Curriculum modules for the WHO’s International Classification of

Functioning, Disability and Health (ICF).

The purpose of this document is to provide a basis for education on the International
Classification of Functioning, Disability and Health (ICF) and its derived classification
for children and youth (ICF-CY) for potential users and in all countries. It was developed
by members of the World Health Organization Functioning and Disability Reference
Group and Education Committee to be broadly appropriate for a range of ICF uses. New
modules for specific purposes and applications may be developed later. This international
curriculum describes desirable contents of generic modules for ICF education, including
an introductory module on the content, structure and purpose of ICF.

The curriculum modules can be selected, ordered and used at a level of detail appropriate
to whom the education is addressed and the length of time available. The curriculum is a
resource for suitable instructors to guide them in designing materials and programs that
are specifically suited to the needs of a particular target audience, in different settings.

Audiences for courses or materials developed from this curriculum may include the
general public, care providers and advocates, health professionals, people from the
education and other sectors involved with services for people with disability including
those with disabilities themselves. As such, education materials will need to be
appropriate to the audience.

Methods of education may range from paper or web based written materials (in formats
appropriate for people using alternative communication methods), short
courses/presentations, to longer workshops, course of study (on-line or face-to-face).

Learners will be able to refer to the WHO website which will provide links to educational
materials that address these modules, once these become freely and publicly available.

As the ICF is more widely implemented and more experience in using and teaching ICF
accumulates, we expect that this curriculum will evolve. We are interested in learning
about ICF education experiences as they relate to this curriculum so that its utility and
usefulness will improve over time.

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Introductory Module: An overview of the ICF

Intent:
This module introduces the ICF and provides an overview of what will be covered in
more detail in other modules.

Content:
 What is classification and why classify?
o Importance of classifications as standards for health information systems
 ICF as an international classification
o The WHO Family of International Classifications and the place of ICF
o ICF as a code set for use at the individual, institutional and population
level.
o ICF-CY as a derived classification
 ICF as an international standard
o ICF as a model for understanding functioning and disability
 Conceptual model of functioning and disability in ICF
 An overview of the International Classification of Functioning, Disability and
Health
 Main uses of the ICF and ICF-CY,
o The role of classifications in health information systems
o Uses at the individual, institutional and population level

 Examples of use at the individual, institutional and population level

 Instruments and tools
o Check list
o WHO DAS II
 Where to find further information about the ICF [links]
o To ICF ( WHO website)
o To WHO Collaborating Centres that will include the ICF didactic material
they considered in their language.

Outcome:
On completion of this module the learner will be able to describe the ICF, its place in
health information systems and its main uses. The learner will be aware of the content
of other modules and other sources of information about the ICF.
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The model, components and structure of the ICF

Intent:
To increase familiarity with the components of the ICF model, the definitions and the
interactions between components.

Content:

 Structure and content of the ICF (brief description)

o Introduction
o Chapters
o Annexes
 Components of the ICF
o Definitions of components
o Delineation between components
 ICF conceptual model
o Foundations of ICF
 Structure of the classification
o Hierarchy of domains and categories
o Chapters
o Inclusions and Exclusions
 Qualifiers and constructs
 Where to find further information about the ICF [links]
o To ICF ( WHO website)
o To WHO Collaborating Centres that will include the ICF didactic material
they considered in their language.

Outcome:
On completion of this module the learner should be able to describe the model in the ICF,
define the ICF’s components and be familiar with the interaction between components of
the model of functioning and disability and the use of qualifiers and constructs.

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The Context for the ICF: Past and Future

Intent:

To outline the reasons for the development of the ICF and the history of its development
in order to define its rationale in health and health-related information systems

Content:
 Social, demographic and epidemiologic trends
 Ethics, health and disability
 History of ICF development
o Classification of consequences of diseases
o ICIDH
o Revision of ICIDH leading to ICF
 The reasoning behind the development of the ICF, including the revision of
ICIDH
 The biopsychosocial concept of functioning and disability
 New elements of ICF and the differences between ICIDH and ICF
 UN conventions and standard rules
 ICF-CY: background, rationale and use.
 Where to find further information about the ICF [links]
o To ICF Annex 7 ( WHO website)
o To WHO Collaborating Centres (link to ICF didactic material in their
language).

Outcome:
On completion of this module the learner should be able to describe and discuss the
reasons behind the development of ICF and the ICF-CY and the concepts of functioning,
disability and health espoused in the ICF.

Uses of ICF

Intent:
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To explain the purposes for which information on functioning, disability and health is
collected and how the ICF may be used, including the use of ICF based instruments.

Content:
Key topics should be organised under the five main categories of use in the ICF
introduction:
 Statistical
o Global health monitoring and reporting
o Use of ICF with the International Classification of Diseases and other
members of the WHO-FIC and other international standards.
o ICF-based survey instruments
 Research
o Clinical and social care and outcomes monitoring
o Medical, health system, public health, and social policy research
o ICF-based measurement tools
 Clinical
o Clinical and social care and outcomes monitoring
o Communication between professionals, across settings and services
o Case management
o ICF-based clinical measurement tools, including specific code sets for
particular settings and applications
 Policy and advocacy
o Evidence for health and social policy
o Eligibility determination
o Planning and evaluating health services and programs
 Educational
o Clinical education
o Examples of use of ICF based on the needs of the group to whom the
training is addressed.

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 The WHO Family of International Classification Network prioritized four strategic
areas for the implementation of the ICF:

 Population level – measurement of health and disability in the general

population; surveys and census
 Clinical and service level – health outcome assessment
 Administrative and clinical information level – health records and information
systems
 Social policy level – disability certification, education, labour market and law.

