Transcript PROFESSIONALISM IN MEDICAL EDUCATION

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Integration
in
Medical Education
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OBJECTIVES
Define “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.
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What is a
curriculum??
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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.
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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
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Types of Curricula
The 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.
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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.
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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:
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develop flexible knowledge,
effective problem solving skills,
self-directed learning (SDL),
effective collaboration skills &
intrinsic motivation
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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
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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.
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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.
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Basic curricular structures
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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.
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Educational strategies
• Six educational strategies by Prof Harden.
• Each strategy can be represented as a spectrum
or continuum:
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Student-centered/teacher-centered
Problem-based/information-gathering
Integrated/discipline-based
Community-based/hospital-based
Elective/uniform
Systematic/apprenticeship (internship)-based
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SPICES Model of Educational Strategies
• Student centered
• Teacher centered
 “What the student learn rather than what is taught"
• Problem-based
• Information-oriented
• Integrated or Interprofessional
• Subject or
Discipline-based
 Integration throughout the curriculum
• Community-based
 Less emphasis on hospitalbased programs
• Hospital-based
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SPICES Model of Educational Strategies
• Elective-driven
• Uniform
 According to student needs,
learning & teaching adjusted to the
needs of students
• Systematic
 To ensure that all
students have had
comparable learning
experience
• apprenticeship
(internship)-based
i.e Opportunistic
(=resourceful)
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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.
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Think, Pair & Share:
What is Integration??
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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 library
▫ Clinical medicine: learned in wards and
operating theatres of university tertiary
hospitals
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• 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.
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• Disciplines should integrate their
contributions into a thematic,
probably systems-based curriculum
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• Integration was one of the key
criteria for assessing the degree of
innovation in a medical curriculum
in the SPICES curriculum model
(Harden, 1984).
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Old Curriculum
Basic Sciences:
•Anatomy
•Physiology
•Pathology/Immunology/Microbiology….
•Biochemistry
•Pharmacology
Clinical:
•Medicine, surgery, Ob/Gyn, Peadiatrics,
•ENT/Oph….
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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
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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
(=numerous) molecular, cellular, genetic,
environmental, and social influences that
interact in complex ways to determine health
and disease.
Dienctag
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“ The teaching of different subject areas
in a thematic manner, so that the
different disciplines are not emphasized”
Internal dictionary of Adult & CME
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“ The organization of teaching of matter to
interrelate or unify (join, unite) subjects
frequently taught in separate academic
courses or departments”
Harden
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Curriculum
Integration
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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.
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Advantages
1. Matching curriculum aims.
2. Achieving higher level of
objectives.
3. Avoiding information overload.
4. Making learning interesting &
effectives
5. Motivating students.
6. Benefiting staff.
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Disadvantages
1. Loosing subject identity.
2. Requiring interdepartmental
planning.
3. Resources shortage.
4. Contents coverage.
5. Motivating students.
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Types of Integration
Vertical
integration
Horizontal
Integration
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Summary
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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.
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I wish you a very successful and
enjoyable time in your course
All the best