INTEGRATION I KOJURI J. M.D. CARDIOLOGIST INTERVENTIONIST ASSOCIATE PROFESSOR OF SUMS I

Definition "An integrated study is one in which students broadly explore knowledge in various subjects related to certain aspects of their environment" Humphreys, Post, and Ellis Kojuri J

Definition In general, all of the definitions of integrated curriculum or interdisciplinary curriculum include: A combination of subjects An emphasis on projects Sources that go beyond textbooks Relationships among concepts Thematic units as organizing principles Flexible schedules Flexible student groupings. Kojuri J

The integrative process must occur within the minds of our students, but the curriculum should be structured to promote that goal. Kojuri J

Temporal Co-ordination Integration Ladder INTEGRATION Inter-disciplinary Trans-disciplinary Multi-disciplinary Correlation Complementary Sharing Temporal Co-ordination Harmonization Nesting Awareness Kojuri J Isolation

Ladder Kojuri J

Vertical integration of learning objectives Community Need Assessment Role Definition Task Analysis Clinical Educational Need Assessment Educational Goals Basic Science Educational Need Assessment Instructional Objectives Kojuri J

Vertical integration of learning objectives Valvular Heart Diseases are Common In Iran Role Definition Task Analysis Clinical Educational Need Assessment Educational Goals Basic Science Educational Need Assessment Instructional Objectives Kojuri J

Vertical integration of learning objectives Valvular Heart Diseases are Common In Iran Diagnosis Initial Treatment And Referral Heart PEx., problem oriented Hx,… Relevant clinical knowledge, skills, … Educational Goals anatomy and physiology of heart valves, … Instructional Objectives Kojuri J

Intra-course (connected) integration Within each subject area, course content is connected topic to topic, concept to concept, and relates ideas explicitly. Kojuri J

        Conventional Fragmented Anatomy Histology Embryology Physiology         1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Conventional Fragmented Curriculum         1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Internal Medicine Surgery Pediatrics Gynecology Heart Kidney Kojuri J Nervous System Lung

Synchronized (Sequenced) Integration An Asynchronized Curriculum Anatomy Histology Embryology Physiology    1 2 3 4    1 2 3 4 Time  1 2 3 4 1 2 3 4 1 2 3 4  1 2 3 4 1 2 3 4 1 2 3 4 Kidney Heart Nervous System Lung Kojuri J

Synchronized (Sequenced) Integration A Synchronized Curriculum Anatomy Histology Embryology Physiology         Time 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Kidney Heart Nervous System Lung Kojuri J

Horizontal integration Integration of the basic sciences for example: an organ system approach or Integration of the clinical sciences for example: interdisciplinary clerkships Kojuri J

Horizontal Integration Heart Lung Kidney Nervous System   1 2 3 4 1 2 3 4   1 2 3 4 1 2 3 4   1 2 3 4 1 2 3 4   1 2 3 4 1 2 3 4 Horizontal Integration In Basic Science  Anatomy  Histology Organ System Approach  Embryology  Physiology Kojuri J

Horizontal integration of clinical courses Some schools divide their clerkships into ambulatory clerkships called: Ambulatory primary care comprehensive care community-based care these courses integrate family medicine, obstetrics and gynecology and pediatrics, and inpatient clerkships which are organized by individual departments; e.g., Connecticut. Kojuri J

Vertical integration Vertical integration refers to the interweaving of clinical skills and knowledge into the basic science years and, in turn, reinforcing and continuing to teach basic science concepts as they apply during the clinical years. Kojuri J

Conventional unintegrated curriculum Basic Science Clinical Science Kojuri J

Vertical distribution of courses Kojuri J

Vertical diffusion of content Basic Science Clinical Science Kojuri J

Vertical diffusion of content Pure anatomy Anatomy with clinical correlations Clinical anatomy Surgical anatomy Surgery with anatomical correlations Pure surgery Kojuri J

vertical integration of basic and clinical science Anatomy Histology Embryology Physiology     Heart 1 2 3 4 1 2 3 4 Lung 1 2 3 4 1 2 3 4 Kidney Nervous System displacement and merging         1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 Physiology and Internal Medicine Anatomy and Surgery vertical integration of basic and clinical science Kojuri J

Early exposure to clinical settings A vast majority of schools expose students to real patients in clinical settings in the first two years, the courses having such names as doctoring skills clinical applications of basic science patient-doctor physician and society clinical skills EARLY CLINICAL EXPOSURE CMPETENCY BASED EDUCATION Kojuri J

Spiral curriculum Vertical Integration Horizontal Integration Content is broken into its smallest components Prerequisite of each component is determined Instruction of basic science content is postponed in curriculum as long as it is possible Instruction of clinical science components are pushed forward in curriculum as long as it is possible horizontal integration of contents is performed at each level Vertical Integration Horizontal Integration Kojuri J

