1. Integration in Medical Education
AMAL AL-OTAIBI
CP, MME

2. OBJECTIVES Define “curriculum”, Identify different types of curricula,
Identify the content structures of a curriculum,
List different educational strategies.
Define integration.
Identify types of integration
Identify rationale for integrated learning
Identify the advantages & disadvantages.

3. What is a curriculum??

4. What is a curriculum?
The curriculum is the content or objectives for which school hold students accountable.
The curriculum is the set of instructional strategies teachers plan to use.
These conceptual differences are based on distinction between a curriculum as expected end of education (Intended learning outcomes), and a curriculum as the expected means of education (Instructional plans).

5. 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

6. Types of Curriculum:
1- The official curriculum: (The written curriculum):
“It is documented according to a common theme and to successive grade levels with curriculum guide, course outlines, and list of objectives.”
The purpose is to give
Teachers a basis of planning for lessons and assessing students
Administrators a basis for supervising teachers and holding them accountable for their practices and results.

7. 2-The Operational Curriculum
What is actually taught by the teachers and how it is communicated.
This includes what the teacher teaches in the class and the learning outcome for the students.

8. 3- Hidden Curriculum
Includes the norms and values of the surrounding society.
It is not part of the either the official or operational curricula.
It has a deeper and durable impact on students.

9. 4- The Null Curriculum
Subject matters that is not taught at all although they appear to be important.
E.g. Student’s Psychology, Parenting (how to teach and care for student).

10. 5- Extra Curriculum
All planned experiences outside the school subject.
It contrasts with the official curriculum by its responsiveness to students.
E.g. Sports, social programs, competition programs

11. Different curricular models
Outcome-Based Education- What sort of doctor is needed?
What the doctor able to do
Doing the right thing
How the doctor approaches his practice
Doing the thing right
The doctor as a professional
The right person is doing it

12. Different curricular models
Problem-Based Learning
Task-Based Learning
A range of tasks undertaken by a doctor are identified. E.g. Management of a patient with abdominal pain which is used as the focus for learning.
An Integrated system-based approach.
Community-Based Education

13. Basic curricular structures
The discrete curriculum,
The linear curriculum,
The pyramidal structure, AND
The spiral curriculum.

14. Basic curricular structures
The discrete curriculum
The self-sufficient programs: unrelated or independent contents A B C D

15. The linear curriculum
Each concept or skill of the content need the mastery of the previous concept or skill.
Called Mastery Learning Strategies (Bloom,1871)
Linear Configuration A B C D

16. The pyramidal structure
Multiple unrelated concepts or skills for learning subsequent concepts or skills. A B C D E F G

17. The spiral curriculum Organization of concepts and skills
There is interactive revisiting of topics throughout the block
Topics are revisited at numerous levels of difficulty
New learning is strongly related to previous learning.
The competence of students increases with each visit to a topic.

18. Educational strategies
Six educational strategies have been identified in relation to curriculum in medical schools 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/opportunistic

19. Educational strategies
Six educational strategies have been identified in relation to curriculum in medical schools 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/opportunistic

20. SPICES Model of Educational Strategies
Hospital-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

21. SPICES Model of Educational Strategies
Hospital-based
SPICES Model of Educational Strategies
Elective-driven
According to student needs
learning & teaching adjusted to the needs of students
Uniform
Systematic
Opportunistic

22. Think, Pair & Share:
What is Integration??

23. 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 libraries
Clinical medicine: learned in wards and operating theatres of university tertiary hospitals

24. 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.

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

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

27. Old Curriculum Basic Sciences: Anatomy Physiology
Pathology/Immunology/Microbiology….
Biochemistry
Pharmacology
Clinical:
Medicine, surgery, Ob/Gyn, Peadiatrics,
ENT/Oph….

28. Learn like doctor & think like doctor
…because human beings are complex
organisms whose discrete systems are
linked intricately and elaborately within
the body and modified profoundly by
external influences, we need to teach in
ways that reflect this complexity and that
stimulate students to synthesize information across disciplines.
Dienctag

29. Learn like doctor & think like doctor
A sick patient does not represent a biochemistry
problem, an anatomy problem, a genetics
problem, or an immunology problem; rather,
each person is the product of myriad molecular,
cellular, genetic, environmental, and social
influences that interact in complex ways to determine health and disease.
Dienctag

30. What is Integration??

31. 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

32. Integration: a definition
“ The organization of teaching of matter to interrelate or unify subjects frequently taught in separate academic courses or departments”
Harden

33. Curriculum
Integration

34. The rationale
Curriculum organization denotes a systematic arrangement of curriculum elements,
It will results in a more relevant, meaningful, and student centered curriculum,
Integration makes the learning contexts close in which the information is to be retrieved.

35. Think, Pair & Share: Advantages & Disadvantages??

36. Advantages 1. Matching curriculum aims.
2. Achieving higher level of objectives.
3. Avoiding information overload.
4. Making learning interesting & effectives
5. Motivating students.

37. Disadvantages 1. Loosing subject identity.
2. Requiring interdepartmental planning.
3. Resources shortage.

38. Types of Integration Clinical Basic Science Horizontal Integration
Vertical integration
Horizontal Integration

39. Summary

40. 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 med education every where.

41. I wish you a very successful and enjoyable time in your course
All the best