This refers to objectives that are specific, measurable, achievable, relevant and time bound. For example, the main objective of your course may be to deliver basic arthroscopy skills. With reference to the other chapters in this book you will be able to be specific as to what basic arthroscopy skills are and you will be able to know how best to teach them. You should set out to measure whether your course has taught these skills to your participants and that the goals you set on the course where achievable. You will seek feedback that the course was relevant to their day-to-day activities. Throughout that process you will ensure that you, your faculty and the participants are time bound by a published programme.

Keep it simple stupid refers to the fact that with every layer of complexity there is further potential for something to go wrong or a further level of potential misunderstanding. So whenever possible simplify, from the title of your course, to the slides in a presentation to the language used to describe a concept.

W H Auden in his poem of the same said, ‘Thousands have lived without love, not one without water’. You will have attended a course I am sure when 80 % of the time was spent doing other things apart from the practical aspect that you had come to learn. The many things that we will cover in this chapter have their place; however, the key will always be the practical aspect and it is vital that you consider that first thing first at all points along your planning and implementation of your course.

As in surgery it is aspects of course design. To illustrate this we will consider the timing and length of refreshment breaks.

Routinely we would recommend four refreshments breaks in a day-long course, one on arrival, mid-morning, lunch and mid-afternoon. So how long should these be? Your own experience of attending a course will tell you that refreshment breaks can be anything from 10 min up to 2 h. So when you are determining the length of your own breaks the detail is in what you and your faculty consider their purpose to be. The refreshment break on arrival should be considered an opportunity for people to mingle and a time to ensure that the administrative staff can deal with any last-minute housekeeping issues. The programme must show that this refreshment break is considered to be for that purpose i.e. (Registration (coffee and light breakfast)). The next refreshment break should be mid-morning and long enough that it can be shortened! It should take place close to rooms that your practical’s are taking place in and you should ensure that there are enough toilets and that they are well signposted so that toilet breaks do not delay participants and faculty to making it back in time for the next session. The lunch break should be honestly planned with adequate time for visiting sponsors stands if that is required, whilst still having time to sit down and reflect on the course so far. The afternoon refreshment break should be just over an hour after lunch so as to coincide with the peak lethargy of everyone on the course brought about by digesting lunch.

So you can see that just taking into account the refreshment breaks, the detail can be quite significant and it is this detail that you and your working group must work through so as to get to right solution for your course.