than initial content delivery.

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Design Considerations 

The Preparation phase should be intentionally designed to prepare residents for meaningful participation in the Application phase while developing effective lifelong learning habits. The following design principles should guide the development of preparatory educational activities and resources.

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The BCSC is the Curriculum. Within this methodology, the BCSC serves as the foundational curricular resource for resident learning. The Preparation phase is intentionally designed to help residents maximize the educational value of the BCSC rather than replace it with alternative educational materials. When a subject does not align with a BCSC chapter, create a meaningful preparation activity that engages the learner and primes them for the application phase during in-person learning. 

Promote Active Reading. The role of the module designer is to design educational resources that facilitate active reading.

Thoughtfully designed activities encourage residents to engage with the material, organize their thinking, identify knowledge gaps, and connect new concepts with existing understanding. These resources are intended to increase the educational value of the time or reading.

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Design Resources for Continued Use. Educational resources should be designed with the entire learning experience in mind. Resources developed during the Preparation phase will continue to provide educational value during the Application and Reinforcement phases whenever appropriate. Well-designed resources should also remain useful as residents revisit topics throughout residency, allowing the same educational resource to support learners with increasing depth and sophistication as their knowledge and clinical experience grow.

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Design for Progressive Learning. Preparation activities should provide educational value for residents at every stage of training. A PGY-2 and a PGY>2 may engage with the same educational resource, yet each should derive value appropriate to their level of knowledge and clinical experience. Well-designed resources allow junior residents to build foundational understanding while simultaneously challenging more senior residents to refine clinical reasoning, recognize nuances, and integrate prior experience.

Explain the Educational Purpose. Residents should understand why they are being asked to complete each educational activity. Brief explanations of the learning science behind these activities help residents engage more intentionally and develop effective learning habits that extend beyond a single module. These explanations are standardized across the curriculum. 

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Respect Resident Time. Preparation activities should be intentional, efficient, and aligned with the educational objectives of the module. Every preparatory activity should have a clearly defined purpose and justify the time required to complete it. The goal is to maximize educational value—not educational workload.

Designer Workflow/Practical Guidance

When designing the Preparation phase, begin by considering what residents should know before entering the Application phase. Then develop educational resources that prepare them for that experience while promoting active engagement with the assigned BCSC (or other) reading.

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Include the appropriate standardized educational explanation wherever a defined learning strategy is introduced.

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Step 1. Define the Educational Objectives (required)
Begin by identifying the knowledge, concepts, and clinical reasoning skills residents should possess before entering the Application phase. These objectives should align with the overall goals of the learning module and guide every subsequent design decision.

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The educational objectives should answer a simple question:

What foundational understanding should residents bring to the in-person learning session?

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Step 2. Review the Assigned BCSC Chapter
Read the assigned BCSC chapter from the perspective of the module designer. Consider where residents are most likely to struggle, which concepts are foundational, what misconceptions commonly occur, and where additional educational resources may improve understanding.
 

Step 3. Design the Generation Activity (required)
Every Preparation phase should begin with a brief generation activity completed before residents begin reading the assigned BCSC chapter. Generation activities encourage residents to activate prior knowledge, identify misconceptions, and begin thinking about the topic before encountering new information. The objective is to prepare the brain for learning.

Include the standard explanation describing its educational purpose. This explanation helps residents understand why the activity is being completed before reading and how it supports learning. 

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Why Am I Doing This? (Generation)
Before learning something new, it helps to first think about what you already know. This activity activates your existing knowledge, reveals misconceptions, and prepares your brain to learn more effectively as you read.
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Step 4. Design Educational Resources
Educational resources should be designed to advance the educational objectives of the module while providing value throughout the learning experience. Consider how each resource can support multiple educational purposes during Preparation, Application, and Reinforcement.

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Examples include comparison tables, concept maps, annotated figures, algorithms, mnemonics, visual diagrams, memory palaces, guided notes, or other educational resources designed to improve learning. The specific format is less important than the educational purpose it serves.

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Why Am I Doing This? (Active Reading)
Learning is more effective when you actively engage with the material rather than simply reading it. This activity is designed to help you think about, organize, and connect new information as you work through the chapter, leading to deeper understanding and better long-term retention.

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Step 5. Incorporate Self-Assessments (required)

Provide residents a brief self-assessment to help learners identify strengths, recognize misconceptions, and focus subsequent study on areas requiring additional attention. The purpose is for residents to monitor their own understanding before reading and before the application phase; it also provides information to faculty about residents’ knowledge gaps. 

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Self-assessments will include a brief pre-quiz with confidence ratings. Whenever possible, provide immediate feedback to reinforce correct understanding and address misconceptions before the in-person learning session.

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Like all educational activities within the methodology, self-assessments should state the educational purpose: 

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Why Am I Doing This? (Self-Assessment)
This activity is designed to help you monitor your understanding and identify areas that need additional review. The goal is not to earn a score, but to recognize what you know well and where you should focus your continued learning.
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AI Toolkit (optional)
AI can generate self-assessment activities, including multiple-choice questions with confidence-rating prompts that are aligned with the educational objectives.

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Example Prompt:
Create 5 self-assessment questions in multiple choice format (with confidence rankings), modeled after the Ophthalmic Knowledge Assessment Program (OKAP) and ophthalmology board test based on BCSC Book X, Chapter Y. The questions should help residents identify strengths and misconceptions before the Application phase. Include brief explanations for the correct answers.

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Step 6. Review the Preparation Phase as an Integrated Experience

Before finalizing the Preparation phase, review it as a complete educational experience.

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Designer Reflection

Before finalizing the Preparation phase, reflect on the overall educational experience. Every component should have a clear educational purpose and work together to prepare residents for meaningful participation in the Application phase.

Consider the following questions:

• Does the Preparation phase build upon, rather than replace, the assigned BCSC reading?

• Have I designed activities that promote active engagement with the material rather than passive reading?

• Are the educational resources intentionally designed to support multiple educational purposes and continue providing value throughout the Application and Reinforcement phases?

• Do the educational resources accommodate residents at different stages of training while remaining valuable as learners progress through residency?

• Have I included appropriate opportunities for residents to assess their understanding before the in-person learning session?

• Have I incorporated the appropriate standardized “Why Am I Doing This?” explanations for each educational strategy?

• Does every educational activity have a clearly defined purpose that justifies the time required to complete it?

• Will residents arrive prepared to actively participate in the Application phase?

Phases of Educational Module