Integration in

Medical Education

OBJECTIVESDefine “curriculum”,Identify different types of curricula,Identify the content structures of a

curriculum, List different educational strategies.Define integration.Recall the concept.Recognize the benefits.Identify the advantages & disadvantages.

What is a curriculum?

?

What is a curriculum?

•The curriculum is the set of courses and their content offered at a school or university with which students will interact for the purpose of achieving identified educational outcomes.

•The curriculum is the set of instructional strategies teachers plan to use.

What is a curriculum?

•A curriculum is about what should happen in a teaching program – about the intension of the teachers and about the way they make this happen.

•The curriculum in fact is What the student learns How the student learns (strategy/s &

Learning/teaching tools) How the student assessed The learning environment Learning outcomes

Types of CurriculaThe Concurrent Curricula

•The official curriculum: (The written curriculum),

•The Operational Curriculum,•Hidden Curriculum

is a side effect of an education, which are learned but not openly intended such as the transmission of values, and beliefs conveyed in the classroom and the social environment.

Different curricular models•Outcome-Based Education (OBE)- What

sort of doctor is needed?

philosophy that focuses on measuring student performance, which are called outcomes. Students demonstrate that they have learned the required skills and content

OBE contrasts with traditional education which primarily focuses on the resources that are available to the student, which are called inputs.

Different curricular models

•Problem-Based Learning (PBL)is a student-centered education in which

students learn about a subject in context of complex, many-sided & realistic problems

The goals of PBL are to help students: develop flexible knowledge, effective problem solving skills, self-directed learning (SDL), effective collaboration skills & intrinsic motivation

Different curricular models•Problem-Based Learning (PBL)

Working in groups, students identify what they already know, what

they need to know, & how & where to access new information that may lead to resolution of the problem.

The role of the instructor is facilitator who provides appropriate support, modeling of the process, & monitoring the learning

Different curricular models

•Task-Based Learning:

The primary focus of classroom activity is the task and information the students have, is the instrument which the students use to complete it.

Different curricular models

•Core & Student selection Components•An Integrated system-based approach.•Community-Based Education

learners are encouraged to actively apply concepts & information, skills or attitudes to local situations. E.g. students would not just study pollution, but would be encouraged & provided with the opportunity to observe, examine and hopefully reverse pollution of pond water at local levels through a variety of actions.

Basic curricular structures

•The discrete (=separate, isolated) curriculum,

•The linear curriculum,•The pyramidal structure, AND•The spiral curriculum.

Curriculum in which students repeat the study of a subject at different grade levels, each time at a higher level of difficulty and in greater depth.

Educational strategies

•Six educational strategies by Prof Harden.•Each strategy can be represented as a

spectrum or continuum: Student-centered/teacher-centered Problem-based/information-gathering Integrated/discipline-based Community-based/hospital-based Elective/uniform Systematic/apprenticeship (internship)-based

SPICES Model of Educational Strategies

•Student centered “What the student learn rather than what is taught"

• Teacher centered

• Problem-based

• Information-oriented

• Integrated or Inter-professional Integration throughout the

curriculum

• Subject or Discipline-based

• Community-based Less emphasis on

hospital-based programs

• Hospital-based

Hospital-based

SPICES Model of Educational Strategies

• Elective-driven According to student needs,

learning & teaching adjusted to the needs of students

• Uniform

• Systematic To ensure that all

students have had comparable learning experience

• apprenticeship (internship)-based

i.e Opportunistic (=resourceful)

Some background onStudents learning

Principles of Adult learning?The need to know — adult learners need to know why they need to learn something before undertaking to learn it

Learner self-concept — need to be responsible for their own decisions

Role of learners' experience — have a variety of experiences of life - the richest resource for learning

Readiness to learn — are ready to learn those things they need to know in order to cope effectively with life situations

Orientation to learning — are motivated to learn to the extent that they perceive (=see, notice) that it will help them perform tasks they confront (challenge) in their life situations.

Think, Pair & Share:

What is Integration??

Abraham Flexner Recommendations: •Under Flexner’s influence, medical

curricula around the world came to be structured into:

▫Preclinical medicine: learned in lecture theatres, teaching laboratories, dissecting rooms, and librarie

▫Clinical medicine: learned in wards and operating theatres of university tertiary hospitals

•In the late twentieth century, national bodies began to respond to the wind of change to meet patients’ needs to be achieved through curriculum integration.

•Disciplines should integrate their contributions into a thematic, probably systems-based curriculum

•Integration was one of the key criteria for assessing the degree of innovation in a medical curriculum in the SPICES curriculum model (Harden, 1984).

Old Curriculum

Basic Sciences:• Anatomy• Physiology• Pathology/Immunology/Microbiology….• Biochemistry• Pharmacology

Clinical:• Medicine, surgery, Ob/Gyn, Peadiatrics,• ENT/Oph….

Learn like doctor & think like doctor

…because human beings are complex organisms whose discrete (=separate) systems are linked intricately (=complicatedly) and elaborately within the body and modified profoundly (=greatly) by external influences, we need to teach in ways that reflect this complexity and that stimulate students to synthesize information across disciplines.

Dienctag

Learn like doctor & think like doctor

A sick patient does not represent a biochemistryproblem, an anatomy problem, a geneticsproblem, or an immunology problem; rather,each person is the product of myriad (=numerous) molecular, cellular, genetic, environmental, and social influences that interact in complex ways to determine health and disease. Dienctag

What is Integration??

Integration: a definition

“ The teaching of different subject areas in a thematic manner, so that the different disciplines are not emphasized”

Internal dictionary of Adult & CME

Integration: a definition

“ The organization of teaching of matter to interrelate or unify (join, unite) subjects frequently taught in separate academic courses or departments”

Harden

CurriculumIntegration

Curriculum:What is taught in a school

Think, Pair & Share:Differences in integrated & discipline-based curriculum??

The Rationale (=basis,foundation)

• Curriculum organization denotes (=means) a systematic arrangement of curriculum elements.It will results in a more relevant, meaningful,

and student centered curriculum.

• Integration makes the learning contexts close to the context in which the information is to be retrieved (=recovered, regained). E.g. integrated learning within integrated context such as primary care medicine.

Think, Pair & Share: Advantages& Disadvantages??

Advantages1. Matching curriculum aims.

2. Achieving higher level of objectives.

3. Avoiding information overload.

4. Making learning interesting & effectives

5. Motivating students.

6. Benefiting staff.

Disadvantages1. Loosing subject identity.

2. Requiring interdepartmental planning.

3. Resources shortage.

4. Contents coverage.

5. Motivating students.

Clinical

Basic

Science

Horizontal Integration

Vertical integration

Types of Integration

Summary

Summary

Learning take place better if it is contextual.

Overcrowding information could be solved by integration.

Integration is the necessity & not the luxury.

This is the relatively new trend which has been applied in medical education every where.

I wish you a very successful and enjoyable time in your course

All the best