Integrated curriculum: a contemporary innovation strategy in medical education

Abstract

In its traditional form, medical education begins with learning basic science disciplines, with subsequent transition to clinical training. The basic sciences are taught as a series of separate academic courses, with no coordination applied at the inter-disciplinary level. During past decades, the integrated curriculum has become increasingly popular as a novel instructional strategy that promotes contextual learning in medical practice. The curriculum breaks down the barriers between basic and clinical sciences (vertical integration), interconnects teaching of various basic science disciplines (horizontal integration) and facilitates the acquisition of critical thinking, problem-solving and team-working skills through collaborative learning. The vertical integration is encouraged with training in clinical and communication skills starting in the first semester, teaching basic sciences at the interface with medical problems and involving clinicians in giving lectures on applied anatomy and clinical physiology. In order to facilitate the horizontal integration, basic science disciplines are taught concurrently within interdisciplinary units aligned around the body organ systems. This contributes to a better understanding of complex interrelations between structure and function and stimulates wider insights into mechanisms of the disease. The integrated curriculum supports conceptual learning rather than simple memorisation of fragmented factual knowledge. As such, it relieves the information overload imposed on students due to a rapid growth of medical knowledge in the contemporary world. With the integrated curriculum, the main emphasis is placed on problem-oriented learning guided by an experienced tutor in a small group of students. In this setting, a realistic medical case is used as a trigger for discussion aimed at linking basic science concepts with the clinical problem. Through collaborative problem-solving, students develop a clinical reasoning and team-working skills. Overall, problem-based learning puts forward a student-centred approach in a sense that students themselves are primarily responsible for identifying relevant learning objectives and self-guided acquisition of medical knowledge. This raises their motivation in learning basic sciences and markedly improves the perception of learning environment. In summary, the integrated curriculum offers a number of benefits to medical students and appears to provide an effective instrument in developing professional competencies required in clinical work.