Examples of ICF applications for each of these areas may be introduced.

 Where to find further information about the ICF [links]
o ICF-based instruments - Specific by language, by institution, by objective.

Outcome:
On completion of this module learners will be able to describe examples of ICF use
relevant to their practice and needs, and will know how to find out more about ICF uses.

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Documentation and Coding using ICF

Intent:
To outline the purpose of documentation and coding, provide examples in a range of
applications and introduce legal and ethical issues applicable to using a classification for
a range of purposes in the health and social welfare systems.
Content:
 Selecting components and domains appropriate to purpose
 Use of the qualifiers
 Use of capacity and performance
 Options for using activities and participation (WHO 4 options)
 Coding rules (ICF Annex 2)
 Illustrative examples of coding
 The need for advanced information on interpretation and coding, for specific
applications
 Ethical and legal issues in the use of ICF (Annex 6)
 Professional ethics
 Legal requirements regarding use of personal health information
 General privacy and confidentiality principles
 Informed consent
 Ethical purpose of classification and data use – ICF use for enhancing
opportunities for people with disabilities
 ‘Nothing about us without us’ – the importance of people with disabilities
participating voluntarily in scientific and clinical activities concerning them
 The UN Convention on the Rights of Persons with Disabilities – (Article 31)
 Adherence to relevant national laws and regulations
 Completeness of information
 Release and dissemination of information
 Where to find further information about the ICF [links]*

Outcome:
On completion of this module the learner should be able to describe the role of coding in
information systems and data collections, will have experienced use of ICF framework
and selection of ICF dimensions and domains relevant to the purpose of a data collection,
at the appropriate level of the classification, and will have selected and applied qualifiers
and constructs and will understand the need for further education for specific purposes.

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Learners should be familiar with the contents of Annex 6 of ICF, the laws, conventions
and issues concerning the use of personal health information in their country and discuss
the implications of such conventions and laws on collecting and using information on
functioning, disability and health.
On completion of this module the learners should be aware of the need for additional
training and supervision to have an adequate level to implement the ICF, notice the
complexity of these issues and be aware of the need for context-specific consideration of
them.

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The WHO Family of International Classifications

Intent:
To introduce the purpose of classification and to demonstrate the context of the ICF in
relation to families of classifications.

Content:
 What is a classification and why classify?
 Role of classifications in health information systems
 WHO Family of International Classifications
o Reference classifications
o Derived classifications
 ICF the Children and Youth Version –ICF-CY
o Related classifications
 The broader UN Family of classifications and its relation to the WHO-FIC
 National classifications and families of classifications
 Using classifications together to describe health and health systems
 Updating and maintaining WHO-FIC classifications
 Where to find further information about the ICF [links]
o WHO FIC website
o WHO FIC Collaborating Centres

Outcome:
On completion of this module the learner should be able to describe the WHO Family of
International Classifications, state the difference between types of classifications in the
family, list the members and the purposes for which they are used.
Learners should also be able to describe the processes for maintaining and updating
classifications such that they are able to contribute to the process.

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Quality Assurance
Intent:
To raise awareness about the various factors that influence the quality of data.

Content:
 Sources of information (e.g. consumer/patient, clinician, parent or guardian)
 Requirements for good data
 Influences on the quality of data
 Responsibility for data quality
 Risks of poor data quality
 Processes for acquiring additional information

Outcome:
On completion of this module the learner will be able to describe characteristics of good
quality data and potential threats to quality.

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Considerations for educating users and potential users of the ICF

1 Background of the learner

Functioning and disability are complex concepts of interest to a wide range of people
including professionals, each with a different philosophy. Different groups, including
people with disabilities, care providers and advocates are likely to focus on different
aspects of the classification.
Best practice use of the ICF keeps the person whose information is being recorded as the
focus of the coding, irrespective of the professional or other background of the coder.
The interaction between the professional and the person should also be considered.
In developing materials based on these curriculum modules the views of people with
disabilities, their families and advocates should be considered.

2 Continuous education
Education on ICF may be for the general public, including people whose information is
being recorded, and if so, then materials may be general in nature. More detailed levels of
information will be required for a more professional audiences, so, although the same
modules should be covered, it may be necessary to increase the level and complexity of
the information covered and the time taken to convey the information.
Professional education may start in undergraduate courses of health professionals, but
may also continue in the form of continuous professional development. This could be
done by means of different approaches (see 3 below). Different modules may be used
independently or concurrently. The order of presentation may be varied according to the
intended outcomes.
Depending on the context and background of the learners, some modules may need to be
expanded in order to adequately train individuals for their intended use of the ICF. This
document provides a structure for basic, introductory ICF educational opportunities but it
is expected that more detailed courses on these curriculum modules for specific users will
be developed.
Some modules may be repeated periodically to remind the learner of the importance of
good data. Some sections of modules, such as the legal and ethical aspects, may change
over time and in different countries. Continuous education may be required to
accommodate changes in the classification and the development of additional coding
guidelines and in light of new experiences with using the ICF.

3 Multiple Approaches
In order to ensure the best learning and retention by the student of ICF, it may be
necessary to use multiple or alternative approaches such as:
 Information papers and pamphlets in multiple formats
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  Online and other electronic courses
 Classes or lectures at professional in-service meetings
 Professional conferences (talks, poster presentations or exhibits)
 Paper-based educational materials (case studies, user guides)
 Coding guidelines in the ICF

It is recognized that there is a need for an empirical basis for the selection of methods.

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