Webbed integration Case Problem Theme Problem based learning A fertile theme is webbed to curriculum contents and disciplines; subjects use the theme to sift out appropriate concepts, topics, and ideas. Case Problem Theme Problem based learning Case based learning Kojuri J

Threaded model of curriculum integration Skill Skill Curricular Area Curricular Area Curricular Area Thinking skills, social skills, study skills, and/or the Essential Skills “thread” through all learning. This model of curriculum integration focuses on a meta-curriculum that overlays subject content matter. Kojuri J

Integration: teacher and setting Basic science content is thought by a PhD teacher in university classroom   Clinical science content is thought by a MD teacher in hospital Kojuri J

Integration: teacher and setting  Basic and some clinical science content is thought by a MD-PhD teacher in university classroom  Kojuri J

Integration: teacher and setting Basic and some clinical science content is thought by joint MD and PhD teams    Kojuri J

Integration: teacher and setting  clinical and some basic science content is thought by joint MD and PhD teams   participation of pharmacologists in clinical rounds Kojuri J

Integration: teacher and setting Simply change the setting of basic science teaching to clinical ones   Kojuri J

Shared integration Shared planning and teaching take place in two disciplines in which overlapping concepts or ideas emerge as organizing elements. Kojuri J

Vertical integration in evaluation of educational achievement      conventional model of evaluation:      an exam after each course                 Kojuri J    

Vertical integration in evaluation of educational achievement or a single exam at the end of basic science courses   Kojuri J

Vertical integration in evaluation of educational achievement by delaying basic science exam   Kojuri J

Integration Through Central Governance of Curriculum           Fragmented curriculum, departments, and governance Kojuri J

Integration Through Central Governance of Curriculum           Curriculum Committee central governance on different departments Kojuri J

        Integration Through Central Governance of Curriculum Committee Interdisciplinary Departments Central governance on teams, build by removing the walls between departments Kojuri J

        Integration Through Central Governance of Curriculum Committee Interdisciplinary Departments Integrated Curriculum Central governance on integrated teams who deliver an integrated curriculum Kojuri J

Core curriculum Extracting the core curriculum from curriculum contents and objectives is essential to vertical integration of curriculum Kojuri J

Phase I Literature Research Advance preparation Best model for reform 1)Traditional 2) Horizontal integration 3) Vertical integration Resistance Kojuri J

Vision impossible Kojuri J

Phase II Malcom Skilbek Situational analysis Kojuri J

Phase III Specialty group formation Each group one head coordinator Daily 4-8 hour meeting Program remerging Program presentation Getting special permissions Kojuri J

نمای کلی برنامه Kojuri J

نمای کلی برنامه Kojuri J

اموزش مدولی Kojuri J

Phase IV Evaluation Kojuri J

الگوی سیپ (CIPP) معرف چهار نوع (مرحله) ارزشیابی می باشد: الف) ارزشیابی زمینه (Context Evaluation) ب) ارزشیابی درونداد (Input Evaluation) ج) ارزشیابی فرایند (Process Evaluation) د) ارزشیابی بازده (Product Evaluation)

مدل كركپاتريك مدل دیگر مورد استفاده مدل چهار سطحی کرکپاتریک است.

در سطح اول مدل کرکپاتریک، رضايت دانشجويان از برنامه مورد سؤال به عمل آمده و نقات قوت و ضعف برنامه از ديد دانشجويان مشخص مي شود. در سطح دوم ميزان دستيابي به اهداف آموزشي توسط خودسنجي از دانشجويان (Self Assessment)، سنجش نظرات دانشجويان به صورت گروهي (Team Assessment) و همچنين امتحانات صورت مي گيرد.امتحانات به صورت Interdisciplinary برگزار شده و بناي آن بر اساس ارائه بازخورد به منظور ارتقاء عملكرد دانشجو است همچنين از نتايج امتحان علوم پايه به عنوان ملاك جامعي براي دستيابي به اهداف آموزشي استفاده خواهد شد. پس از انجام ارزشيابي در اين دو سطح تلاش هايي جهت دستيابي به سطح سوم مدل كريك پاتريك صورت مي گيرد در سطح سوم تغییر در رفتار مورد ارزشیابی قرار می گیرد. در سطح چهارم اندازه گیری پیامد ها مد نظر است.

ابزار ارزيابي ابزار ارزيابي برنامه به شرح زیر می باشد: 1- پرسشنامه 2- مصاحبه نيمه ساختارمند 3- جلسات Focus Group (مصاحبه با صاحبنظران) 4- Tutor Report 5- پورتفوليوي دانشجويان 6- سؤالات امتحان دانشجويان 7- گروه هاي بارش افكار دانشجويي 8- فرم هاي نگرش سنجي 9- چك ليست بررسي امكانات ، وسايل كمك آموزشي، روش هاي آموزشي

Situation war! Kojuri J

Phase V Going toward vertical integration: 1) Teacher coordination 2) Inserting clinical science to basic science 3) Early clinical exposure 4) Curriculum overload Kojuri J

Foggy situation Kojuri J